Infurna Maria Rita, Reichl Corinna, Parzer Peter, Schimmenti Adriano, Bifulco Antonia, Kaess Michael
Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany; Department of Psychological and Educational Sciences, University of Palermo, Palermo, Italy; Institute of Psychology, Faculty of Behavioural and Cultural Studies, University of Heidelberg, Heidelberg, Germany.
Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
J Affect Disord. 2016 Jan 15;190:47-55. doi: 10.1016/j.jad.2015.09.006. Epub 2015 Sep 26.
Research documents a strong relationship between childhood maltreatment and depression. However, only few studies have examined the specific effects of various types of childhood abuse/neglect on depression. This meta-analysis estimated the associations between depression and different types of childhood maltreatment (antipathy, neglect, physical abuse, sexual abuse, and psychological abuse) assessed with the same measure, the Childhood Experience of Care and Abuse (CECA) interview.
A systematic search in scientific databases included use of CECA interview and strict clinical assessment for major depression as criteria. Our meta-analysis utilized Cohen's d and relied on a random-effects model.
The literature search yielded 12 primary studies (reduced from 44), with a total of 4372 participants and 34 coefficients. Separate meta-analyses for each type of maltreatment revealed that psychological abuse and neglect were most strongly associated with the outcome of depression. Sexual abuse, although significant, was less strongly related. Furthermore, the effects of specific types of childhood maltreatment differed across adult and adolescent samples.
Our strict criteria for selecting the primary studies resulted in a small numbers of available studies. It restricted the analyses for various potential moderators.
This meta-analysis addressed the differential effects of type of childhood maltreatment on major depression, partially explaining between-study variance. The findings clearly highlight the potential impact of the more "silent" types of childhood maltreatment (other than physical and sexual abuse) on the development of depression.
研究表明童年期受虐与抑郁症之间存在密切关系。然而,仅有少数研究考察了各类童年期虐待/忽视对抑郁症的具体影响。本荟萃分析评估了使用相同测量工具——童年期关爱与虐待经历(CECA)访谈——所评估的抑郁症与不同类型童年期虐待(反感、忽视、身体虐待、性虐待和心理虐待)之间的关联。
在科学数据库中进行系统检索,纳入使用CECA访谈以及以对重度抑郁症的严格临床评估为标准的研究。我们的荟萃分析采用了科恩d值,并依赖随机效应模型。
文献检索得到12项原始研究(从44项减少而来),共有4372名参与者和34个效应系数。对每种虐待类型进行单独的荟萃分析显示,心理虐待和忽视与抑郁症结局的关联最为紧密。性虐待虽然有显著关联,但相关性较弱。此外,童年期特定类型虐待的影响在成人和青少年样本中存在差异。
我们对原始研究的严格筛选标准导致可用研究数量较少。这限制了对各种潜在调节因素的分析。
本荟萃分析探讨了童年期虐待类型对重度抑郁症的不同影响,部分解释了研究间的差异。研究结果清楚地凸显了童年期较“隐蔽”的虐待类型(而非身体和性虐待)对抑郁症发展的潜在影响。