生命历程视角下早年受虐经历对中老年人心理健康的影响
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摘要
研究个体早年受虐经历是否会对其心理健康造成长远影响,关系到心理健康服务工作在源头上的开展。基于中国健康与养老追踪调查数据(CHARLS,2013,2014),从社会和家庭两个层面探讨了早年受虐经历对个体中老年期心理健康的影响。研究发现,早年受虐经历使得个体中老年期患有抑郁症的概率明显高于那些没有受虐经历的群体。相较于家庭内父母或兄弟姐妹的虐待,社会上同龄人的虐待对个体中老年期抑郁的影响更大。成年后的受教育水平和经济水平会对该影响效应起到不同的调节作用:随着个体受教育水平的提高,早年受虐经历对中老年人抑郁水平的影响在弱化;但随着个体经济状况的改善,这种影响却在增强。
Studying whether individual's early abuse experience having a long-term impact on his or her mental health is related to the development of mental health service work at the source.Based on the data of China Health and Retirement Longitudinal Study(CHARLS,2013,2014),this paper explores the effect of individual early childhood abuse on middle-aged and aged people depression from both social and family levels.The study found that early experiences of abuse will significantly enhance the probability of occurrence of depression of middle-aged and aged people.The effects of abuse at different levels on their depression are heterogeneous.The abuse at the social level has a greater impact on the occurrence of depression ofmiddle-aged and aged people,and the impact of child abuse at the household level is relatively small. In the household level,the impact of parental abuse at the household level is greater than the impact of abuse by brothers and sisters. In addition,the level of education will weaken the impact of early childhood abuse on middle-aged and aged people depression,While the improvement of adult economic conditions will strengthen the impact of early childhood abuse experience.
Studying whether individual's early abuse experience having a long-term impact on his or her mental health is related to the development of mental health service work at the source.Based on the data of China Health and Retirement Longitudinal Study(CHARLS,2013,2014),this paper explores the effect of individual early childhood abuse on middle-aged and aged people depression from both social and family levels.The study found that early experiences of abuse will significantly enhance the probability of occurrence of depression of middle-aged and aged people.The effects of abuse at different levels on their depression are heterogeneous.The abuse at the social level has a greater impact on the occurrence of depression ofmiddle-aged and aged people,and the impact of child abuse at the household level is relatively small. In the household level,the impact of parental abuse at the household level is greater than the impact of abuse by brothers and sisters. In addition,the level of education will weaken the impact of early childhood abuse on middle-aged and aged people depression,While the improvement of adult economic conditions will strengthen the impact of early childhood abuse experience.
引文
龚智力.抑郁症的危害及防治[J].中国社区医师:医学专业半月刊,2008,(9):35-35.
郭兰婷,张志群.中学生抑郁情绪与童年经历、家庭和学校因素分析[J].中国心理卫生杂志,2003,17(7):458-461.
胡巧绒.美国儿童虐待法律保护体系介绍及对我国的启示[J].青少年犯罪问题,2011,(5):63-67.
凌宇,杨娟,钟斌等.童年创伤经历与自尊对青少年抑郁的影响[J].中国临床心理学杂志,2009,17(1):54-56.
师艳荣.日本儿童虐待问题及其防治体系的构建[J].南方论丛,2013,(3):11-18.
石智雷,吴志明.早年不幸对健康不平等的长远影响:生命历程与双重累积劣势[J].社会学研究,2018,3:166-192.
宋锐,刘爱书.儿童心理虐待与抑郁:自动思维的中介作用[J].心理科学,2013,(4):855-859.
王梦娇,宋丽萍,宋保利等.抑郁症患者心理弹性、防御机制与抑郁的相关性分析[J].中国健康心理学杂志,2017,25(2):165-168.
王敏,郭菲,陈祉妍.社会支持在童年虐待与心理健康间的中介作用[J].中华行为医学与脑科学杂志,2015,24(6):546-548.
位照国,陆邵佳,吴韦玮等.童年期创伤影响成年抑郁表达的中间机制[A].中华医学会第十次全国精神医学学术会议论文汇编[C].2012.
吴韦玮,陆邵佳,位照国等.童年虐待经历及认知偏差与抑郁的关系[J].中国临床心理学杂志,2013,21(4):609-612.
许成岗,焦志安,曹文胜等.抑郁障碍与童年期被虐待经历的关系[J].精神医学杂志,2007,20(3):147-149.
阎燕燕,孟宪璋.童年创伤和虐待与成年精神障碍[J].中国临床心理学杂志,2005,13(2):208-209.
