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儿童虐待、神经结构与青少年精神病理学:一项纵向研究。

Child Abuse, Neural Structure, and Adolescent Psychopathology: A Longitudinal Study.

作者信息

Busso Daniel S, McLaughlin Katie A, Brueck Stephanie, Peverill Matthew, Gold Andrea L, Sheridan Margaret A

机构信息

Harvard University, Cambridge, MA.

University of Washington, Seattle.

出版信息

J Am Acad Child Adolesc Psychiatry. 2017 Apr;56(4):321-328.e1. doi: 10.1016/j.jaac.2017.01.013. Epub 2017 Feb 3.

Abstract

OBJECTIVE

Child abuse exerts a deleterious impact on a broad array of mental health outcomes. However, the neurobiological mechanisms that mediate this association remain poorly characterized. Here, we use a longitudinal design to prospectively identify neural mediators of the association between child abuse and psychiatric disorders in a community sample of adolescents.

METHOD

Structural magnetic resonance imaging (MRI) data and assessments of mental health were acquired for 51 adolescents (aged 13-20; M=16.96; SD=1.51), 19 of whom were exposed to physical or sexual abuse. Participants were assessed for abuse exposure (time 1), participated in MRI scanning and a diagnostic structured interview (time 2), and 2 years later were followed-up to assess psychopathology (time 3). We examined associations between child abuse and neural structure, and identified whether abuse-related differences in neural structure prospectively predicted psychiatric symptoms.

RESULTS

Abuse was associated with reduced cortical thickness in medial and lateral prefrontal and temporal lobe regions. Thickness of the left and right parahippocampal gyrus predicted antisocial behavior symptoms, and thickness of the middle temporal gyrus predicted symptoms of generalized anxiety disorder. Thickness of the left parahippocampal gyrus mediated the longitudinal association of abuse with antisocial behavior.

CONCLUSION

Child abuse is associated with widespread disruptions in cortical structure, and these disruptions are selectively associated with increased vulnerability to internalizing and externalizing psychopathology. Identifying predictive biomarkers of vulnerability following childhood maltreatment may uncover neurodevelopmental mechanisms linking environmental experience with the onset of psychopathology.

摘要

目的

儿童虐待对一系列心理健康结果产生有害影响。然而,介导这种关联的神经生物学机制仍未得到充分描述。在此,我们采用纵向设计,在前瞻性地识别社区青少年样本中儿童虐待与精神障碍之间关联的神经介导因素。

方法

对51名青少年(年龄13 - 20岁;M = 16.96;SD = 1.51)获取了结构磁共振成像(MRI)数据和心理健康评估,其中19人曾遭受身体虐待或性虐待。在第1时间点评估参与者的虐待暴露情况,在第2时间点让他们参与MRI扫描和诊断性结构化访谈,2年后进行随访以评估精神病理学情况(第3时间点)。我们研究了儿童虐待与神经结构之间的关联,并确定神经结构中与虐待相关的差异是否能前瞻性地预测精神症状。

结果

虐待与内侧和外侧前额叶及颞叶区域的皮质厚度减少有关。左右海马旁回的厚度可预测反社会行为症状,颞中回的厚度可预测广泛性焦虑障碍症状。左侧海马旁回的厚度介导了虐待与反社会行为之间的纵向关联。

结论

儿童虐待与皮质结构的广泛破坏有关,这些破坏与内化和外化精神病理学易感性增加有选择性关联。识别童年期虐待后易感性的预测生物标志物可能揭示将环境经历与精神病理学发作联系起来的神经发育机制。

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