童年逆境和青少年饮食障碍的发展轨迹
Andrea Joensen1, Leonie K Elsenburg2, Else Marie Olsen3
1Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
The International journal of eating disorders
|July 29, 2025
概括
童年逆境显著增加了饮食障碍 (ED) 的风险,特别是未被诊断的病例. 较高的逆境暴露与患ED的可能性更大,这表明存在关键诊断差距.
科学领域:
- 儿童和青少年精神病学 儿童和青少年精神病学
- 发展心理学 发展心理学
- 公共卫生 公共卫生
背景情况:
- 童年逆境是饮食障碍 (ED) 的确立危险因素.
- 儿童逆境的累积和不断变化的性质及其对ED发展的影响尚未完全理解.
- 现有的研究往往忽略了ED的范围,包括自我报告或未被诊断的病例.
研究的目的:
- 通过从0-9岁的轨迹评估的累积童年逆境与临床诊断的ED (10-18岁) 之间的关联.
- 调查童年逆境轨迹与18岁时诊断和自我报告的ED症状的复合结果之间的联系.
- 探索诊断和未诊断EDS之间的风险差异,与童年逆境相关.
主要方法:
- 利用了来自丹麦 (N=500,240) 和丹麦国家出生队列 (DNBC-18;N=43,687) 的基于人口的数据.
- 通过国家注册识别诊断的ED和通过DNBC-18.18通过未诊断的ED.
- 采用基于小组的多轨迹模型来定义0-9岁的逆境轨迹 (低,物质剥夺,损失/损失威胁,高) 并使用回归模型分析关联.
主要成果:
- 确定了四个不同的童年逆境轨迹组:低 (72.1%),物质剥夺 (18.0%),损失或损失威胁 (5.5%) 和高 (4.4%).
- 虽然在总人口中没有发现整体关联,但高逆境组显示出更高的饮食障碍 (EDNOS) 风险 (IRR=1.58).
- 在DNBC-18队列中,高逆境组表现出ED的风险增加,完全由未诊断的病例驱动 (RRR=1.73).
结论:
- 经历过高水平的童年逆境的人面临着显著增加患上饮食障碍的风险.
- 这种增加的风险在未被诊断的饮食障碍中尤为明显,这表明诊断差距很大.
- 调查结果强调了认识到累积逆境对ED发展的影响的重要性,并解决症状识别,寻求帮助和获得护理的差异.
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