逆境维度与基于群体的心理健康轨迹之间的生活方式特异性关联

Lifestyle-specific association between adversity dimensions with group-based mental health trajectories

逆境维度与基于群体的心理健康轨迹之间的生活方式特异性关联

Authors: Zuo M, Ling XB, Wang SS, Ma K, Wan YH, Su PY, Tao FB, Sun Y.

Source：J Affect Disord. 2024 Aug 12;364:305-313. doi: 10.1016/j.jad.2024.08.015.

Abstract

Background: Childhood adversity (CA) has a substantial correlation with mental health problems. Keeping a healthy lifestyle is essential for mental health interventions; it is unclear, however, how healthy lifestyle affect the relationship between CA and persistent mental health problems.

Methods: This longitudinal study (n = 1112, 54.5 % male) collected the data on CA (measured through three dimensions: threat, deprivation and unpredictability), mental health problems, and lifestyle factors. Group-based multi-trajectory modeling (GBMTM) was utilized to estimate trajectories for three mental health problems (i.e., depression, ADHD and overanxiety). Close friendships, regular physical activity, appropriate sleep duration, shorter screen time, and healthy eating were combined to establish a healthy lifestyle score (which ranges from 0 to 5). Higher scores indicated a healthier lifestyle.

Results: Three trajectories of mental health problems were identified: persistently low risk (24.9 %), persistently medium-high risk (50.0 %), and persistently high risk (25.1 %). Multinomial logistic regression showed that high adversity (high-threat: β = 2.01, P < 0.001; high-deprivation: β = 1.03, P < 0.001; high-unpredictability: β = 0.83, P = 0.001; high-overall adversity: β = 1.64, P < 0.001) resulted in a persistently high risk of mental health problems; these outcomes were maintained after robust control for covariates. Further lifestyle stratification, null associations were observed among children with a healthy lifestyle, irrespective of their gender; however, after controlling for covariates, the above associations remained relatively stable only among boys.

Limitations: The generalizability of our findings is restricted by 1) limited racial diversity and 2) missing data.

Conclusions: This finding underscores the benefits of promoting a healthy lifestyle in children to prevent persistent mental health problems caused by CA.

Keywords: Childhood adversity; Children; Cohort study; Group-based mental health trajectories; Healthy lifestyle.

摘要

背景：儿童期逆境（CA）与心理健康问题有很大的相关性。保持健康的生活方式对于心理健康干预至关重要;然而，目前尚不清楚健康的生活方式如何影响CA与持续性心理健康问题之间的关系。

研究方法：这项纵向研究（n = 1112，54.5%男性）收集了CA（通过三个维度测量：威胁，剥夺和不可预测性），心理健康问题和生活方式因素的数据。基于组的多轨迹建模（GBMTM）被用来估计三个心理健康问题的轨迹（即，抑郁症、多动症和过度焦虑）。亲密的友谊，规律的身体活动，适当的睡眠时间，较短的屏幕时间和健康的饮食相结合，以建立一个健康的生活方式评分（范围从0到5）。分数越高，表明生活方式越健康。

结果如下：确定了三种心理健康问题的轨迹：持续低风险（24.9%），持续中高风险（50.0%）和持续高风险（25.1%）。多项logistic回归显示，高逆境（高威胁：β = 2.01，P 0.001;高剥夺：β = 1.03，P 0.001;高不可预测性：β = 0.83，P = 0.001;高总体逆境：β = 1.64，P 0.001）导致心理健康问题的持续高风险;在对协变量进行稳健控制后，这些结果得以维持。进一步的生活方式分层，在健康生活方式的儿童中观察到零关联，无论其性别如何;然而，在控制协变量后，上述关联仅在男孩中保持相对稳定。

局限性：我们的研究结果的普遍性受到1）有限的种族多样性和2）缺失数据的限制。

结论：这一发现强调了促进儿童健康生活方式对预防CA引起的持续性心理健康问题的好处。

关键词：童年逆境;儿童;队列研究;基于群体的心理健康轨迹;健康的生活方式。