دانلود مقاله ISI انگلیسی شماره 37122
عنوان فارسی مقاله

رابطه بین کودک آزاری، طلاق والدین و اختلالات روانی خودکشی در طول عمر در نمونه بزرگسالان در نمونه ملی

کد مقاله سال انتشار مقاله انگلیسی ترجمه فارسی تعداد کلمات
37122 2009 9 صفحه PDF سفارش دهید محاسبه نشده
خرید مقاله
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عنوان انگلیسی
The relationship between child abuse, parental divorce, and lifetime mental disorders and suicidality in a nationally representative adult sample ☆
منبع

Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)

Journal : Child Abuse & Neglect, Volume 33, Issue 3, March 2009, Pages 139–147

کلمات کلیدی
سوء استفاده از کودکان - سوء استفاده فیزیکی کودکان - طلاق والدین بدرفتاری فیزیکی - کودک آزاری جنسی - شاهد خشونت خانگی - آسیب شناسی روانی والدین - اختلالات روانی - افکار خودکشی - اقدام به خودکشی - اختلالات روانپزشکی
پیش نمایش مقاله
پیش نمایش مقاله رابطه بین کودک آزاری، طلاق والدین و اختلالات روانی خودکشی در طول عمر در نمونه بزرگسالان در نمونه ملی

چکیده انگلیسی

Abstract Objectives To determine how the experiences of child abuse and parental divorce are related to long-term mental health outcomes using a nationally representative adult sample after adjusting for sociodemographic variables and parental psychopathology. Methods Data were drawn from the National Comorbidity Survey (NCS, n = 5,877; age 15–54 years; response rate 82.4%). Logistic regression models were used to determine the odds of experiencing lifetime psychiatric disorders and suicidal ideation and attempts.

