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キーワード:
Anxiety, coping efficacy, depression, negative life events, prospective-longitudinal substance use
要旨:
Aims. To prospectively examine whether negative life events (NLE) and
low perceived coping efficacy (CE) increase the risk for the onset of
various forms of psychopathology and low CE mediates the associations
between NLE and incident mental disorders.
Methods. A representative community sample of adolescents and young
adults (N= 3017, aged 14-24 at baseline) was prospectively followed up
in up to three assessment waves over 10 years. Anxiety, depressive and
substance use disorders were assessed at each wave using the
DSM-IV/M-CIDI. NLE and CE were assessed at baseline with the Munich
Event List and the Scale for Self-Control and Coping Skills.
Associations (odds ratios, OR) of NLE and CE at baseline with incident
mental disorders at follow-up were estimated using logistic regressions
adjusted for sex and age.
Results. NLE at baseline predicted the onset of any disorder, any
anxiety disorder, panic disorder, agoraphobia, generalised anxiety
disorder, any depression, major depressive episodes, dysthymia, any
substance use disorder, nicotine dependence and abuse/dependence of
illicit drugs at follow-up (OR 1.02-1.09 per one NLE more). When
adjusting for any other lifetime disorder prior to baseline, merely the
associations of NLE with any anxiety disorder, any depression, major
depressive episodes, dysthymia and any substance use disorder remained
significant (OR 1.02-1.07). Low CE at baseline predicted the onset of
any disorder, any anxiety disorder, agoraphobia, generalised anxiety
disorder, any depression, major depressive episodes, dysthymia, any
substance use disorder, alcohol abuse/dependence, nicotine dependence
and abuse/dependence of illicit drugs at follow-up (OR 1.16-1.72 per
standard deviation). When adjusting for any other lifetime disorder
prior to baseline, only the associations of low CE with any depression,
major depressive episodes, dysthymia, any substance use disorder,
alcohol abuse/dependence, nicotine dependence and abuse/dependence of
illicit drugs remained significant (OR 1.15-1.64). Low CE explained
9.46, 13.39, 12.65 and 17.31% of the associations between NLE and any
disorder, any depression, major depressive episodes and dysthymia,
respectively. When adjusting for any other lifetime disorder prior to
baseline, the reductions in associations for any depression (9.77%) and
major depressive episodes (9.40%) remained significant, while the
reduction in association for dysthymia was attenuated to
non-significance (p-value>0.05).
Conclusions. Our findings suggest that NLE and low perceived CE elevate
the risk for various incident mental disorders and that low CE partially
mediates the association between NLE and incident depression. Subjects
with NLE might thus profit from targeted early interventions
strengthening CE to prevent the onset of depression.
