本校學位論文庫
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麻岚斐
張東航
大健康學院
社會工作學碩士學位課程(中文學制)
碩士
2023
童年創傷對老年認知功能的影響 : 社會參與和抑鬱的鏈式中介效應
The Association Between Childhood Trauma and Cognitive Functioning Among Chinese Older People : The Serial Mediating Effect of Social Participation and Depression
童年創傷 ; 認知功能 ; 社會參與 ; 抑鬱水平 ; 老年人
Childhood Trauma ; Cognitive Function ; Social Participation ; Depression ; Older Adults
公開日期：23/5/2027
背景：人口老齡化是當今社會的重要議題和共同挑戰。作為衡量老年人健康狀況的關鍵指標，認知功能的重要性不容忽視。而童年期是每個個體無法逾越的時期，這一時期所遭遇的創傷事件會形成「風險鏈」，通過生理途徑、社會途徑等對個體認知功能產生持久而深遠的影響。但是，此類研究鮮少在老年群體中展開，因此，本研究旨在探索童年創傷經歷與老年認知功能間的關係，以及社會參與和抑鬱水平在其中的中介效應。
方法：本研究基於生命歷程視角，結合累積劣勢理論，利用中國健康與養老追蹤調查數據庫（CHARLS）中2014年生命歷程調查和2015年追蹤調查的數據進行二手數據分析。
結果：採用Hayes SPSS宏來檢驗中介模型，發現超過90%的老年人至少經歷過一種童年創傷，並且童年創傷顯著負向預測認知功能，童年創傷、社會參與和認知功能之間的間接效應顯著，童年創傷、抑鬱水平和認知功能之間的間接效應顯著，童年創傷、社會參與、抑鬱水平和認知功能之間的鏈式中介效應顯著。同時，童年創傷經歷與老年認知功能衰退存在性別、年齡和受教育水平上的差異，男性、高齡和受教育水平低的群體因童年創傷誘發認知衰退的風險更高。
討論：本研究認為早期預防並及時乾預童年創傷事件的發生有助於預防晚年的認知損傷。同時，積極推動老年人參與社會參與，密切關注其心理健康狀況對於維護其認知功能及整體健康狀況具有不可忽視的重要意義。
方法：本研究基於生命歷程視角，結合累積劣勢理論，利用中國健康與養老追蹤調查數據庫（CHARLS）中2014年生命歷程調查和2015年追蹤調查的數據進行二手數據分析。
結果：採用Hayes SPSS宏來檢驗中介模型，發現超過90%的老年人至少經歷過一種童年創傷，並且童年創傷顯著負向預測認知功能，童年創傷、社會參與和認知功能之間的間接效應顯著，童年創傷、抑鬱水平和認知功能之間的間接效應顯著，童年創傷、社會參與、抑鬱水平和認知功能之間的鏈式中介效應顯著。同時，童年創傷經歷與老年認知功能衰退存在性別、年齡和受教育水平上的差異，男性、高齡和受教育水平低的群體因童年創傷誘發認知衰退的風險更高。
討論：本研究認為早期預防並及時乾預童年創傷事件的發生有助於預防晚年的認知損傷。同時，積極推動老年人參與社會參與，密切關注其心理健康狀況對於維護其認知功能及整體健康狀況具有不可忽視的重要意義。
Background: Population aging and cognitive function as a measure of older adults' health pose a significant challenge in today's society. Childhood represents a critical period where traumatic experiences can have enduring and profound effects on cognitive function through physiological and social pathways, generating a "chain of risk." However, limited research exists on this topic among Chinese older adults. Therefore, this study aims to investigate the association between childhood trauma and cognitive function in older adults, as well as the mediating effects of social participation and depression.
Methods: Adopting a life course perspective and integrating the cumulative disadvantage theory, this study conducted a secondary analysis of data from the Chinese Health and Retirement Longitudinal Study (CHARLS). Specifically, the 2014 Life History Survey and the 2015 Follow-up Survey data were utilized.
Results: By employing the Hayes SPSS Process Macro to examine the mediation model, the study showed a significant negative relationship between childhood trauma and cognitive function. The indirect effects of childhood trauma on cognitive function through social participation and depression were also found to be significant. Moreover, significant chain mediation effects were observed among childhood trauma, social participation, depression, and cognitive function. Furthermore, the impact of childhood trauma on subsequent cognitive decline in older people varied based on gender, age, and education level, with a higher risk of cognitive decline associated with childhood trauma among males, older individuals, and those with lower education levels.
