Numerous studies find a cumulative effect of different types of childhood adversities on increasing risk for serious adult mental and medical outcomes. This study uses the National Comorbidity Survey‐Replication sample to investigate the cumulative impact of 8 childhood adversities on complex adult psychopathology as indexed by (a) number of lifetime diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM‐IV; American Psychiatric Association, 1994); (b) number of 4 DSM‐IV disorder categories (mood, anxiety, impulse control, and substance abuse disorders); and (c) coexistence of internalizing and externalizing disorders. Seven of the 8 childhood adversities were significantly associated with complex adult psychopathology. Individuals with 4 or more childhood adversities had an odds ratio of 7.3, 95% confidence interval [4.7, 11.7] for 4 disorder categories. Additive and multiplicative synergistic effects increasing adult psychopathology were found for specific pairwise combinations of childhood adversities. Synergistic patterns differed by gender suggesting that women are more impacted by sexual abuse and men by economic hardship. The absence of childhood adversities was protective, in that it significantly decreased an individual's risk for subsequent adult mental illness. The results support the clinical impression that increased childhood adversity is associated with more complex adult psychopathology. 標題:童年協同逆境與複雜成人精神病理學 撮要:眾多研究指出不同種類的童年逆境的累進效應增加成人嚴重精神和身体疾病的風險。我們採用全國共病普查－複製樣本來研究8種童年逆境的累進影響,在下列複雜成人精神病理等方面：(1)終身DSM‐IV診斷數目；(2)4個DSM病類別的數目(情緒、焦慮、控制衝動、和物質濫用)；及(3)內化和外化疾病的共存。8種童年逆境中有7種與複雜成人精神病理學有統計學上顯著關連，有4個或以上童年逆境人士對4種疾病類別的優勢比為7.3, 95%CI[4.7,11.7] 。只有童年逆境專屬配對組合才能有添加和相乘的協同效應去增加成人精神病理學方面。協同模式有性別差異,如女性受性侵犯影響大些，而男性則被經濟困難影響多些。沒有任何童年逆境是有保護作用，對日後成人精神病的個人發病風險有統計上顯著的減少。本研究証實臨床經驗，即更多童年逆境與更複雜成人精神病學有相連。 标题:童年协同逆境与复杂成人精神病理学 撮要:众多研究指出不同种类的童年逆境的累进效应增加成人严重精神和身体疾病的风险。我们采用全国共病普查－复制样本来研究8种童年逆境的累进影响,在下列复杂成人精神病理等方面：(1)终身DSM‐IV诊断数目；(2)4个DSM病类别的数目(情绪、焦虑、控制冲动、和物质滥用)；及(3)内化和外化疾病的共存。8种童年逆境中有7种与复杂成人精神病理学有统计学上显著关连，有4个或以上童年逆境人士对4种疾病类别的优势比为7.3, 95%CI[4.7,11.7] 。只有童年逆境专属配对组合才能有添加和相乘的协同效应去增加成人精神病理学方面。协同模式有性别差异,如女性受性侵犯影响大些，而男性则被经济困难影响多些。没有任何童年逆境是有保护作用，对日后成人精神病的个人发病风险有统计上显著的减少。本研究证实临床经验，即更多童年逆境与更复杂成人精神病学有相连。