バース大学の心理学者がThe Lancet Psychiatry誌に発表した新しい研究は、子どもたちのトラウマがもたらす広範囲な影響を浮き彫りにしています。 A new study published in The Lancet Psychiatry from Bath psychologists highlights the far-reaching effects of trauma in children.
2022-11-03 バース大学
英国、ブラジル、南アフリカの心理学者のチームは、2004年のペロタス出生コホート研究の一環として検査された子どもたちのデータを分析した。このコホート研究は、ブラジル南部の都市ペロタスを拠点に、生まれてから11歳になるまでの子どもたちを追跡調査し、健康と人生の転帰を追跡してきた。
この研究では、4,000人以上の子どものデータを分析し、不安障害と気分障害、ADHDと多動性障害、行動障害と反抗性障害の有病率を測定し、6歳と11歳における子どものトラウマへの曝露を評価した。トラウマとなる出来事には、子どもたちが直接体験したものと、愛する人を含む他者に起こったと目撃されたものが含まれる。
その結果、6歳までにトラウマにさらされることは、不安障害や精神障害全体のリスクの高さと関連していることがわかった。11歳までにトラウマにさらされると、精神疾患全体、および不安障害、気分障害、ADHD/多動性障害、行動障害/反抗性障害の4つの特定クラスの障害を発症する可能性が高くなることが示された。これらの疾患は、トラウマに暴露されたグループでは、暴露されていない子どもたちよりも50%から100%発症しやすいことがわかった。
<関連情報>
- https://www.bath.ac.uk/announcements/birth-cohort-study-reveals-the-mental-health-burden-of-trauma-in-childhood/
- https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(22)00337-6/fulltext
ブラジルにおける小児期のトラウマと小児期の精神疾患との関連性:人口ベースの前向き出生コホート研究 Associations between childhood trauma and childhood psychiatric disorders in Brazil: a population-based, prospective birth cohort study
Andreas Bauer, Graeme Fairchild, Gemma HammertonJoseph Murray, Ina S Santos, Luciana Tovo Rodrigues, Tiago N Munhoz, Aluísio J D Barros, Alicia Matijasevich, Sarah L Halligan
The Lancet Psychiatry Published:October 31, 2022
DOI:https://doi.org/10.1016/S2215-0366(22)00337-6
Summary
Background
Childhood trauma is a proposed transdiagnostic risk factor for psychopathology, but epidemiological evidence from low-income and middle-income countries (LMICs) is scarce. We investigated associations between trauma and child psychiatric disorders in a birth cohort in Brazil.
Methods
The 2004 Pelotas Birth Cohort is an ongoing, population-based, prospective birth cohort, including all hospital births occurring between Jan 1 and Dec 31, 2004, in the city of Pelotas, Brazil. When the children were aged 6 and 11 years, trained psychologists administered the Development and Well-Being Assessment clinical interview to caregivers to assess current child psychiatric disorders (anxiety disorders, mood disorders, ADHD and hyperactivity disorders, and conduct and oppositional disorders), and lifetime trauma exposure (ie, experiencing or witnessing life-threatening events) including interpersonal and non-interpersonal events. Analyses used multiple imputation and logistic regression models.
Outcomes
Of 4263 live births, 4231 children were included in the study sample, and 4229 (2195 [51·9%] boys and 2034 [48·1%] girls; 2581 [61·7%] with White mothers and 1600 [38·3%] with Black or mixed race mothers) were included in the imputed analyses. 1154 (34·3%) of 3367 children with complete data at age 11 years had been exposed to trauma by that age. After adjusting for confounders, at age 6 years, trauma was associated with increased odds of anxiety disorders (adjusted odds ratio 1·79 [95% CI 1·33–2·42]) and any psychiatric disorder (1·59 [1·22–2·06]), and at age 11 years, with any psychiatric disorder (1·45 [1·17–1·79]) and all four specific diagnostic classes of anxiety disorders (1·47 [1·04–2·09]), mood disorders (1·66 [1·08–2·55]), ADHD and hyperactivity disorders (1·47 [1·01–2·13]), and conduct and oppositional disorders (1·76 [1·19–2·61]). Interpersonal trauma and non-interpersonal trauma were each associated with increased odds of multiple psychiatric disorders, even when adjusting for their co-occurrence.
Interpretation
A considerable mental health burden associated with childhood trauma is already evident by middle childhood in this sample from Brazil. Evidence-based efforts to reduce the incidence of childhood trauma in Brazil and address its consequences are urgently needed.
Funding
Children’s Pastorate, WHO, National Support Program for Centres of Excellence, Brazilian National Research Council, Brazilian Ministry of Health, São Paulo Research Foundation, University of Bath, Wellcome Trust.
Translation
For the Portuguese translation of the abstract see Supplementary Materials section.
