健康的生活方式可能能够缓冲由童年期逆境所致的心理健康问题持续高风险

Lifestyle-specific association between adversity dimensions with group-based mental health trajectories

逆境维度与基于群体的心理健康轨迹的生活方式特异性关联

Author: Min Zuo, Xuebing Ling, Shanshan Wang, Kai Ma, Yuhui Wan, Puyu Su, Fangbiao Tao, Ying Sun

Source: Journal of Affective Disorders

DOI: 10.1016/j.jad.2024.08.015

Abstract

Background

Childhood adversity (CA) has a substantial correlation with mental health problems. Keeping a healthy lifestyle is essential for mental health interventions; it is unclear, however, how healthy lifestyle affect the relationship between CA and persistent mental health problems.

Methods

This longitudinal study (n = 1112, 54.5 % male) collected the data on CA (measured through three dimensions: threat, deprivation and unpredictability), mental health problems, and lifestyle factors. Group-based multi-trajectory modeling (GBMTM) was utilized to estimate trajectories for three mental health problems (i.e., depression, ADHD and overanxiety). Close friendships, regular physical activity, appropriate sleep duration, shorter screen time, and healthy eating were combined to establish a healthy lifestyle score (which ranges from 0 to 5). Higher scores indicated a healthier lifestyle.

Results

Three trajectories of mental health problems were identified: persistently low risk (24.9 %), persistently medium-high risk (50.0 %), and persistently high risk (25.1 %). Multinomial logistic regression showed that high adversity (high-threat: β = 2.01, P < 0.001; high-deprivation: β = 1.03, P < 0.001; high-unpredictability: β = 0.83, P = 0.001; high-overall adversity: β = 1.64, P < 0.001) resulted in a persistently high risk of mental health problems; these outcomes were maintained after robust control for covariates. Further lifestyle stratification, null associations were observed among children with a healthy lifestyle, irrespective of their gender; however, after controlling for covariates, the above associations remained relatively stable only among boys.

Limitations

The generalizability of our findings is restricted by 1) limited racial diversity and 2) missing data.

Conclusions

This finding underscores the benefits of promoting a healthy lifestyle in children to prevent persistent mental health problems caused by CA.

摘要

背景 童年期逆境与心理健康有着极大的关联。保持健康的生活方式对心理健康干预至关重要。然而，目前还不清楚健康的生活方式是如何影响童年期逆境与持续性心理健康问题之间的关联。

方法 通过一项纵向研究（n=1112，其中54.5%为男性）收集童年期逆境（通过威胁、剥夺与不可预测性3个维度进行衡量），心理健康问题和生活方式指标。使用组基轨迹模型来拟合3种心理健康问题（即抑郁、焦虑和ADHD）的轨迹。亲密友谊、定期体育锻炼、充足的睡眠时长、较短的视屏时间和健康的饮食行为共同构建出健康生活方式的得分（得分范围是0～5），越高的得分表示越健康的生活方式。

结果 组基轨迹模型拟合出3种心理健康问题的轨迹：持续低风险（24.9%），持续中高风险（50.0%）和持续高风险（25.1%）。多元逻辑回归的结果表明，逆境程度高导致心理健康问题的风险持续高（高威胁：β＝2.01，P＜0.001；高剥夺：β＝1.03，P＜0.001；高不可预测性：β＝0.083，P＝0.001；高总体逆境：β＝1.64，P＜0.001）；在对协变量进行调整后，这些结果的关联依然稳定。进一步对生活方式进行分层后可以发现，无论是男童还是女童，在生活方式健康的儿童中，逆境与心理健康问题轨迹的关联消失；然而，在控制了协变量后，这一发现仅在男童中保持相对稳定。

局限性 研究结果的普遍性受到1）有限的民族和2）数据缺失的限制。

结论 这一发现强调了促进儿童保持健康的生活方式对预防由童年期逆境引起的持续性心理健康问题的益处。