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前瞻性研究儿童期性虐待和生理不对称在精神病理学发展中的作用。

A prospective examination of the role of childhood sexual abuse and physiological asymmetry in the development of psychopathology.

机构信息

Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.

出版信息

Child Abuse Negl. 2010 Oct;34(10):752-61. doi: 10.1016/j.chiabu.2010.02.010. Epub 2010 Sep 17.

Abstract

OBJECTIVE

Recent literature has emphasized the simultaneous assessment of multiple physiological stress response systems in an effort to identify biobehavioral risk factors of psychopathology in maltreated populations. The current study assessed whether an asymmetrical stress response, marked by activation in one system and a blunted response in another system, predicted higher levels of psychopathology over time.

METHODS

Data were collected from an ongoing, prospective study of females with a substantiated history of childhood sexual abuse (n=52) and a non-abused comparison group (n=77). Childhood sexual abuse was determined at the initial study visit. Vagal tone and cortisol were measured 7 years later to assess physiological response to a laboratory stressor across these systems. Depressive symptoms and antisocial behaviors were assessed 6 years after the completion of the laboratory stressor.

RESULTS

Structural equation modeling indicated that a prior history of childhood sexual abuse predicted an asymmetrical physiological response to stress in late adolescence. In turn, this asymmetrical response predicted both higher levels of depression and antisocial behaviors in young adulthood.

CONCLUSIONS

Childhood sexual abuse may sensitize females to respond to moderate daily stressors in a manner that places them at higher risk for experiencing depressive symptoms and antisocial behaviors over time.

PRACTICE IMPLICATIONS

The management of mild to moderate stress in the everyday lives of maltreated females may be a particularly useful point of intervention in order to protect against later psychopathology.

摘要

目的

近期文献强调应同时评估多个生理应激反应系统,以确定受虐待人群精神病理学的生物行为风险因素。本研究旨在评估一种不对称的应激反应模式——一个系统激活而另一个系统反应迟钝——是否预示着随着时间的推移,更高水平的精神病理学。

方法

本研究的数据来自一项正在进行的、对有确凿儿童期性虐待史的女性(n=52)和未受虐待的对照组(n=77)的前瞻性研究。在最初的研究访问中确定儿童期性虐待的发生。7 年后测量迷走神经张力和皮质醇,以评估这些系统对实验室应激源的生理反应。在完成实验室应激源后的 6 年内评估抑郁症状和反社会行为。

结果

结构方程模型表明,儿童期性虐待史预测了青春期后期应激的不对称生理反应。反过来,这种不对称反应预测了成年早期更高水平的抑郁和反社会行为。

结论

儿童期性虐待可能使女性对中度日常应激源产生敏感反应,从而使她们在以后的生活中更有可能经历抑郁症状和反社会行为。

实践意义

在受虐待女性的日常生活中管理轻度至中度应激可能是一个特别有用的干预点,以防止以后出现精神病理学。

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