Abstract

Objectives: We evaluated whether the effects of recent stressful life events (SLEs) and early childhood adversities (ECAs) on depressive symptoms are consistent between men and women and across older age, and whether there was evidence for the following: stress sensitization, whereby the psychological impact of SLEs is greater for individuals with ECAs compared with those without; or stress proliferation effect, whereby those with ECAs are more likely to report more SLEs than those without ECAs to effect depressive symptoms.

Method: ECAs, SLEs in the past two years, and current depressive symptoms through a modified CES-D were obtained from 11,873 individuals participating in a population representative study of older adults, yielding 82,764 observations. Mixed-effects regression models on depressive symptoms were constructed to control for multiple observations per participant and evaluate within-person effects over time, thereby reducing bias from reverse causation.

Results: Results suggest a stress proliferation effect and do not support stress sensitization. ECAs contribute to vulnerability for depressive symptoms, with a dosage effect for each additional ECA. Recent SLEs result in greater depressive symptom risk, with stable effects over age and dosage effects for each additional SLE that were smaller than the effects of ECAs among men, but not women. Belonging to an ethnic minority group, having less education, and less household income at baseline were associated with greater depressive symptom risk.

Conclusions: Findings suggest the importance of addressing early childhood adversity and sociodemographic factors, among at-risk older adults to mitigate life-course stress proliferative processes and thereby reduce disparate risk for depression in older age.

摘要

目标：我们评估了近期压力性生活事件 (SLE) 和儿童早期逆境 (ECA) 对抑郁症状的影响在男性和女性之间以及在不同年龄段是否一致，以及是否有以下证据：压力敏感，由此与没有 ECA 的人相比，SLE 对有 ECA 的人的心理影响更大；或应激增生效应，据此，那些有 ECA 的人比没有 ECA 的人更有可能报告更多的 SLE 以影响抑郁症状。

方法：过去两年的 ECA、SLE 以及通过改良的 CES-D 得出的当前抑郁症状是从参与老年人群代表性研究的 11,873 名个体中获得的，产生了 82,764 项观察结果。构建了关于抑郁症状的混合效应回归模型，以控制每个参与者的多次观察，并随着时间的推移评估人内效应，从而减少反向因果关系的偏差。

结果：结果表明存在应激增殖效应，但不支持应激敏化。ECA 会导致抑郁症状的脆弱性，每增加一个 ECA 就会产生剂量效应。最近的 SLE 会导致更大的抑郁症状风险，随着年龄和剂量的稳定影响，每个额外的 SLE 都小于 ECA 对男性的影响，但对女性则不然。属于少数民族、受教育程度较低和基线时家庭收入较低与抑郁症状风险较高有关。

结论：研究结果表明，在高危老年人中解决幼儿时期的逆境和社会人口因素对于减轻生命过程中的压力增殖过程，从而降低老年人患抑郁症的不同风险具有重要意义。