童年期注意缺陷多动障碍的特质、社会排斥与中年期心理困扰
童年期注意缺陷多动障碍的特质、社会排斥与中年期心理困扰
Childhood attention deficit hyperactivity disorder traits, societal exclusion and midlife psychological distress
——《自然·心理健康》第4卷，第4期，2026年4月——
【摘要】大多数关于注意缺陷多动障碍（ADHD）的研究主要集中在童年期或成年早期。对于童年期ADHD特质在整个生命周期中的影响，目前人们知之甚少。本研究旨在探讨：(1) 童年期ADHD特质是否与成年期直至中年期的心理困扰发展轨迹相关；(2) 社会排斥在ADHD特质与中年期心理困扰之间的关系中扮演何种角色。研究数据来源于“1970年英国队列研究”（出生时样本量N=17,196），这是一项前瞻性纵向队列研究。ADHD特质在受访者10岁时通过一份经验证的14项量表进行测量。心理困扰在5个时间点（26岁至46岁）通过“不适感量表”（Malaise Inventory Scale）进行评估。关于社会排斥5个领域（健康、人际关系、政治参与、经济状况及公共服务）的测量数据，则是在受访者34岁时获取的。研究发现，童年期ADHD特质水平越高，其在整个成年期所经历的心理困扰水平也越高，且更有可能处于心理困扰水平较高的发展轨迹中。在调整了性别、种族和儿童期社会阶层等因素后，对于那些在童年期表现出高水平ADHD特质（占总样本的5.05%）的人群而言，其在中年期出现具有临床意义的心理困扰的预测概率约为27%；相比之下，未表现出高水平ADHD特质的人群的这一概率约为18%。在ADHD特质与中年期心理困扰的关联中，社会排斥充当了一条间接传导路径；具体而言，这种间接作用是通过健康、人际关系、经济及公共服务领域的排斥来实现的，但不包括政治参与领域的排斥。研究表明，具有较高水平童年期ADHD特质的人群在成年期更有可能经历心理困扰，而这种现象在一定程度上可归因于社会排斥的影响。对于ADHD人群而言，其所遭受的社会排斥可能正是导致其长期心理健康状况恶化的一个决定性因素。因此，着力消除贯穿整个生命周期的结构性及人际关系障碍，是促进ADHD人群福祉的一项重要举措。
[Abstract] Most research on attention deficit hyperactivity disorder (ADHD) focuses on childhood or early adulthood. Less is known about the impact of childhood ADHD traits across the lifespan. This study aims to test (1) whether childhood ADHD traits are associated with trajectories of psychological distress across adulthood up to midlife, and (2) the role of societal exclusion in the relationship between ADHD traits and midlife distress. Data were from the 1970 British Cohort Study (N?=?17,196 at birth), a prospective longitudinal cohort. ADHD traits were measured at age 10 using a validated 14-item measure. Psychological distress was assessed at 5 time points (26–46) using the Malaise Inventory Scale. Measures of 5 domains of societal exclusion (health, relational, political, economic and services) were available at age 34. Higher childhood ADHD traits were associated with higher distress across adulthood and being in higher distress trajectories. The predicted probability of having clinically relevant distress in midlife was about 27% for people who had high childhood ADHD traits (5.05%), compared with 18% for those who did not have high ADHD traits, adjusting for sex, ethnicity and childhood social class. Societal exclusion acted as an indirect pathway in the association between ADHD traits and midlife psychological distress through health, relational, economic and services exclusion, but not political exclusion. People with higher childhood ADHD traits are more likely to experience psychological distress in adulthood, which was partly explained by societal exclusion. Exclusion experienced by people with ADHD may be a determinant of long-term adverse mental health outcomes. Addressing structural and relational barriers across the life course is an important step toward promoting well-being for people with ADHD.
论文原文：Amber John, Elizabeth O’Nions, Lucy Corrigan, et al. (2026). Childhood attention deficit hyperactivity disorder traits, societal exclusion and midlife psychological distress. Nature ? Mental Health, Volume 4, Issue 4, Pages 566–573. April 2026.
https://doi.org/10.1038/s44220-026-00600-0
（翻译兼责任编辑：MARY）
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