Is there a link between childhood adversity, attachment style and Scotland’s excess mortality? Evidence, challenges and potential research

BMC Public Health

Debate

A. E. Williamson¹  D. Walsh²  M. Smith³  G. McCartney⁴ 

[1] General Practice and Primary Care, School of Medicine, University of Glasgow, 1 Horselethill Road, G12 9LX, Glasgow, UK;Glasgow Centre for Population Health, Olympia Building, 2-16 Orr Street, Bridgeton Cross, G40 2QH, Glasgow, UK;NHS Greater Glasgow and Clyde, Commonwealth House, 32 Albion Street, G1 1LH, Glasgow, UK;NHS Health Scotland, Meridian Court, 5 Cadogan Street, G2 6QE, Glasgow, UK;

关键词: Scotland;    Public health;    Mortality;    Health inequalities;    Social determinants of health;    Adverse childhood experiences;    Attachment;   

DOI  :  10.1186/s12889-016-3201-z

 received in 2015-11-21, accepted in 2016-06-08,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundScotland has a persistently high mortality rate that is not solely due to the effects of socio-economic deprivation. This “excess” mortality is observed across the entire country, but is greatest in and around the post-industrial conurbation of West Central Scotland. Despite systematic investigation, the causes of the excess mortality remain the subject of ongoing debate.DiscussionAttachment processes are a fundamental part of human development, and have a profound influence on adult personality and behaviour, especially in response to stressors. Many studies have also shown that childhood adversity is correlated with adult morbidity and mortality.The interplay between childhood adversity and attachment is complex and not fully elucidated, but will include socio-economic, intergenerational and psychological factors. Importantly, some adverse health outcomes for parents (such as problem substance use or suicide) will simultaneously act as risk factors for their children.Data show that some forms of “household dysfunction” relating to childhood adversity are more prevalent in Scotland: such problems include parental problem substance use, rates of imprisonment, rates of suicide and rates of children being taken into care. However other measures of childhood or family wellbeing have not been found to be substantially different in Scotland compared to England.SummaryWe suggest in this paper that the role of childhood adversity and attachment experience merits further investigation as a plausible mechanism influencing health in Scotland. A model is proposed which sets out some of the interactions between the factors of interest, and we propose parameters for the types of study which would be required to evaluate the validity of the model.

【 授权许可】

CC BY   
© The Author(s). 2016