مقدمه انگلیسی

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نتیجه گیری انگلیسی

Results Among the 5,159 respondents, 65% did not experience parental divorce or child abuse, 13% reported parental divorce only, 15% reported child abuse only, and 8% experienced both parental divorce and child abuse. The sociodemographic profiles for each group are presented in Table 1. When investigating sociodemographic variables with categories of parental divorce and child abuse, differences were found among all sociodemographic variables. Table 2 contains the logistic regression results for the associations between parental divorce and child abuse. The results indicate that parental divorce compared to living in an intact two parent family was associated with increased odds of all individual types of child abuse. Table 1. Sociodemographic characteristics of the sample. Neither parental divorce nor child abuse (n = 3,123) Parental divorce only (n = 674) Child abuse only (n = 873) Parental divorce and child abuse (n = 489) % (SE) % (SE) % (SE) % (SE) Gender*** Male 52.6 (1.37) 54.9 (2.86) 38.4 (2.54) 41.0 (3.21) Female 47.4 (1.37) 45.1 (2.86) 61.6 (2.54) 59.0 (3.21) Age*** 15–24 years 23.1 (.93) 41.7 (2.66) 14.9 (1.49) 35.4 (2.81) 25–34 years 29.1 (1.26) 30.2 (2.87) 32.4 (2.49) 35.1 (3.00) 35–44 years 29.9 (1.31) 18.9 (2.54) 32.9 (2.47) 18.6 (2.71) 45–54 years 17.9 (1.15) 9.1 (1.88) 19.9 (2.10) 10.9 (2.19) Marital status*** Married 61.6 (1.27) 50.7 (2.87) 65.9 (2.32) 49.6 (3.13) Separated/widowed/divorced 10.8 (.87) 7.8 (1.50) 13.7 (1.58) 18.3 (2.91) Never-married 27.6 (1.08) 41.4 (2.65) 20.4 (1.92) 32.1 (2.71) Household income*** $0–$19,999 20.3 (1.02) 33.6 (2.51) 28.3 (2.19) 38.0 (2.95) $20,000–$34,999 24.1 (1.14) 25.4 (2.66) 21.8 (2.06) 27.4 (2.91) $35,000–$69,999 40.1 (1.36) 28.6 (2.66) 34.2 (2.45) 25.2 (2.73) $70,000 or more 15.5 (1.00) 12.4 (2.10) 15.8 (2.22) 9.4 (1.93) Education*** 0–11 years 18.1 (.97) 28.2 (2.27) 18.4 (2.00) 32.8 (2.83) 12 years 34.8 (1.31) 37.0 (2.92) 36.5 (2.45) 36.8 (3.02) 13–15 years 23.4 (1.15) 23.4 (2.33) 21.9 (2.03) 20.3 (2.51) 16 years or more 23.8 (1.20) 11.4 (2.16) 23.3 (2.38) 10.1 (2.31) Ethnicity*** White 80.7 (1.08) 66.3 (2.75) 75.9 (2.18) 73.8 (2.73) Black 7.8 (.78) 21.7 (2.57) 9.0 (1.49) 14.3 (2.41) Hispanic 7.4 (.68) 10.4 (1.52) 13.2 (1.74) 9.3 (1.54) Other 4.1 (.55) 1.6 (.47) 1.9 (.48) 2.5 (.73) *** Chi square value significant at p < .01. Table options Table 2. The associations between child abuse and parental divorce. Child abuse variables Parental divorce Two parent families (% (n)) Parental divorce (% (n)) Parental divorce versus two parent families (AOR (95% CI)) Child physical maltreatment 8.4 (398) 17.3 (207) 2.49 (1.87–3.32)* Child sexual abuse 6.2 (311) 12.7 (188) 2.62 (1.97–3.49)* Child neglect 1.4 (82) 7.0 (99) 6.07 (3.85–9.57)* Witnessing domestic violence 9.0 (443) 26.3 (314) 3.60 (2.79–4.64)* Any child abuse 18.9 (873) 38.7 (489) 2.94 (2.36–3.66)* AOR = odds ratios adjusted for sex, age, marital status, education, income, race; unweighted n; weighted percents. * p < .01. Table options Table 3 contains the prevalence and adjusted odds ratios for the relationships between parental divorce and child abuse (independent variable) with all lifetime internalizing psychiatric disorders (dependent variables). In the models adjusting for sociodemographic variables, having experienced parental