被拘留的男性青少年罪犯童年累积不良经历和易怒情绪与精神障碍的关联。
The associations of cumulative adverse childhood experiences and irritability with mental disorders in detained male adolescent offenders.
作者信息
Bielas Hannes, Barra Steffen, Skrivanek Christine, Aebi Marcel, Steinhausen Hans-Christoph, Bessler Cornelia, Plattner Belinda
机构信息
Department of Child and Adolescent Psychosomatic Medicine and Psychotherapy, Clinic Fontane, Mittenwalde, Germany.
Department of Psychosomatics and Psychiatry, Child Protection Team, University Children's Hospital Zurich, Zurich, Switzerland.
出版信息
Child Adolesc Psychiatry Ment Health. 2016 Sep 22;10:34. doi: 10.1186/s13034-016-0122-7. eCollection 2016.
BACKGROUND
Adverse childhood experiences (ACEs) and psychiatric disorders are common in juvenile detainees. Emotional dysregulation resulting from cumulated ACEs may be characterized by symptoms of irritability. The present study examined whether the accumulation of ACEs, irritability, or both predicted mental disorders in incarcerated adolescents with and without controlling for one another and for socio-demographic factors.
METHODS
One hundred thirty male detained juvenile offenders (aged 13.8-19.5 years) were assessed by structured clinical interviews and a self-reporting scale for irritability. Univariate and multivariate regression models were used to examine the shared and distinct associations of ACEs and irritability with psychiatric diagnoses.
RESULTS
A total of 75 % of the participants reported more than one ACE. The ACE total score was positively related to self-reported irritability. The ACE total score predicted depressive disorders, suicidality, post-traumatic stress disorder (PTSD), and anxiety disorders. Irritability was positively related to depressive disorders, suicidality, disruptive behavior disorder (DBD), substance use disorder (SUD), and attention deficit hyperactivity disorder (ADHD). These associations remained significant in multivariate models.
CONCLUSIONS
This study provides evidence for the predictive impact of self-reported ACEs and irritability with regard to adolescent psychiatric disorders in young male inmates. Both variables differed in their predictive power for PTSD, internalizing, and externalizing disorders indicating the need for specific therapeutic interventions. Taking a close look at their trauma history seems to be of special importance for juveniles suffering from PTSD and anxiety disorders. For delinquent adolescents with DBD, ADHD and SUD, the training of emotion regulation techniques appears most promising. Approaches focusing on both, ACEs and emotion-focused contents may be implemented in the treatment of depressive disorders and suicidality.
背景
童年不良经历（ACEs）和精神障碍在青少年被拘留者中很常见。累积的ACEs导致的情绪失调可能表现为易怒症状。本研究考察了ACEs的累积、易怒情绪或两者在相互控制以及控制社会人口学因素的情况下，是否能预测被监禁青少年的精神障碍。
方法
通过结构化临床访谈和一份易怒情绪的自我报告量表对130名男性青少年被拘留罪犯（年龄在13.8 - 19.5岁之间）进行评估。使用单变量和多变量回归模型来检验ACEs和易怒情绪与精神疾病诊断之间的共同和独特关联。
结果
共有75%的参与者报告有不止一种ACEs。ACEs总分与自我报告的易怒情绪呈正相关。ACEs总分可预测抑郁症、自杀倾向、创伤后应激障碍（PTSD）和焦虑症。易怒情绪与抑郁症、自杀倾向、破坏性行为障碍（DBD）、物质使用障碍（SUD）和注意力缺陷多动障碍（ADHD）呈正相关。这些关联在多变量模型中仍然显著。
结论
本研究为自我报告的ACEs和易怒情绪对年轻男性囚犯青少年精神障碍的预测影响提供了证据。这两个变量在预测PTSD、内化性和外化性障碍方面的预测能力不同，表明需要特定的治疗干预。仔细审视他们的创伤史对于患有PTSD和焦虑症的青少年似乎尤为重要。对于患有DBD、ADHD和SUD的青少年罪犯，情绪调节技术的训练似乎最有前景。针对ACEs和以情绪为重点内容的方法可用于治疗抑郁症和自杀倾向。
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