Morgan Craig, Gayer-Anderson Charlotte
Society and Mental Health Research Group, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
World Psychiatry. 2016 Jun;15(2):93-102. doi: 10.1002/wps.20330.
There is a substantial body of research reporting evidence of associations between various forms of childhood adversity and psychosis, across the spectrum from experiences to disorder. This has been extended, more recently, to include studies of cumulative effects, of interactions with other factors, of specific effects, and of putative biological and psychological mechanisms. In this paper we evaluate this research and highlight the remaining methodological issues and gaps that temper, but do not dismiss, conclusions about the causal role of childhood adversity. We also consider the emerging work on cumulative, synergistic, and specific effects and on mechanisms; and discuss the broader implications of this line of research for our understanding of psychosis. We conclude that the current balance of evidence is that childhood adversities - particularly exposure to multiple adversities involving hostility and threat - do, in some people, contribute to the onset of psychotic experiences and psychotic disorders.
有大量研究报告了各种形式的童年逆境与精神病之间存在关联的证据,涵盖了从经历到疾病的整个范围。最近,这一研究范围得到了扩展,包括对累积效应、与其他因素的相互作用、特定效应以及假定的生物学和心理学机制的研究。在本文中,我们对这一研究进行评估,并强调了仍然存在的方法学问题和差距,这些问题虽削弱但并未否定关于童年逆境因果作用的结论。我们还考虑了关于累积、协同和特定效应以及机制的新出现的研究工作;并讨论了这一系列研究对于我们理解精神病的更广泛意义。我们的结论是,目前的证据平衡表明,童年逆境——尤其是暴露于涉及敌意和威胁的多种逆境中——在某些人身上确实会导致精神病体验和精神疾病的发作。