Brown Ruth C, Berenz Erin C, Aggen Steven H, Gardner Charles O, Knudsen Gun Peggy, Reichborn-Kjennerud Ted, Kendler Kenneth S, Amstadter Ananda B
Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.
Division of Mental Health, Norwegian Institute of Public Health (Drs. Knudsen and Reichborn-Kjennerud), the Institute of Psychiatry, University of Oslo, Norway (Dr. Reichborn-Kjennerud).
Psychol Trauma. 2014 Nov;6(6):652-660. doi: 10.1037/a0034326.
Broad associations between trauma exposure (TE) and Axis I psychopathology have been noted in the literature. However, it is not clear if TE is directly associated with Axis I disorders or if the relationship is better accounted for by familial factors (i.e., early environment and/or genetic factors). The current investigation used the co-twin control method in a large sample of adult twin pairs from the Norwegian Twin Registry ( = 2,776), including 449 twin pairs discordant for DSM-IV Criterion A TE. History of TE and Axis I psychopathology was assessed using DSM-IV based clinical interview. Results suggested that TE was significantly associated with greater likelihood of meeting criteria for major depression, dysthymia, anxiety, substance abuse, eating disorders, and somatization disorder in the general population (odds ratios [OR] ranging from 1.33 to 2.21). Among twins discordant for TE, results suggested that TE may exert a direct influence on major depression, dysthymia, anxiety, substance abuse, eating disorders, and somatization disorder. Shared familial effects may also account for at least some of the relationship between TE and major depression. TE may play an important role in the development of a wide range of Axis I psychopathology above and beyond familial factors. Research and clinical implications are discussed.
文献中已指出创伤暴露（TE）与轴I精神病理学之间存在广泛关联。然而，尚不清楚TE是否直接与轴I障碍相关，或者这种关系是否更好地由家族因素（即早期环境和/或遗传因素）来解释。本研究采用共双胞胎对照方法，对来自挪威双胞胎登记处的大量成年双胞胎对（n = 2776）进行了研究，其中包括449对在DSM-IV标准A创伤暴露方面不一致的双胞胎对。使用基于DSM-IV的临床访谈评估创伤暴露史和轴I精神病理学。结果表明，在一般人群中，创伤暴露与符合重度抑郁症、心境恶劣、焦虑症、物质滥用、进食障碍和躯体化障碍标准的可能性显著相关（优势比[OR]范围为1.33至2.21）。在创伤暴露不一致的双胞胎中，结果表明创伤暴露可能对重度抑郁症、心境恶劣、焦虑症、物质滥用、进食障碍和躯体化障碍产生直接影响。共同的家族效应也可能至少部分解释了创伤暴露与重度抑郁症之间的关系。创伤暴露可能在一系列轴I精神病理学的发展中发挥重要作用，超出了家族因素的影响。本文讨论了研究和临床意义。
