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Time-Dependent Effects of Exposure to Physical and Sexual Violence on Psychopathology Symptoms in Late Childhood: In Search of Sensitive Periods in Development.
Journal of the American Academy of Child and Adolescent Psychiatry ( IF 13.3 ) Pub Date : 2019-05-10 , DOI: 10.1016/j.jaac.2019.02.022
Erin C Dunn 1 , Kristen Nishimi 2 , Alexander Neumann 3 , Alice Renaud 4 , Charlotte A M Cecil 5 , Ezra S Susser 6 , Henning Tiemeier 7
Affiliation  

OBJECTIVE Exposure to interpersonal violence is a known risk factor for psychopathology. However, it is unclear whether there are sensitive periods when exposure is most deleterious. We aimed to determine whether there were time periods when physical or sexual violence exposure was associated with greater child psychopathology. METHOD This study (N = 4,580) was embedded in Generation R, a population-based prospective birth cohort. Timing of violence exposure, reported through maternal reports (child age, 10 years) was categorized by age at first exposure, defined as: very early (0-3 years), early (4-5 years), middle (6-7 years), and late (8+ years) childhood. Using Poisson regression, we assessed the association between timing of first exposure and levels of internalizing and externalizing symptoms, using the Child Behavior Checklist at age 10 years. RESULTS Violence exposure at any age was associated with higher internalizing (physical violence: risk ratio [RR] = 1.46, p < 0.0001; sexual violence: RR = 1.30, p < .0001) and externalizing symptoms (physical violence: RR = 1.52, p < 0.0001; sexual violence: RR = 1.31, p = 0.0005). However, the effects of violence were time dependent: compared to children exposed at older ages, children first exposed during very early childhood had greater externalizing symptoms. Sensitivity analyses suggested that these time-based differences emerged slowly across ages 1.5, 3, 6, and 10 years, showing a latency between onset of violence exposure and emergence of symptoms, and were unlikely to be explained by co-occurring adversities. CONCLUSION Interpersonal violence is harmful to childhood mental health regardless of when it occurs. However, very early childhood may be a particularly sensitive period when exposure results in worse psychopathology outcomes. Results should be replicated in fully prospective designs.

中文翻译:

身体和性暴力暴露对儿童后期心理病理症状的时间依赖性:寻找发育的敏感时期。

目的暴露于人际暴力是心理病理学的已知危险因素。但是,目前尚不清楚暴露是否有害最敏感的时期。我们旨在确定是否存在身体或性暴力暴露与更大的儿童心理病理相关的时间段。方法该研究(N = 4,580)嵌入了基于人群的预期出生队列R世代。通过孕妇报告(儿童年龄,10岁)报告的暴力暴露时间按初次暴露的年龄分类,定义为:非常早(0-3岁),早期(4-5岁),中等(6-7岁) ),以及儿童期晚(超过8岁)。使用Poisson回归,我们评估了首次接触时间与内在和外在症状水平之间的关联,在10岁时使用儿童行为清单。结果任何年龄的暴力暴露都与更高的内在化(身体暴力:风险比[RR] = 1.46,p <0.0001;性暴力:RR = 1.30,p <.0001)和外在症状(身体暴力:RR = 1.52, p <0.0001;性暴力:RR = 1.31,p = 0.0005)。但是,暴力的影响是时间依赖性的:与年龄较大的儿童相比,在儿童早期就首次接触的儿童具有更大的外在症状。敏感性分析表明,这些基于时间的差异在1.5、3、6和10岁之间缓慢出现,表明暴力暴露开始与症状出现之间存在潜伏期,不太可能由共同发生的逆境来解释。结论人际暴力无论何时发生,都对儿童的心理健康有害。但是,当接触导致更差的心理病理结果时,非常早的童年可能是一个特别敏感的时期。结果应在完全预期的设计中复制。
更新日期:2020-01-23
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