Prospectively ascertained child maltreatment and its association with DSM-IV mental disorders in young adults.

Scott KM; Smith DR; Ellis PM

摘要

CONTEXT: Evidence for an association between child maltreatment and later psychopathology heavily relies on retrospective reports of maltreatment. The few studies using prospective ascertainment of child maltreatment show weaker associations, raising the possibility that it is not maltreatment, but rather the memory of maltreatment, that raises the risk of later mental disorders. OBJECTIVES: To estimate associations between prospectively ascertained child maltreatment and a wide range of subsequently measured DSM-IV mental disorders and to show the influence of retrospectively reported maltreatment in the comparison group on these associations. DESIGN: Retrospective cohort study. SETTING: Nationally representative New Zealand community. PARTICIPANTS: Respondents aged 16 to 27 years (n = 2144) from a mental health survey, 221 of whom were identified as having records on a national child protection agency database. MAIN OUTCOME MEASURES: Twelve-month and lifetime prevalence of individual DSM-IV mood, anxiety, and substance use disorders, and disorder groups assessed with the World Health Organization Composite International Diagnostic Interview. RESULTS: After adjusting for demographic and socioeconomic correlates, child protection agency history was associated with several individual mental disorders, mental disorder comorbidity, and all mental disorder groups, both 12-month and lifetime. Odds of 12-month posttraumatic stress disorder were 5.12 (95% confidence interval [CI], 2.42-10.83); of any 12-month mood disorder, 1.86 (95% CI, 1.12-3.08); of any anxiety disorder, 2.41 (95% CI, 1.47-3.97); and of any substance use disorder, 1.71 (95% CI, 1.01-2.88). These associations increased in magnitude when those who retrospectively reported child maltreatment were removed from the comparison group. CONCLUSIONS: Prospectively ascertained child maltreatment is significantly associated with a range of subsequent mood, anxiety, and substance use disorders, indicating that maltreatment, not just the memory of maltreatment, is associated with subsequent psychopathology. There is a need for both targeted mental health interventions with the present and past clients of child welfare agencies and for concerted population-level strategies to meet the needs of the many other children who experience maltreatment.

机译：背景:儿童之间的关联的证据虐待,后来精神病理学依赖于回顾虐待的报告。使用准确定的一些研究儿童虐待的显示较弱的协会,提高的可能性,它不是虐待,而是的记忆虐待,引发了后来的风险精神疾患。前瞻性地确定之间的关联儿童虐待和广泛的随后dsm - iv精神障碍和测量回顾性报道的影响对照组在这些虐待关联。设置:新西兰全国代表性社区。27年心理健康调查(n = 2144),221人被确认记录一个国家儿童保护机构数据库。结果测量:十二个月,一生流行的个人dsm - iv的情绪,焦虑,和物质使用障碍,障碍组与世界卫生组织评估复合性国际诊断访谈。结果:人口和调整后社会经济关联,儿童保护机构历史与几个人联系在一起精神障碍、精神障碍疾病,和所有精神障碍组,和12个月一生。障碍是5.12(95%可信区间(CI),2.42 - -10.83);(95% CI, 1.12 - -3.08);2.41 (95% CI, 1.47 - -3.97);使用障碍,1.71(95%可信区间,1.01 - -2.88)。协会当这些增幅巨大谁回顾性报告虐待儿童从对比组中删除。结论:前瞻性地确定孩子虐待有显著相关一系列后续的情绪、焦虑和物质使用障碍,表明虐待,不是只是虐待的记忆,有关与随后的精神病理学。为有针对性的心理健康干预措施与孩子的现在和过去的客户福利机构和协调一致群体策略来满足的需要许多其他的孩子体验虐待。

Prospectively ascertained child maltreatment and its association with DSM-IV mental disorders in young adults.

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