The Menninger, Houston, TX 77035, USA.
J Affect Disord. 2013 Jul;149(1-3):313-8. doi: 10.1016/j.jad.2013.01.045. Epub 2013 Mar 16.
Exposure to traumatic events is a nonspecific risk factor for psychiatric symptoms including depression. The trauma-depression link finds support in numerous studies; however, explanatory mechanisms linking past trauma to current depressive symptoms are poorly understood. This study examines the role that attachment insecurity plays in mediating the relationship between prior exposure to trauma and current expression of depression severity.
Past trauma and attachment anxiety and avoidance were assessed at baseline in a large cohort (N=705) of adults admitted to a specialized adult psychiatric hospital with typical lengths of stay ranging from 6 to 8 weeks. Depression severity was assessed at day 14 of treatment using the Beck Depression Inventory-II.
Interpersonal trauma (e.g., assaults, abuse) was correlated with depression severity, whereas exposure to impersonal trauma (e.g., natural disasters, accidents) was not. Adult attachment partially mediated the relationship between past interpersonal trauma and depression severity at day 14 among psychiatric inpatients.
Measure of trauma exposure did not systematically differentiate the age of exposure or relationship to the perpetrator. Individuals scoring high on the self-report attachment measure may be prone to over-report interpersonal traumas.
Treatment of depression in traumatized patients should include an assessment of attachment insecurity and may be fruitful target for intervention.
暴露于创伤性事件是非特异性的精神症状（包括抑郁）风险因素。大量研究支持创伤与抑郁之间的联系；然而，将过去的创伤与当前的抑郁症状联系起来的解释机制仍知之甚少。本研究探讨了依恋不安全感在多大程度上可以调节既往创伤暴露与当前抑郁严重程度之间的关系。
在一个专门的成人精神病院，对一个由 705 名成年人组成的大样本（N=705）进行了基线评估，他们的平均住院时间为 6 至 8 周。使用贝克抑郁量表 II 在治疗的第 14 天评估抑郁严重程度。
人际创伤（如攻击、虐待）与抑郁严重程度相关，而非人际创伤（如自然灾害、事故）则不相关。成人依恋部分中介了住院精神病患者中过去人际创伤与第 14 天抑郁严重程度之间的关系。
创伤暴露的测量没有系统地区分暴露的年龄或与施害者的关系。在自我报告的依恋量表上得分高的个体可能容易过度报告人际创伤。
在创伤患者中治疗抑郁时，应评估依恋不安全感，这可能是干预的一个有希望的目标。
