Department of Pediatrics,University of California San Diego,La Jolla, CA,USA.
Department of Psychiatry,University of California San Diego,La Jolla, CA,USA.
Psychol Med. 2017 Oct;47(13):2379-2392. doi: 10.1017/S0033291717001064. Epub 2017 Apr 26.
The stress sensitization theory hypothesizes that individuals exposed to childhood adversity will be more vulnerable to mental disorders from proximal stressors. We aimed to test this theory with respect to risk of 30-day major depressive episode (MDE) and generalized anxiety disorder (GAD) among new US Army soldiers.
The sample consisted of 30 436 new soldier recruits in the Army Study to Assess Risk and Resilience (Army STARRS). Generalized linear models were constructed, and additive interactions between childhood maltreatment profiles and level of 12-month stressful experiences on the risk of 30-day MDE and GAD were analyzed.
Stress sensitization was observed in models of past 30-day MDE (χ2 8 = 17.6, p = 0.025) and GAD (χ2 8 = 26.8, p = 0.001). This sensitization only occurred at high (3+) levels of reported 12-month stressful experiences. In pairwise comparisons for the risk of 30-day MDE, the risk difference between 3+ stressful experiences and no stressful experiences was significantly greater for all maltreatment profiles relative to No Maltreatment. Similar results were found with the risk for 30-day GAD with the exception of the risk difference for Episodic Emotional and Sexual Abuse, which did not differ statistically from No Maltreatment.
New soldiers are at an increased risk of 30-day MDE or GAD following recent stressful experiences if they were exposed to childhood maltreatment. Particularly in the military with an abundance of unique stressors, attempts to identify this population and improve stress management may be useful in the effort to reduce the risk of mental disorders.
应激敏感化理论假设，暴露于儿童期逆境的个体更容易受到近期应激源引起的精神障碍的影响。我们旨在通过新入伍的美国士兵 30 天内主要抑郁发作（MDE）和广泛性焦虑障碍（GAD）的风险来检验这一理论。
该样本包括 30436 名参加陆军应激与适应研究（Army STARRS）的新兵。构建了广义线性模型，并分析了儿童期虐待情况与 12 个月应激经历水平之间的相加交互作用对 30 天 MDE 和 GAD 风险的影响。
在过去 30 天 MDE（χ28=17.6，p=0.025）和 GAD（χ28=26.8，p=0.001）的模型中观察到应激敏感化。这种敏感化仅发生在报告的 12 个月应激经历水平较高（3+）时。在 30 天 MDE 风险的两两比较中，与无应激经历相比，所有虐待情况的 3+应激经历与无应激经历之间的风险差异均显著更大。对于 30 天 GAD 的风险也有类似的结果，除了偶发性情绪和性虐待的风险差异，与无虐待情况相比，这一差异在统计学上无显著差异。
新兵如果在近期经历应激源后暴露于儿童期虐待，他们在 30 天内出现 MDE 或 GAD 的风险会增加。在军队这个充满独特压力源的环境中，尤其如此，尝试识别出这一人群并改善压力管理可能有助于降低精神障碍的风险。
