دانلود مقاله ISI انگلیسی شماره 37122
ترجمه فارسی عنوان مقاله

رابطه‌ی بین سوء استفاده از کودک، طلاق والدین و اختلالات روانی و تمایل به خودکشی

عنوان انگلیسی
The relationship between child abuse, parental divorce, and lifetime mental disorders and suicidality in a nationally representative adult sample ☆
کد مقاله سال انتشار تعداد صفحات مقاله انگلیسی
37122 2009 9 صفحه PDF
منبع

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

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

فهرست مطالب ترجمه فارسی
چکیده

کلمات کلیدی

روش‌ها و نمونه:

محاسبات:

سوء استفاده‌ی جنسی از کودکان:

شاهد خشونت در خانه:

نادیده گرفتن کودک:

اختلالات روانی:

اندیشه به خودکشی و سوء قصد:

متغیرهای جمعیت‌شناختی اجتماعی:

نتایج:

جدول 1: ویژیگی های جمعیت شناختی افراد 

جدول 2: روابط بین سوء استفاده از کودک و طلاق والدین

جدول 3: نتایج رگرسیون لجستیک برای طلاق والدین، سوء استفاده از کودک، و اختلالات روانی

جدول 4: نتایج رگرسیون لجستیک برای طلاق والدین، سوء استفاده از کودک، و اختلالات درونی سازی

جدول 5: نتایج رگرسیون لجستیک برای طلاق والدین، سوء استفاده از کودک، و اندیشه به خودکشی و سوء قصد به آن.

 
ترجمه 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
کلمات کلیدی انگلیسی
Child abuse; Parental divorce; Child physical abuse; Physical maltreatment; Child sexual abuse; Witnessing domestic violence; Parental psychopathology; Mental disorder; Suicidal ideation; Suicide attempts; Psychiatric disorders
ترجمه چکیده
اهداف: تعیین اینکه تجربه‌ی سوء استفاده از کودک و طلاق والدین چگونه با سلامت ذهنی طولانی مدت در ارتباط هستند، با استفاده از افراد بزرگسال به عنوان نمونه‌های ملی، پس از تنظیم متغیرهای جمعیت‌شناسی و آسیب‌شناسی روانی والدین. روش‌ها: داده‌ها از پژوهش ملی مربوط به وجود همزمان دو بیماری گرفته شده است (NCS، n=5/877؛ سن 15-54 سال؛ میزان پاسخ %4/82). مدل‌های رگرسیون منطقی برای تعیین احتمال تجربه‌ی اختلالات روانی و اندیشه‌های خودکشی‌گرایانه و سوء قصد بکار برده شدند. نتایج: طلاق والدین به تنهایی پس از تنظیم متغیرهای جمعیت‌شناسی با اختلالات روانی همراه بود (AOR از 30/1 تا 37/2)، در حالیکه تنها سوء استفاده از کودک با اختلالات روانی (AOR از 39/1 تا 07/6) و اندیشه‌های خودکشی‌گرایانه (AOR=2/08؛ 77/2-57/1= CI 95%) و سوء قصد (AOR=1/54؛ 31/2-02/1= CI 95%)، پس از تنظیم متغیرهای جمعیت‌شناسی، همراه بود. با این حال، در مقایسه با کسانی که تنها طلاق والدین و یا تنها تجاوز را تجربه کرده بودند، تجربه‌ی هر دو طلاق والدین و سوء استفاده از کودک موجب افزایش قابل توجه احتمال PTSD در طول زندگی (CI=6/69-14/55 95%؛ AOR=9/87)، اختلال رفتاری (CI=2/92-5/51 95%؛ AOR=4/01) و اندیشه‌های خودکشی‌گرایانه (CI=1/84-4/08 95%؛ AOR=2/74) می شود. این نتایج با تنظیم متغیرهای آسیب‌شناسی روانی والدین کاهش یافتند. نتیجه‌گیری: هنگامیکه تجربه‌ی طلاق والدین با تجاوز به کودک همراه است، کاهش سلامت ذهنی نسبت به تنها طلاق والدین و یا تنها سوء استفاده از کودک بسیار بیشتر است. بنابراین، طلاق والدین، مصیبتی است که نقش زیادی در کاهش سلامت ذهنی دارد بخصوص زمانیکه با سوء استفاده از کودک همراه باشد. آسیب‌شناسی روانی والدین این روابط را تضعیف کرد که نشان می‌دهد آن می‌تواند مکانیسمی برای توصیف رابطه‌ی بین سوء استفاده از کودک، طلاق والدین و اختلالات روانی و سوء قصد به خودکشی باشد.
پیش نمایش مقاله
پیش نمایش مقاله  رابطه‌ی بین سوء استفاده از کودک، طلاق والدین و اختلالات روانی و تمایل به خودکشی

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.