Ask Helga, Waaktaar Trine, Seglem Karoline Brobakke, Torgersen Svenn
Centre for Child and Adolescent Mental Health, RBUP Eastern and Southern Norway, Nydalen, P.O box 4623, 0405, Oslo, Norway.
Department of Psychology, Faculty of Social Sciences, University of Oslo, Blindern, P.O box 1094, 0317, Oslo, Norway.
J Abnorm Child Psychol. 2016 Jan;44(1):101-14. doi: 10.1007/s10802-015-9977-y.
Somatic complaints in children and adolescents may be considered part of a broader spectrum of internalizing disorders that include anxiety and depression. Previous research on the topic has focused mainly on the relationship between anxiety and depression without investigating how common somatic symptoms relate to an underlying factor and its etiology. Based on the classical twin design with monozygotic and dizygotic twins reared together, our study aimed to explore the extent to which the covariation between three phenotypes in adolescent girls and boys can be represented by a latent internalizing factor, with a focus on both common and specific etiological sources. A population-based sample of twins aged 12-18 years and their mothers and fathers (N = 1394 families) responded to questionnaire items measuring the three phenotypes. Informants' ratings were collapsed using full information maximum likelihood estimated factor scores. Multivariate genetic analyses were conducted to examine the etiological structure of concurrent symptoms. The best fitting model was an ACE common pathway model without sex limitation and with one substantially heritable (44%) latent factor shared by the phenotypes. Concurrent symptoms also resulted from shared (25%) and non-shared (31%) environments. The factor loaded most on depression symptoms and least on somatic complaints. Trait-specific influences explained 44% of depression variance, 59% of anxiety variance, and 65% of somatic variance. Our results suggest the presence of a general internalizing factor along which somatic complaints and mental distress can be modeled. However, specific influences make the symptom types distinguishable.
儿童和青少年的躯体主诉可能被视为内化性障碍这一更广泛范畴的一部分，内化性障碍包括焦虑和抑郁。此前关于该主题的研究主要集中在焦虑与抑郁之间的关系，而未探讨常见躯体症状与潜在因素及其病因之间的关联。基于经典的同卵和异卵双胞胎共同抚养的双生子设计，我们的研究旨在探讨青少年女孩和男孩三种表型之间的协变在多大程度上可由一个潜在的内化因素来表征，重点关注共同和特定的病因来源。一个基于人群的12至18岁双胞胎及其父母（N = 1394个家庭）的样本对测量这三种表型的问卷项目做出了回应。使用全信息最大似然估计因子得分对信息提供者的评分进行汇总。进行多变量遗传分析以检验并发症状的病因结构。最佳拟合模型是一个无性别限制的ACE共同路径模型，且有一个由这些表型共享的高度可遗传（44%）的潜在因素。并发症状也源于共享（25%）和非共享（31%）环境。该因子在抑郁症状上的负荷最大，在躯体主诉上的负荷最小。特质特异性影响分别解释了抑郁变异的44%、焦虑变异的59%和躯体变异的65%。我们的结果表明存在一个一般的内化因素，据此可对躯体主诉和精神困扰进行建模。然而，特定影响使得症状类型可区分。
