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首页> 外文学位 >Childhood Adversities and Complex Adult Psychopathology: Findings from the National Comorbidity Survey Replication (NCS-R) Study.
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Childhood Adversities and Complex Adult Psychopathology: Findings from the National Comorbidity Survey Replication (NCS-R) Study.

机译：童年时期的逆境和复杂的成人心理病理学：来自国家合并症调查复制（NCS-R）研究的发现。

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摘要

Mental disorders affect over 26% of Americans aged 18 and older. For individuals having lifetime psychiatric diagnoses, comorbidity with one or more psychiatric disorders is common and occurs in 35--50% of adults with a mental illness. Retrospective epidemiological studies have reported significant associations between childhood adversities and adult mental disorders. Using the National Comorbidity Survey Replication (NCS-R) data, the central study objective examined how patterns of childhood adversities contribute to complex clusters of lifetime psychiatric disorders in adults, defined by the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-IV). Childhood adversities of (1) sexual abuse, (2) physical abuse, (3) parental depression or anxiety, (4) parental alcohol or drug abuse, (5) living with one or no biological parent, (6) domestic violence, (7) being a crime victim, and (8) economic hardship were examined. The study examined two related hypotheses. The aims for the first hypothesis included: to import, review and subset NCS-R data, and next characterize descriptive epidemiology for DSM-IV mental disorder groupings and complex adult psychopathology with associations to childhood adversities by gender and age cohorts. Complex adult psychopathology is defined as clustering of two or more lifetime DSM-IV diagnoses spanning more than one clinical disorder group (mood, anxiety, impulse, substance abuse). It was hypothesized that childhood adversities patterns and the associations to subsequent complex adult psychopathology profiles would differ by gender and age cohorts. Gender-related differences in disorder rates were present in all four mental disorder groups but not in complex adult psychopathology. Males had higher prevalence rates of impulse and substance abuse, while females had higher rates of anxiety and mood disorders. Childhood sexual abuse occurred almost four times more often in females, who subsequently had significantly higher rates of anxiety and mood disorders compared with males. Age-related differences were present in impulse disorders for both genders. Being a childhood crime victim was reported more in males, who had higher proportions of adult impulse disorders. Being exposed to no childhood adversities showed a protective trend against subsequent development of complex adult psychopathology. Exposure to a single adversity did not increase the risk of complex adult psychopathology. Second, it was hypothesized that males and females would have different pairwise interactions among childhood adversities associated with subsequent outcomes of complex DSM-IV internalizing and externalizing profiles. The two aims for the second hypothesis included determining the best two-factor common structure for 19 DSM-IV disorders, and assessment of additive and multiplicative interactions among childhood adversity patterns and complex adult psychopathology outcomes. Economic hardship and sexual abuse worked synergistically with other childhood adversities for the subsequent development of the complex profile of co-occurring internalizing and externalizing disorders. Parental depression and anxiety disorders were also synergistic in both males and females with other adversities. This study provides novel descriptive epidemiology in table format, examining age and gender related differences, combinations and trends for childhood adversities, common mental illnesses and complex adult psychopathology. The research supports the hypothesis that environmental risk factors of childhood maltreatment are associated with co-occurring psychiatric disorder profiles.
机译：精神障碍影响18岁以上的美国人中的26％以上。对于具有终生精神病诊断的个人，一种或多种精神病合并症很常见，并在35--50％的患有精神疾病的成年人中发生。回顾性流行病学研究报告了儿童逆境与成人精神障碍之间的显着关联。中心研究目标使用国家合并症调查复制（NCS-R）数据，研究了儿童逆境的模式如何导致成年人终生精神疾病的复杂集群，这是由美国精神病学协会的诊断和统计手册（DSM-IV）定义的。 （1）性虐待，（2）身体虐待，（3）父母沮丧或焦虑，（4）父母酗酒或吸毒，（5）与一个或没有亲生父母住在一起，（6）家庭暴力， 7）是犯罪受害者，并且（8）检查了经济困难。该研究检查了两个相关的假设。第一个假设的目的包括：导入，审查和分类NCS-R数据，然后表征DSM-IV精神障碍分组和复杂的成年人心理病理学的描述性流行病学，并按性别和年龄组与儿童期逆境相关联。复杂的成人心理病理学被定义为两个或多个一生的DSM-IV诊断的聚集，跨越一个以上的临床疾病组（情绪，焦虑，冲动，药物滥用）。据推测，儿童期的逆境模式以及与随后复杂的成人心理病理学特征的关联会因性别和年龄组而异。在所有四个精神障碍组中都存在性别相关的疾病发生率差异，但在复杂的成人心理病理学中则没有。男性的冲动和药物滥用患病率较高，而女性的焦虑和情绪障碍患病率较高。儿童时期的性虐待发生率几乎是女性的四倍，其后的焦虑和情绪障碍发生率明显高于男性。男女的冲动障碍都存在与年龄有关的差异。据报告，儿童期犯罪的受害者更多是男性，成年人的冲动障碍比例更高。没有童年的逆境暴露出了保护性的趋势，可以防止随后的复杂成人心理病理学发展。暴露于单一逆境并没有增加复杂的成人心理病理学风险。其次，假设在复杂的DSM-IV内部化和外部化配置文件的后续结果中，童年逆境中的男性和女性将具有不同的成对交互作用。第二个假设的两个目标包括确定19种DSM-IV疾病的最佳两因素共同结构，以及评估儿童逆境模式与复杂的成人心理病理结果之间的加性和乘性相互作用。经济困难和性虐待与其他儿童时期的逆境协同作用，随后发展了同时发生的内在化和外在化疾病的复杂特征。男性和女性与其他逆境中的父母抑郁和焦虑症也具有协同作用。这项研究以表格形式提供了新颖的描述性流行病学，研究了年龄和性别相关的差异，儿童逆境，常见精神疾病和复杂的成人心理病理学的组合和趋势。该研究支持以下假说：儿童期虐待的环境危险因素与同时发生的精神疾病特征有关。

著录项

  • 作者

    Putnam, Karen Thompson.;

  • 作者单位

    University of Cincinnati.;

  • 授予单位 University of Cincinnati.;
  • 学科 Mental health.;Public health.;Epidemiology.
  • 学位 Ph.D.
  • 年度 2011
  • 页码 113 p.
  • 总页数 113
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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