Discussion: This study reveals that early prevention and timely intervention in childhood trauma can contribute to the prevention of cognitive impairment in later life. Moreover, promoting social participation among older adults and closely monitoring their mental health status have considerable implications for maintaining cognitive function and overall well-being.
Methods: Adopting a life course perspective and integrating the cumulative disadvantage theory, this study conducted a secondary analysis of data from the Chinese Health and Retirement Longitudinal Study (CHARLS). Specifically, the 2014 Life History Survey and the 2015 Follow-up Survey data were utilized.
Results: By employing the Hayes SPSS Process Macro to examine the mediation model, the study showed a significant negative relationship between childhood trauma and cognitive function. The indirect effects of childhood trauma on cognitive function through social participation and depression were also found to be significant. Moreover, significant chain mediation effects were observed among childhood trauma, social participation, depression, and cognitive function. Furthermore, the impact of childhood trauma on subsequent cognitive decline in older people varied based on gender, age, and education level, with a higher risk of cognitive decline associated with childhood trauma among males, older individuals, and those with lower education levels.
Discussion: This study reveals that early prevention and timely intervention in childhood trauma can contribute to the prevention of cognitive impairment in later life. Moreover, promoting social participation among older adults and closely monitoring their mental health status have considerable implications for maintaining cognitive function and overall well-being.
2024
中文
49
致 謝 I
摘 要 III
Abstract IV
圖目錄 VIII
表目錄 IX
第一章 緒 論 1
1.1研究背景 1
1.2研究問題與研究目的 2
1.3研究意義 2
1.3.1理論意義 2
1.3.2現實意義 3
1.4概念界定 4
1.4.1童年創傷 4
1.4.2認知功能 4
第二章 文獻綜述 5
2.1理論基礎 5
2.1.1生命歷程理論 5
2.1.2累積劣勢理論 5
2.2 概念框架 6
2.3老年人認知功能的影響因素 7
2.4童年創傷与認知功能的關係 8
2.5社會參與與認知功能的關係 9
2.6抑鬱與認知功能的關係 10
2.7童年創傷与社會參與的關係 10
2.8童年創傷与抑鬱的關係 11
2.9社會參與与抑鬱的關係 11
2.10文獻評述 12
第三章 研究設計 14
3.1研究假設 14
3.2數據來源 14
3.3樣本與變量處理 15
3.3.1因變量 15
3.3.2自變量 16
3.3.3中介變量 16
3.3.4控制變量 17
3.4數據分析方法 17
第四章 研究發現 18
4.1描述性統計分析 18
4.2雙變量分析 19
4.2.1各變量間的差異性分析 19
4.2.2各主要變量間的相關性分析 20
4.3 模型檢驗 25
4.4 中介效應檢驗 27
第五章 討論、優勢與局限 29
5.1討論 29
5.2研究優勢 32
5.3研究局限 33
第六章 實踐意涵與研究建議 34
6.1實踐意涵 34
6.2研究建議 35
參考文獻 37
作者簡歷 49
摘 要 III
Abstract IV
圖目錄 VIII
表目錄 IX
第一章 緒 論 1
1.1研究背景 1
1.2研究問題與研究目的 2
1.3研究意義 2
1.3.1理論意義 2
1.3.2現實意義 3
1.4概念界定 4
1.4.1童年創傷 4
1.4.2認知功能 4
第二章 文獻綜述 5
2.1理論基礎 5
2.1.1生命歷程理論 5
2.1.2累積劣勢理論 5
2.2 概念框架 6
2.3老年人認知功能的影響因素 7
2.4童年創傷与認知功能的關係 8
2.5社會參與與認知功能的關係 9
2.6抑鬱與認知功能的關係 10
2.7童年創傷与社會參與的關係 10
2.8童年創傷与抑鬱的關係 11
2.9社會參與与抑鬱的關係 11
2.10文獻評述 12
第三章 研究設計 14
3.1研究假設 14
3.2數據來源 14
3.3樣本與變量處理 15
3.3.1因變量 15
3.3.2自變量 16
3.3.3中介變量 16
3.3.4控制變量 17
3.4數據分析方法 17
第四章 研究發現 18
4.1描述性統計分析 18
4.2雙變量分析 19
4.2.1各變量間的差異性分析 19
4.2.2各主要變量間的相關性分析 20
4.3 模型檢驗 25
4.4 中介效應檢驗 27
第五章 討論、優勢與局限 29
5.1討論 29
5.2研究優勢 32
5.3研究局限 33
第六章 實踐意涵與研究建議 34
6.1實踐意涵 34
6.2研究建議 35
參考文獻 37
作者簡歷 49
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