divorce only was associated with increased odds of having any mood disorder, depression, dysthymia, bipolar I, and PTSD, while having experienced parental divorce and child abuse was associated with increased odds of all internalizing psychiatric disorders. When adjusting for sociodemographic variables and parental psychopathology, having experienced parental divorce only remained significantly associated with dysthymia and PTSD, while having experience parental divorce and child abuse remained significant associated with all internalizing psychiatric disorders with the exception of GAD, panic disorder, and agoraphobia. When investigating differences between parental divorce only, child abuse only, and parental divorce with child abuse, an additive effect between parental divorce and child abuse was found for any anxiety disorder and PTSD when adjusting for sociodemographic variables. However, the effects of the relationships decreased when also adjusting for parental psychopathology. Interaction effects between parental divorce and child abuse were tested in the internalizing disorders models, but significant interaction effects were not found. Table 3. Logistic regression results for parental divorce, child abuse, and lifetime internalizing psychiatric disorders. Neither parental divorce nor child abuse (n = 3,123) Parental divorce only (n = 674) Child abuse only (n = 873) Parental divorce and child abuse (n = 489) Any mood disorder % (n) 14.8 (693) 19.8 (163) 33.8 (370) 34.2 (194) AOR-1 (95% CI) 1.00 (–) 1.66 (1.26–2.18)*,‡ 2.71 (2.15–3.42)‡ 2.94 (2.23–3.89)‡ AOR-2 (95% CI) 1.00 (–) 1.35 (.94–1.93)* 2.59 (1.98–3.40)‡ 2.18 (1.48–3.20)‡ Major depression % (n) 13.1 (601) 16.2 (142) 29.4 (324) 30.0 (169) AOR-1 (95% CI) 1.00 (–) 1.46 (1.10–1.93)*,‡ 2.56 (2.02–3.24)‡ 2.73 (2.06–3.62)‡ AOR-2 (95% CI) 1.00 (–) 1.25 (.85–1.83) 2.49 (1.89–3.27)‡ 1.92 (1.29–2.84)‡ Dysthymia % (n) 4.8 (241) 7.3 (44) 11.1 (135) 11.1 (71) AOR-1 (95% CI) 1.00 (–) 1.90 (1.23–2.94)‡ 2.11 (1.53–2.92)‡ 2.40 (1.61–3.59)‡ AOR-2 (95% CI) 1.00 (–) 1.95 (1.12–3.40) 2.34 (1.62–3.39)‡ 1.82 (1.00–3.30) Bipolar I % (n) .8 (36) 1.9 (13) 2.7 (33) 4.7 (22) AOR-1 (95% CI) 1.00 (–) 2.36 (1.07–5.18) 3.59 (1.90–6.78)‡ 5.45 (2.64–11.25)‡ AOR-2 (95% CI) 1.00 (–) 1.10 (.27–4.46) 3.35 (1.59–7.05)‡ 4.44 (1.84–10.73)‡ Any anxiety disorder % (n) 23.0 (989) 27.6 (218) 41.4 (436) 52.2 (273) AOR-1 (95% CI) 1.00 (–) 1.28 (.99–1.66)* 2.18 (1.75–2.72)*,‡ 3.23 (2.44–4.29)‡ AOR-2 (95% CI) 1.00 (–) 1.23 (.87–1.74)* 2.24 (1.73–2.90)‡ 2.74 (1.81–4.15)‡ GAD % (n) 3.9 (171) 4.1 (33) 9.3 (105) 7.2 (41) AOR-1 (95% CI) 1.00 (–) 1.36 (.83–2.24) 2.16 (1.53–3.04)‡ 1.86 (1.18–2.95)‡ AOR-2 (95% CI) 1.00 (–) 1.72 (.93–3.19) 2.38 (1.60–3.54)‡ 1.51 (.79–2.88) Social phobia % (n) 11.1 (487) 13.4 (106) 20.7 (212) 23.6 (121) AOR-1 (95% CI) 1.00 (–) 1.20 (.90–1.61)* 2.01 (1.58–2.57)‡ 2.20 (1.66–2.92)‡ AOR-2 (95% CI) 1.00 (–) 1.07 (.73–1.57) 1.91 (1.45–2.52)‡ 1.60 (1.08–2.37) Simple phobia % (n) 9.3 (389) 11.7 (90) 14.5 (161) 19.7 (109) AOR-1 (95% CI) 1.00 (–) 1.23 (.89–1.70)* 1.39 (1.06–1.83) 1.97 (1.46–2.66)‡ AOR-2 (95% CI) 1.00 (–) 1.37 (.91–2.07) 1.42 (1.04–1.95) 1.89 (1.26–2.83)‡ Panic disorder % (n) 2.9 (120) 2.7 (22) 4.7 (58) 6.7 (40) AOR-1 (95% CI) 1.00 (–) 1.16 (.67–2.02)* 1.50 (.98–2.29) 2.29 (1.44–3.65)‡ AOR-2 (95% CI) 1.00 (–) 1.46 (.74–2.90) 1.47 (.90–2.42) 1.83 (.98–3.43) Agoraphobia % (n) 4.8 (191) 7.5 (54) 9.3 (93) 13.6 (66) AOR-1 (95% CI) 1.00 (–) 1.44 (.95–2.17)* 1.82 (1.31–2.53)‡ 2.45 (1.54–3.88)‡ AOR-2 (95% CI) 1.00 (–) 1.92 (1.15–3.20) 1.79 (1.23–2.61)‡ 1.99 (.90–4.39) PTSD % (n) 2.9 (135) 6.1 (40) 16.7 (178) 24.4 (138) AOR-1 (95% CI) 1.00 (–) 2.37 (1.35–4.18)*,‡ 6.07 (4.40–8.37)*,‡ 9.87 (6.69–14.55)‡ AOR-2 (95% CI) 1.00 (–) 2.23 (1.03–4.82)* 6.40 (4.41–9.28)‡ 7.81 (4.55–13.41)‡ AOR-1 = adjusted for sex, age, marital status, education, income, race; AOR-2 = adjusted for sex, age, marital status, education, income, race; parental psychopathology. * Denotes statistically different from divorce and abuse category at p < .05; unweighted n; weighted percents. ‡ Denotes statistically different from the neither divorce nor child abuse category at p < .01. Table options Table 4 contains the prevalence and adjusted odds ratios for the relationships between parental divorce and child abuse (independent variable) with lifetime externalizing disorders (dependent variables). In the models adjusting for sociodemographic variables, having experienced parental divorce only was associated with increased odds of having any disruptive disorder, conduct disorder, alcohol abuse/dependence, and drug abuse/dependence, while parental divorce and child abuse was associated with increased odds of all externalizing psychiatric disorders. When adjusting for sociodemographic variables and parental psychopathology, having experienced parental divorce only was no longer associated with any externalizing psychiatric disorders, while having experienced parental divorce and child abuse remained significantly associated with all externalizing psychiatric disorders. When investigating differences between parental divorce only, child abuse only, and parental divorce with child abuse, an additive effect between parental divorce and child abuse was found for any disruptive disorder and conduct disorder when adjusting for sociodemographic variables. However, these relationships were no longer significant when also adjusting for parental psychopathology. Interactions effects between parental divorce and child abuse disorders were tested in the externalizing disorders models, but significant interactions effects were not found. Table 4. Logistic regression results for parental divorce, child abuse, and lifetime externalizing psychiatric disorders. Neither parental divorce nor child abuse (n = 3,123) Parental divorce only (n = 674) Child abuse only (n = 873) Parental divorce and child abuse (n = 489) Any disruptive disorder % (n) 10.8 (414) 17.0 (140) 20.4 (217) 31.3 (168) AOR-1 (95% CI) 1.00 (–) 1.38 (1.03–1.86)* 2.74 (2.07–3.63)*,‡ 3.98 (2.92–5.42)‡ AOR-2 (95% CI) 1.00 (–) 1.02 (.66–1.58)* 2.71 (1.94–3.78)‡ 2.73 (1.75–4.24)‡ Conduct disorder % (n) 9.3 (348) 15.1 (123) 17.6 (177) 27.9 (145) AOR-1 (95% CI) 1.00 (–) 1.42 (1.04–1.94)* 2.68 (1.99–3.60)*,‡ 4.01 (2.92–5.51)‡ AOR-2 (95% CI) 1.00 (–) .99 (.62–1.59)* 2.63 (1.85–3.73)‡ 2.84 (1.80–4.49)‡ Adult antisocial behaviour % (n) 3.6 (155) 5.3 (42) 7.2 (93) 10.6 (64) AOR-1 (95% CI) 1.00 (–) 1.20 (.77–1.86)* 2.43 (1.68–3.53)‡ 2.89 (1.92–4.36)‡ AOR-2 (95% CI) 1.00 (–) .85 (.45–1.63) 2.58 (1.67–4.00)‡ 1.86 (1.05–3.29) Antisocial personality % (n) 2.2 (89) 3.4 (25) 4.4 (53) 7.2 (41) AOR-1 (95% CI) 1.00 (–) 1.27 (.72–2.24)* 2.50 (1.54–4.07)‡ 3.31 (2.02–5.44)‡ AOR-2 (95% CI) 1.00 (–) .69 (.28–1.69)* 2.63 (1.50–4.61)‡ 