杨娟,张小崔,姚树桥.抑郁症认知偏向的神经机制研究进展[J].中国临床心理学杂志,2014,22(5):788-791.
杨楠,李秋波,闫玉忠.浅析抑郁症发病机理的研究现状[J].中国社区医师:综合版,2006,(16):5-6.
于增艳,赵阿勐,刘爱书.儿童期受虐经历与抑郁的元分析[J].心理学报,2017,49(1):40-49.
俞宁,陈沃聪.关于儿童虐待的文化思考[J].中国青年政治学院学报,2011,30(2):125-129.
曾庆巍,刘爱书,栗诗羽.儿童期心理虐待对特质抑郁的影响:反刍思维和创伤后认知改变的链式中介作用[J].中国临床心理学杂志,2015,23(4):665-669.
Briere,J.N.,Child abuse trauma:Theory and treatment of the lasting effects[J].Family Relations,1992,42(2):230.
Cloitre.M.,Cohen.L.R.and Scarvalone.P.,Understanding revictimization among childhood sexual abuse survivors:An interpersonal schema approach[J].Journal of Cognitive Psychotherapy,2002,16(1).
Currie.J.and Widom.C.S.,Long-Term Consequences of Child Abuse and Neglect on Adult Economic Well-Being[J].Child Maltreatment,2010,15(2):111-20.
De Bellis.M.D.,Developmental traumatology:a contributory mechanism for alcohol and substance use disorders[J].Psychoneuroendocrinology,2002,27(1-2):155.
Eckenrode.J.,Laird.M.and Doris.J.,School performance and disciplinary problems among abused and neglected children[J].Developmental Psychology,1993,29(29):53-62.
Gibb.B.E.,Alloy.L.B.,Walshaw.P.D.,et al.Predictors of Attributional Style Change in Children[J].Journal of Abnormal Child Psychology,2006,34(3):408-422.
Haman.C.,Henry.R.and Daley.S.E.,Depression and sensitization to stressors among young women as a function of childhood adversity[J].Journal of Consulting & Clinical Psychology,2000,68(5):782.
Hammen.C.,Henry.R.and Daley S E.Depression and sensitization to stressors among young women as a function of childhood adversity[J].Journal of Consulting & Clinical Psychology,2000,68(5):782.
Heim.C.,Newport.D.J.,Heit.S.,et al.Pituitary-Adrenal and Autonomic Responses to Stress in Women After Sexual and Physical Abuse in Childhood[J].Jama the Journal of the American Medical Association,2000,284(5):592-7.
Heim.C.,Newport.D.J.,Mletzko.T.,et al.The link between childhood trauma and depression:insights from HPA axis studies in humans[J].Psychoneuroendocrinology,2008,33(6):693-710.
Jehu.D.,Mood disturbances among women clients sexually abused in childhood:Prevalence,etiology,treatment[J].Journal of Interpersonal Violence,1989,4(2):164-184.
John.S.G.,Cisler.J.M.and Sigel.B.A.,Emotion Regulation Mediates the Relationship between a History of Child Abuse and Current PTSD/Depression Severity in Adolescent Females[J].Journal of Family Violence,2017(5):1-11.
Joohan.K.,Jeong-Ho.S.,Kang.C.,et al.The Protective Role of Resilience in Attenuating Emotional Distress and Aggression Associated with Early-life Stress in Young Enlisted Military Service Candidates[J].Journal of Korean Medical Science,2015,30(11):1667-74.
Kent.A.and Waller.G.,The impact of childhood emotional abuse:an extension of the child abuse and trauma scale[J].Child Abuse & Neglect,1998,22(5):393.
Lantman.M.V.S.,Mackus.M.,Otten.L.S.,et al.Mental resilience,perceived immune functioning,and health[J].Journal of Multidisciplinary Healthcare,2017,10:107-112.
Leeson.F.J.and Nixon.R.D.,The role of children’s appraisals on adjustment following psychological maltreatment:a pilot study[J].Journal of Abnormal Child Psychology,2011,39(5):759.
Lupien.S.J.,Mcewen.B.S.,Gunnar.M.R.,et al.Effects of stress throughout the lifespan on the brain,behaviour and cognition[J].Nature Reviews Neuroscience,2009,10(6):434.
Meaney.M.J.,Tannenbaum B,Francis D,et al.Early environmental programming hypothalamic-pituitary-adrenal responses to stress[J].Seminars in Neuroscience,1994,6(4):247-259.
