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儿童期逆境和生活事件在整个生命周期对焦虑和抑郁障碍的特异性。

The specificity of childhood adversities and negative life events across the life span to anxiety and depressive disorders.

机构信息

Institute of Psychology, Leiden University, Leiden, The Netherlands.

出版信息

J Affect Disord. 2010 Oct;126(1-2):103-12. doi: 10.1016/j.jad.2010.02.132. Epub 2010 Mar 20.

Abstract

BACKGROUND

Although several studies have shown that life adversities play an important role in the etiology and maintenance of both depressive and anxiety disorders, little is known about the relative specificity of several types of life adversities to different forms of depressive and anxiety disorder and the concurrent role of neuroticism. Few studies have investigated whether clustering of life adversities or comorbidity of psychiatric disorders critically influence these relationships.

METHODS

Using data from the Netherlands Study of Depression and Anxiety (NESDA), we analyzed the association of childhood adversities and negative life experiences across the lifespan with lifetime DSM-IV-based diagnoses of depression or anxiety among 2288 participants with at least one affective disorder.

RESULTS

Controlling for comorbidity and clustering of adversities the association of childhood adversity with affective disorders was greater than that of negative life events across the life span with affective disorders. Among childhood adversities, emotional neglect was specifically associated with depressive disorder, dysthymia, and social phobia. Persons with a history of emotional neglect and sexual abuse were more likely to develop more than one lifetime affective disorder. Neuroticism and current affective disorder did not affect the adversity-disorder relationships found.

LIMITATIONS

Using a retrospective study design, causal interpretations of the relationships found are not warranted.

CONCLUSIONS

Emotional neglect seems to be differentially related to depression, dysthymia and social phobia. This knowledge may help to reduce underestimation of the impact of emotional abuse and lead to better recognition and treatment to prevent long-term disorders.

摘要

背景

尽管有几项研究表明,生活逆境在抑郁和焦虑障碍的病因和维持中起着重要作用,但对于几种生活逆境对不同形式的抑郁和焦虑障碍的相对特异性以及神经质的并发作用知之甚少。很少有研究调查生活逆境的聚类或精神障碍的共病是否会严重影响这些关系。

方法

使用来自荷兰抑郁和焦虑研究(NESDA)的数据,我们分析了 2288 名至少有一种情感障碍的参与者一生中与 DSM-IV 为基础的抑郁或焦虑终生诊断相关的儿童期逆境和负面生活经历。

结果

在控制了共病和逆境聚类的情况下,儿童期逆境与情感障碍的相关性大于一生中负面生活事件与情感障碍的相关性。在儿童期逆境中,情感忽视与抑郁症、心境恶劣和社交恐惧症特异性相关。有情感忽视和性虐待史的人更有可能患上一种以上的终生情感障碍。神经质和当前的情感障碍并不影响发现的逆境与疾病的关系。

局限性

由于使用了回顾性研究设计,因此不保证对发现的关系的因果解释。

结论

情感忽视似乎与抑郁症、心境恶劣和社交恐惧症有不同的关系。这一知识可能有助于减少对情感虐待影响的低估,并有助于更好地识别和治疗,以预防长期障碍。

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