2.11 (1.05–4.24) Any substance use % (n) 23.5 (1078) 27.5 (246) 33.6 (397) 40.4 (224) AOR-1 (95% CI) 1.00 (–) 1.28 (.99–1.66)* 1.98 (1.57–2.49)‡ 2.51 (1.87–3.38)‡ AOR-2 (95% CI) 1.00 (–) .95 (.67–1.36)* 2.03 (1.55–2.66)‡ 2.10 (1.41–3.12)‡ Alcohol abuse/dependence % (n) 20.9 (961) 25.1 (225) 29.5 (350) 34.2 (188) AOR-1 (95% CI) 1.00 (–) 1.30 (1.00–1.69)* 1.91 (1.51–2.41)‡ 2.26 (1.67–3.05)‡ AOR-2 (95% CI) 1.00 (–) .93 (.65–1.33)* 1.91 (1.45–2.51)‡ 1.87 (1.25–2.78)‡ Drug abuse/dependence % (n) 8.9 (419) 12.8 (109) 17.6 (211) 24.9 (140) AOR-1 (95% CI) 1.00 (–) 1.46 (1.08–1.98)* 2.52 (1.95–3.25)‡ 3.46 (2.54–4.70)‡ AOR-2 (95% CI) 1.00 (–) 1.15 (.75–1.77)* 2.48 (1.83–3.34)‡ 2.65 (1.76–4.01)‡ AOR-1 = adjusted for sex, age, marital status, education, income, race; AOR-2 = adjusted for sex, age, marital status, education, income, race; parental psychopathology. * Denotes statistically different from divorce and abuse category at p < .05; unweighted n; weighted percents. ‡ Denotes statistically different from the neither divorce nor child abuse category at p < .01. Table options Table 5 contains the prevalence and adjusted odds ratios for the relationships between parental divorce and child abuse (independent variable) with suicidal ideation and attempts (dependent variables). Having experienced parental divorce only was not associated with suicidal ideation or attempts in any adjusted models. However, having experienced parental divorce and child abuse was associated with suicidal ideation and attempts even after adjusting for sociodemographic variables, any psychiatric disorder, psychiatric comorbidity, and parental psychopathology. In addition, an additive effect between parental divorce and child abuse was found for suicide attempts after adjusting for sociodemographic variables, any psychiatric disorder, and psychiatric comorbidity. However, this effect was reduced when further adjusting for parental psychopathology. Interaction effects between parental divorce and child abuse were tested in the suicide models, but statistically significant interaction effects were not found. Table 5. Logistic regression results for parental divorce, child abuse, and lifetime suicidal ideation and attempts. Neither parental divorce nor child abuse (n = 3,123) Parental divorce only (n = 674) Child abuse only (n = 873) Parental divorce and child abuse (n = 489) Suicidal ideation % (n) 8.5 (359) 12.5 (29) 22.9 (83) 28.1 (84) AOR-1 (95% CI) 1.00 (–) 1.30 (.91–1.86)* 2.08 (1.57–2.77)‡ 2.22 (1.65–2.98)‡ AOR-2 (95% CI) 1.00 (–) .92 (.50–1.67)* 2.00 (1.44–2.79)‡ 1.73 (1.17–2.56)‡ Suicide attempts % (n) 2.6 (106) 3.3 (106) 7.1 (29) 14.8 (83) AOR-1 (95% CI) 1.00 (–) .95 (.56–1.60)* 1.54 (1.02–2.31)* 2.74 (1.84–4.08)‡ AOR-2 (95% CI) 1.00 (–) .68 (.29–1.61)* 1.52 (.96–2.40) 2.05 (1.23–3.41)‡ AOR-1 = adjusted for sex, age, marital status, education, income, race, any lifetime psychiatric disorder and any lifetime psychiatric comorbidity; AOR-2 = adjusted for sex, age, marital status, education, income, race, any lifetime psychiatric disorder and any lifetime psychiatric comorbidity, and parental psychopathology. * Denotes statistically different from divorce and abuse at p < .05; unweighted n; weighted percents. ‡ Denotes statistically different from the neither divorce nor child abuse category at p < .01.

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