Novelo.M.,Von.G.A.,Gomes.Jardim.G.B.,et al.Effects of childhood multiple maltreatment experiences on depression of socioeconomic disadvantaged elderly in Brazil[J].Child Abuse & Neglect,2018,79:350.
Suomi.S.J.,Early determinants of behaviour:evidence from primate studies[J].Br Med Bull,1997,53(1):170-184.
Wolfe.D.A.and Jaffe.P.,Child abuse and family violence as determinants of child psychopathology[J].Canadian Journal of Behavioural Science,1991,23(3):282-299.
Zlotnick.C.,Zakriski.A.L.,Shea.M.T.,et al.The long-term sequelae of sexual abuse:support for a complex posttraumatic stress disorder[J].Journal of Traumatic Stress,1996,9(2):195-205.▲
(1)数据来源为2017年2月23日,世界卫生组织(WHO)官方网站发布的报告,具体报告网址链接为http://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf;jsessionid=779179B00B2F94EDA711BEDAB19B1 CBC?sequence=1
(2)2012年,凤凰资讯一篇报道中,一名男童遭继母虐待生命垂危;2015年,3.31南京虐童案中,一名男童被其养母虐待伤情严重,性格也随之大变,出现畏惧人群等心理;2017年“携程亲子园事件”,涉事幼师恐吓、殴打,甚至喂食小朋友不明物品,一时间在网上引起激烈讨论。
郭兰婷,张志群.中学生抑郁情绪与童年经历、家庭和学校因素分析[J].中国心理卫生杂志,2003,17(7):458-461.
胡巧绒.美国儿童虐待法律保护体系介绍及对我国的启示[J].青少年犯罪问题,2011,(5):63-67.
凌宇,杨娟,钟斌等.童年创伤经历与自尊对青少年抑郁的影响[J].中国临床心理学杂志,2009,17(1):54-56.
师艳荣.日本儿童虐待问题及其防治体系的构建[J].南方论丛,2013,(3):11-18.
石智雷,吴志明.早年不幸对健康不平等的长远影响:生命历程与双重累积劣势[J].社会学研究,2018,3:166-192.
宋锐,刘爱书.儿童心理虐待与抑郁:自动思维的中介作用[J].心理科学,2013,(4):855-859.
王梦娇,宋丽萍,宋保利等.抑郁症患者心理弹性、防御机制与抑郁的相关性分析[J].中国健康心理学杂志,2017,25(2):165-168.
王敏,郭菲,陈祉妍.社会支持在童年虐待与心理健康间的中介作用[J].中华行为医学与脑科学杂志,2015,24(6):546-548.
位照国,陆邵佳,吴韦玮等.童年期创伤影响成年抑郁表达的中间机制[A].中华医学会第十次全国精神医学学术会议论文汇编[C].2012.
吴韦玮,陆邵佳,位照国等.童年虐待经历及认知偏差与抑郁的关系[J].中国临床心理学杂志,2013,21(4):609-612.
许成岗,焦志安,曹文胜等.抑郁障碍与童年期被虐待经历的关系[J].精神医学杂志,2007,20(3):147-149.
阎燕燕,孟宪璋.童年创伤和虐待与成年精神障碍[J].中国临床心理学杂志,2005,13(2):208-209.
杨娟,张小崔,姚树桥.抑郁症认知偏向的神经机制研究进展[J].中国临床心理学杂志,2014,22(5):788-791.
杨楠,李秋波,闫玉忠.浅析抑郁症发病机理的研究现状[J].中国社区医师:综合版,2006,(16):5-6.
于增艳,赵阿勐,刘爱书.儿童期受虐经历与抑郁的元分析[J].心理学报,2017,49(1):40-49.
俞宁,陈沃聪.关于儿童虐待的文化思考[J].中国青年政治学院学报,2011,30(2):125-129.
曾庆巍,刘爱书,栗诗羽.儿童期心理虐待对特质抑郁的影响:反刍思维和创伤后认知改变的链式中介作用[J].中国临床心理学杂志,2015,23(4):665-669.
Briere,J.N.,Child abuse trauma:Theory and treatment of the lasting effects[J].Family Relations,1992,42(2):230.
Cloitre.M.,Cohen.L.R.and Scarvalone.P.,Understanding revictimization among childhood sexual abuse survivors:An interpersonal schema approach[J].Journal of Cognitive Psychotherapy,2002,16(1).
Currie.J.and Widom.C.S.,Long-Term Consequences of Child Abuse and Neglect on Adult Economic Well-Being[J].Child Maltreatment,2010,15(2):111-20.
