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早期社会经济逆境与青年身体疾病:体重指数和抑郁症状的作用。

Early socioeconomic adversity and young adult physical illness: the role of body mass index and depressive symptoms.

作者信息

Wickrama K A S, Kwon Josephine A, Oshri Assaf, Lee Tae Kyoung

机构信息

Department of Human Development and Family Science, University of Georgia, Athens, Georgia.

Department of Human Development and Family Science, University of Georgia, Athens, Georgia.

出版信息

J Adolesc Health. 2014 Oct;55(4):556-63. doi: 10.1016/j.jadohealth.2014.04.006. Epub 2014 May 21.

Abstract

PURPOSE

The present study investigated the psychophysiological inter- and intra-individual processes that mediate the linkage between childhood and/or adolescent socioeconomic adversities and adult health outcomes. Specifically, the proposed model examined the roles of youth depressive symptoms and body mass index (BMI) trajectories as mediators that explain the link between early adversity and young adults' general health and physical illnesses after controlling for gender, race or ethnicity, and earlier general health reports.

METHODS

Using a nationally representative sample of 12,424 from National Longitudinal Study of Adolescent Health (Add Health), this study used growth curve modeling to consider both the severity (initial level) and the change over time (deterioration or elevation) as psychophysiological mediators, thereby acknowledging multiple facets of depressive symptoms and BMI trajectories as psychophysiological mediators of early adversity to adult health.

RESULTS

Results provide evidence for (1) the influence of early childhood and early adolescent cumulative socioeconomic adversity on both the initial levels and changes over time of depressive symptoms and BMI and (2) the independent influences depressive symptoms and BMI trajectories on the general health and the physical illnesses of young adults.

CONCLUSIONS

These findings contribute valuable knowledge to existing research by elucidating how early adversity exerts an enduring long-term influence on physical health problems in young adulthood; furthermore, this information suggests that effective intervention and prevention programs should incorporate multiple facets (severity and change over time) of multiple mechanisms (psychological and physiological).

摘要

目的

本研究调查了介导儿童期和/或青少年期社会经济逆境与成人健康结果之间联系的心理生理个体间和个体内过程。具体而言,所提出的模型检验了青少年抑郁症状和体重指数(BMI)轨迹作为中介因素的作用,这些中介因素在控制了性别、种族或族裔以及早期总体健康报告后,解释了早期逆境与年轻成年人总体健康和身体疾病之间的联系。

方法

本研究使用来自青少年健康全国纵向研究(Add Health)的12424名具有全国代表性的样本,采用生长曲线模型,将严重程度(初始水平)和随时间的变化(恶化或改善)均视为心理生理中介因素,从而认可抑郁症状和BMI轨迹的多个方面作为早期逆境对成人健康的心理生理中介因素。

结果

结果为以下两点提供了证据:(1)儿童早期和青少年早期累积的社会经济逆境对抑郁症状和BMI的初始水平及随时间的变化均有影响;(2)抑郁症状和BMI轨迹对年轻成年人的总体健康和身体疾病有独立影响。

结论

这些发现通过阐明早期逆境如何对年轻成年人的身体健康问题产生持久的长期影响,为现有研究贡献了有价值的知识;此外,这些信息表明有效的干预和预防计划应纳入多种机制(心理和生理)的多个方面(严重程度和随时间的变化)。

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