Child Abuse & Neglect最新文献

Background: Child maltreatment measurement has been a longstanding issue, with discrepancies across administrative records, parent-reports, and self-reports. One proposed solution is "triangulation," or integrating data from multiple reporters and sources. However, it remains unclear how best to operationalize this concept.

Objective: This study examines the concept of "triangulation" by employing different analytic methods to determine whether these methods reveal a common underlying construct of physical abuse and whether they predict adult depression.

Participants and setting: Data come from the Lehigh Longitudinal Study, a 40+ year prospective study that began in the 1970s with children ages 18 months to 6 years of age. Data were collected in early childhood, middle childhood, adolescence, and adulthood (ages 36 and 46, on average).

Methods: We applied five analytic approaches - network analysis, ordinary least squares (OLS) regression, structural equation modeling (SEM), latent profile analysis (LPA), and a cumulative index regression - to assess the relationships among multiple reporters of childhood physical abuse and adult depression.

Results: SEM best modeled the latent construct of physical abuse and significantly predicted adult depression, with adult self-reports playing a particularly strong role. Network analysis also highlighted strong intercorrelations among self-reports and meaningful links with depression.

Conclusion: SEM and network analysis were the most informative for triangulation and prediction of adult depression. Adult self-reports of abuse were most related and most predictive of adult depression.

Background: Adverse childhood experiences (ACEs) exhibit subtype-specific pathways to chronic kidney disease (CKD), yet the differential mediation by psychological distress remains unquantified. This study examines how threat-related versus deprivation-related ACEs influence CKD through depressive symptoms (DS) among aging Chinese adults.

Methods: Among 6308 participants from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2018), ACEs were categorized into threat-related and deprivation-related subtypes. CKD was defined based on new self-reported physician diagnosis in 2018 among participants free of CKD at baseline (2011). DS were assessed at baseline using the CESD-10. Formal mediation analysis with bootstrapping (1000 iterations) quantified the mediating role of DS, adjusting for sociodemographic, behavioral, and clinical confounders.

Results: Threat-related and deprivation-related ACEs showed distinct associations with CKD and differential DS mediation. Threat-related ACEs exhibited broad, graded associations with CKD: cumulative exposure (≥3) significantly elevated CKD risk (OR = 2.138, 95% CI: 1.190-3.611) and had a stronger marginal effect on DS, with DS mediating 19.9% of the total CKD risk. Bullying emerged as the most potent threat subtype, increasing CKD (OR = 1.602, 95% CI: 1.145-2.202) and CKD-DS comorbidity most strongly, with a 16.5% DS-mediated pathway. In contrast, deprivation-related ACEs showed selective associations, with only household mental illness exerting significant effects: it elevated CKD (OR = 1.649, 95% CI: 1.246-2.169) and CKD-DS, with DS mediating 24.6% of its CKD risk. Deprivation-related ACEs had a weaker marginal effect on DS and no significant cumulative CKD association.

Conclusions: Psychological distress mediates the ACEs-CKD pathway more broadly for threat-related exposures (notably bullying), while deprivation-related ACEs operate via selective psychological and socioeconomic pathways (predominantly household mental illness). Precision prevention strategies should prioritize depression management for threat-exposed groups and integrated socioeconomic interventions and psychological support for those affected by deprivation-related ACEs like household mental illness.