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儿童期虐待经历与情绪调节障碍:青少年内化和外化精神病理学的一种跨诊断途径。

Childhood Maltreatment Exposure and Disruptions in Emotion Regulation: A Transdiagnostic Pathway to Adolescent Internalizing and Externalizing Psychopathology.

机构信息

Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195, USA.

Department of Psychology, University of Denver, Denver, CO, USA.

出版信息

Cognit Ther Res. 2016 Jun;40(3):394-415. doi: 10.1007/s10608-015-9735-z. Epub 2015 Dec 12.

Abstract

Child maltreatment is a robust risk factor for internalizing and externalizing psychopathology in children and adolescents. We examined the role of disruptions in emotion regulation processes as a developmental mechanism linking child maltreatment to the onset of multiple forms of psychopathology in adolescents. Specifically, we examined whether child maltreatment was associated with emotional reactivity and maladaptive cognitive and behavioral responses to distress, including rumination and impulsive behaviors, in two separate samples. We additionally investigated whether each of these components of emotion regulation were associated with internalizing and externalizing psychopathology and mediated the association between child maltreatment and psychopathology. Study 1 included a sample of 167 adolescents recruited based on exposure to physical, sexual, or emotional abuse. Study 2 included a sample of 439 adolescents in a community-based cohort study followed prospectively for 5 years. In both samples, child maltreatment was associated with higher levels of internalizing psychopathology, elevated emotional reactivity, and greater habitual engagement in rumination and impulsive responses to distress. In Study 2, emotional reactivity and maladaptive responses to distress mediated the association between child maltreatment and both internalizing and externalizing psychopathology. These findings provide converging evidence for the role of emotion regulation deficits as a transdiagnostic developmental pathway linking child maltreatment with multiple forms of psychopathology.

摘要

儿童虐待是儿童和青少年内化和外化精神病理学的一个强有力的风险因素。我们研究了情绪调节过程的中断作为一种发展机制,将儿童虐待与青少年多种形式精神病理学的发生联系起来。具体来说,我们在两个独立的样本中检查了儿童虐待是否与情绪反应性以及对痛苦的适应不良的认知和行为反应(包括沉思和冲动行为)有关。我们还研究了情绪调节的这些组成部分中的每一个是否与内化和外化精神病理学有关,并在儿童虐待与精神病理学之间的关联中起中介作用。研究 1 包括根据身体、性或情感虐待暴露招募的 167 名青少年样本。研究 2 包括一个基于社区的队列研究中前瞻性随访 5 年的 439 名青少年样本。在这两个样本中,儿童虐待与内化精神病理学水平较高、情绪反应性增强以及习惯性参与沉思和冲动应对痛苦有关。在研究 2 中,情绪反应性和对痛苦的适应不良反应在儿童虐待与内化和外化精神病理学之间的关联中起中介作用。这些发现为情绪调节缺陷作为一种将儿童虐待与多种形式精神病理学联系起来的跨诊断发展途径提供了一致的证据。

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