De Bellis.M.D.,Developmental traumatology:a contributory mechanism for alcohol and substance use disorders[J].Psychoneuroendocrinology,2002,27(1-2):155.
Eckenrode.J.,Laird.M.and Doris.J.,School performance and disciplinary problems among abused and neglected children[J].Developmental Psychology,1993,29(29):53-62.
Gibb.B.E.,Alloy.L.B.,Walshaw.P.D.,et al.Predictors of Attributional Style Change in Children[J].Journal of Abnormal Child Psychology,2006,34(3):408-422.
Haman.C.,Henry.R.and Daley.S.E.,Depression and sensitization to stressors among young women as a function of childhood adversity[J].Journal of Consulting & Clinical Psychology,2000,68(5):782.
Hammen.C.,Henry.R.and Daley S E.Depression and sensitization to stressors among young women as a function of childhood adversity[J].Journal of Consulting & Clinical Psychology,2000,68(5):782.
Heim.C.,Newport.D.J.,Heit.S.,et al.Pituitary-Adrenal and Autonomic Responses to Stress in Women After Sexual and Physical Abuse in Childhood[J].Jama the Journal of the American Medical Association,2000,284(5):592-7.
Heim.C.,Newport.D.J.,Mletzko.T.,et al.The link between childhood trauma and depression:insights from HPA axis studies in humans[J].Psychoneuroendocrinology,2008,33(6):693-710.
Jehu.D.,Mood disturbances among women clients sexually abused in childhood:Prevalence,etiology,treatment[J].Journal of Interpersonal Violence,1989,4(2):164-184.
John.S.G.,Cisler.J.M.and Sigel.B.A.,Emotion Regulation Mediates the Relationship between a History of Child Abuse and Current PTSD/Depression Severity in Adolescent Females[J].Journal of Family Violence,2017(5):1-11.
Joohan.K.,Jeong-Ho.S.,Kang.C.,et al.The Protective Role of Resilience in Attenuating Emotional Distress and Aggression Associated with Early-life Stress in Young Enlisted Military Service Candidates[J].Journal of Korean Medical Science,2015,30(11):1667-74.
Kent.A.and Waller.G.,The impact of childhood emotional abuse:an extension of the child abuse and trauma scale[J].Child Abuse & Neglect,1998,22(5):393.
Lantman.M.V.S.,Mackus.M.,Otten.L.S.,et al.Mental resilience,perceived immune functioning,and health[J].Journal of Multidisciplinary Healthcare,2017,10:107-112.
Leeson.F.J.and Nixon.R.D.,The role of children’s appraisals on adjustment following psychological maltreatment:a pilot study[J].Journal of Abnormal Child Psychology,2011,39(5):759.
Lupien.S.J.,Mcewen.B.S.,Gunnar.M.R.,et al.Effects of stress throughout the lifespan on the brain,behaviour and cognition[J].Nature Reviews Neuroscience,2009,10(6):434.
Meaney.M.J.,Tannenbaum B,Francis D,et al.Early environmental programming hypothalamic-pituitary-adrenal responses to stress[J].Seminars in Neuroscience,1994,6(4):247-259.
Novelo.M.,Von.G.A.,Gomes.Jardim.G.B.,et al.Effects of childhood multiple maltreatment experiences on depression of socioeconomic disadvantaged elderly in Brazil[J].Child Abuse & Neglect,2018,79:350.
Suomi.S.J.,Early determinants of behaviour:evidence from primate studies[J].Br Med Bull,1997,53(1):170-184.
Wolfe.D.A.and Jaffe.P.,Child abuse and family violence as determinants of child psychopathology[J].Canadian Journal of Behavioural Science,1991,23(3):282-299.
Zlotnick.C.,Zakriski.A.L.,Shea.M.T.,et al.The long-term sequelae of sexual abuse:support for a complex posttraumatic stress disorder[J].Journal of Traumatic Stress,1996,9(2):195-205.▲
(1)数据来源为2017年2月23日,世界卫生组织(WHO)官方网站发布的报告,具体报告网址链接为http://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf;jsessionid=779179B00B2F94EDA711BEDAB19B1 CBC?sequence=1
(2)2012年,凤凰资讯一篇报道中,一名男童遭继母虐待生命垂危;2015年,3.31南京虐童案中,一名男童被其养母虐待伤情严重,性格也随之大变,出现畏惧人群等心理;2017年“携程亲子园事件”,涉事幼师恐吓、殴打,甚至喂食小朋友不明物品,一时间在网上引起激烈讨论。