采用路径分析和多元回归研究创伤经历和5-羟色胺转运体对强迫症患者分离体验的可能影响。
Investigating the possible effects of trauma experiences and 5-HTT on the dissociative experiences of patients with OCD using path analysis and multiple regression.
作者信息
Lochner Christine, Seedat Soraya, Hemmings Sian M J, Moolman-Smook Johanna C, Kidd Martin, Stein Dan J
机构信息
MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa.
出版信息
Neuropsychobiology. 2007;56(1):6-13. doi: 10.1159/000109971. Epub 2007 Oct 17.
Dissociation is defined as the disruption of the usually integrated functions of consciousness, such as memory, identity, and perceptions of the environment. Causes include various psychological, neurological and neurobiological mechanisms, none of which have been consistently supported. To our knowledge, the role of gene-environment interactions in dissociative experiences in obsessive-compulsive disorder (OCD) has not previously been investigated. Eighty-three Caucasian patients (29 male, 54 female) with a principal diagnosis of OCD were included. The Dissociative Experiences Scale was used to assess dissociation. The role of childhood trauma (assessed with the Childhood Trauma Questionnaire), and a functional 44-bp insertion/deletion polymorphism in the promoter region of the serotonin transporter, or 5-HTT, in mediating dissociation, was investigated using multiple regression analysis and path analysis using the partial least squares model. Both analyses indicated that an interaction between physical neglect and the S/S genotype of the 5-HTT gene significantly predicted dissociation in patients with OCD. Dissociation may be a predictor of poorer treatment outcome in patients with OCD; therefore, a better understanding of the mechanisms that underlie this phenomenon may be useful. Here, two different but related statistical techniques (multiple regression and partial least squares), confirmed that physical neglect and the 5-HTT genotype jointly play a role in predicting dissociation in OCD.
分离被定义为意识的通常整合功能的破坏,如记忆、身份认同和对环境的感知。其原因包括各种心理、神经和神经生物学机制,但均未得到一致支持。据我们所知,基因 - 环境相互作用在强迫症(OCD)分离体验中的作用此前尚未得到研究。研究纳入了83名主要诊断为强迫症的白种人患者(29名男性,54名女性)。使用分离体验量表来评估分离情况。采用多元回归分析和偏最小二乘模型的路径分析,研究童年创伤(用儿童创伤问卷评估)以及血清素转运体(5-HTT)启动子区域功能性44碱基对插入/缺失多态性在介导分离中的作用。两项分析均表明身体忽视与5-HTT基因的S/S基因型之间的相互作用显著预测了强迫症患者的分离情况。分离可能是强迫症患者治疗效果较差的一个预测指标;因此,更好地理解这一现象背后的机制可能会有所帮助。在此,两种不同但相关的统计技术(多元回归和偏最小二乘)证实,身体忽视和5-HTT基因型共同在预测强迫症的分离情况中发挥作用。