Pathways between early-life adversity and adolescent self-harm: the mediating role of inflammation in the Avon Longitudinal Study of Parents and Children

被引:37
作者
Russell, Abigail Emma [1 ]
Heron, Jon [1 ]
Gunnell, David [1 ,2 ]
Ford, Tamsin [3 ]
Hemani, Gibran [4 ,5 ]
Joinson, Carol [1 ]
Moran, Paul [1 ,2 ]
Relton, Caroline [4 ,5 ]
Suderman, Matthew [4 ,5 ]
Mars, Becky [1 ,2 ]
机构
[1] Univ Bristol, Med Sch, Ctr Acad Mental Hlth Populat Hlth Sci, Bristol, Avon, England
[2] Univ Bristol, Univ Hosp Bristol NHS Fdn Trust, NIHR Biomed Res Ctr, Bristol, Avon, England
[3] Univ Exeter, Coll Med & Hlth, Exeter, Devon, England
[4] Univ Bristol, MRC Integrat Epidemiol Unit, Med Sch, Bristol, Avon, England
[5] Univ Bristol, Populat Hlth Sci, Med Sch, Bristol, Avon, England
基金
英国生物技术与生命科学研究理事会; 英国医学研究理事会; 英国惠康基金;
关键词
Self-harm; suicide; Avon Longitudinal Study of Parents and Children; adverse childhood experiences; mediation; interleukin-6; C-reactive protein; Inflammation; C-REACTIVE PROTEIN; CHILDHOOD EXPERIENCES; HOUSEHOLD DYSFUNCTION; SYSTEMIC INFLAMMATION; RISK; SUICIDE; VICTIMIZATION; BEHAVIOR; MALTREATMENT; ASSOCIATION;
D O I
10.1111/jcpp.13100
中图分类号
B844 [发展心理学(人类心理学)];
学科分类号
040202 ;
摘要
Background Adverse childhood experiences (ACEs) such as physical and emotional abuse are strongly associated with self-harm, but mechanisms underlying this relationship are unclear. Inflammation has been linked to both the experience of ACEs and self-harm or suicide in prior research. This is the first study to examine whether inflammatory markers mediate the association between exposure to ACEs and self-harm. Methods Participants were 4,308 young people from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based birth cohort in the United Kingdom. A structural equation modelling approach was used to fit a mediation model with the number of ACEs experienced between ages 0 and 9 years old (yo), levels of the inflammatory markers interleukin-6 and C-reactive protein measured at 9.5 yo, and self-harm reported at 16 yo. Results The mean number of ACEs young people experienced was 1.41 (SE 0.03). Higher ACE scores were associated with an increased risk of self-harm at 16 yo (direct effect relative risk (RR) per additional ACE 1.11, 95% CI 1.05, 1.18, p < 0.001). We did not find evidence of an indirect effect of ACEs on self-harm via inflammation (RR 1.00, 95% CI 1.00, 1.01, p = 0.38). Conclusions Young people who have been exposed to ACEs are a group at high risk of self-harm. The association between ACEs and self-harm does not appear to be mediated by an inflammatory process in childhood, as indexed by peripheral levels of circulating inflammatory markers measured in childhood. Further research is needed to identify alternative psychological and biological mechanisms underlying this relationship.
引用
收藏
页码:1094 / 1103
页数:10
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