Meta-analysis of the relationship between childhood abuse and social anxiety
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摘要:
目的 了解儿童期虐待经历与社交焦虑的关系及其影响因素，为青少年社交焦虑的干预提供理论依据。 方法 采用随机效应模型，对筛选后获得的30篇文献，93个独立效应值，19 354个样本量进行元分析，采用比值比(OR)对两者之间关系进行整合。 结果 儿童期虐待与社交焦虑呈正相关(r=0.22)，情感虐待(EA)、情感忽视(EN)、情感虐待综合指数(EM)、身体虐待(PA)、身体忽视(PN)、性虐待(SA)亚类型均正向预测社交焦虑(OR值分别为3.14，1.97，2.42，1.78，1.68，1.54)(P值均 < 0.01)。调节效应分析发现，文化背景能调节EN和儿童期虐待综合指数(CI)与社交焦虑的关系(Qb值分别为3.95，3.93)，年龄阶段能调节EA、CI与社交焦虑的关系(Qb值分别为7.65, 8.72)(P值均 < 0.05)。 结论 儿童期虐待正向预测社交焦虑，文化背景、年龄阶段在儿童期虐待与社交焦虑的关系间存在调节效应, 而性别不存在调节效应。 Abstract:Objective To understand the relationship between childhood abuse and social anxiety and its influencing factors, so as to provide a theoretical basis for the intervention targeting social anxiety in adolescents. Methods The Meta-analysis was conducted on the 30 selected articles using random-effects models, comprising 93 independent effect sizes and a total sample of 19 354. Odds ratio (OR) was used to integrate the relationship between childhood abuse and social anxiety. Results There was a significant positive correlation between childhood abuse and social anxiety (r=0.22), and its subtypes (emotional abuse, emotional neglect, emotional maltreatment, physical abuse, physical neglect, sexual abuse) could also positively predict social anxiety (OR=3.14, 1.97, 2.42, 1.78, 1.68, 1.54)(P < 0.01). The moderating effect showed that cultural background could significantly moderate the relationship between emotional neglect and the composite index and social anxiety (Qb=3.95, 3.93), and the relationship between emotional abuse and composite index and social anxiety were significantly moderated by age (Qb=7.65, 8.72)(P < 0.05). Conclusions Childhood abuse is a positive predictor of social anxiety. Cultural background and age have a significant moderating effect on the relationship between childhood abuse and social anxiety, but gender has no significant moderating effect. -
Key words:
- Child abuse /
- Anxiety /
- Mental health /
- Child
1) 利益冲突声明 所有作者声明无利益冲突。 -
图 1 儿童期虐待与社交焦虑关系文献筛选流程
Figure 1. Literature screening process on the relationship between childhood maltreatment and social anxiety
图 2 纳入儿童期虐待与社交焦虑关系文献的发表偏倚检验
Figure 2. Publication bias test for included literatures on the relationship between childhood maltreatment and social anxiety
表 1 纳入儿童期虐待与社交焦虑关系文献的发表偏倚检验结果
Table 1. Results of publication bias test for the included literatures on the relationship between childhood maltreatment and social anxiety
虐待类型 Classic Fail-Safe N Egger's Intercept 标准误 LL值 UL值 P值 EA 3 694 -2.92 1.63 -6.36 0.53 0.09 EN 1 262 -1.93 2.67 -7.62 3.76 0.48 EM 154 0.41 3.56 -10.91 11.72 0.92 PA 325 -1.17 1.32 -4.15 1.80 0.40 PN 360 -3.12 1.40 -6.23 -0.07 0.05 SA 203 -0.25 1.06 -2.62 2.11 0.81 CI 2 232 -1.96 1.96 -6.12 2.19 0.33 合计 2 111 -1.51 0.85 -3.20 0.19 0.08 
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表 2 儿童期虐待与社交焦虑关系研究的异质性检验
Table 2. Heterogeneity of studies on the relationship between childhood maltreatment and social anxiety
虐待类型 Q值 df值 P值 I2值 Tau2值 EA 113.18 17 < 0.01 84.98 0.16 EN 238.90 16 < 0.01 93.30 0.39 EM 5.88 4 >0.05 31.98 0.02 PA 29.30 10 < 0.01 65.87 0.06 PN 50.45 11 < 0.01 78.19 0.11 SA 19.83 11 < 0.05 44.53 0.02 CI 146.90 17 < 0.01 88.43 0.20 合计 827.77 92 < 0.01 88.89 0.22
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表 3 儿童期虐待及亚类型与社交焦虑关系的随机效应模型分析
Table 3. Random-effects model analysis of the relationship between childhood maltreatment and subtypes and social anxiety
虐待亚型 r值 OR值(95%CI) Z值 P值 EA 0.30 3.14(2.54~3.87) 10.63 < 0.01 EN 0.18 1.97(1.44~2.70) 4.21 < 0.01 EM 0.24 2.42(2.00~2.93) 9.06 < 0.01 PA 0.16 1.78(1.48~2.14) 6.08 < 0.01 PN 0.14 1.68(1.35~2.09) 4.61 < 0.01 SA 0.12 1.54(1.34~1.77) 6.18 < 0.01 CI 0.22 2.28(1.81~2.85) 7.12 < 0.01 合计 0.20 1.97(1.82~2.12) 17.88 < 0.01
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表 4 儿童期虐待及亚类型与社交焦虑关系的调节效应分析
Table 4. Moderating effect analysis of the relationship between childhood maltreatment and subtypes and social anxiety
调节变量 虐待类型 类别 OR值(95%CI) Qb值 P值 文化背景 EN 东方文化 1.58(1.15~2.17) 3.95 0.05 西方文化 2.74(1.77~4.25) CI 东方文化 2.51(1.90~3.33) 3.93 0.05 西方文化 1.77(1.44~2.17) 年龄阶段 EA 青少年 3.76(2.88~4.91) 7.65 0.02 成人 3.17(2.01~5.01) 成年早期 2.12(1.56~2.88) CI 青少年 2.91(1.92~4.43) 8.72 0.01 成人 1.67(1.47~1.90) 成年早期 2.25(1.69~3.00)
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