Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Research Division, Remterweg 69-71, D-33617 Bielefeld, Germany.
Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Research Division, Remterweg 69-71, D-33617 Bielefeld, Germany.
Child Abuse Negl. 2017 Oct;72:98-109. doi: 10.1016/j.chiabu.2017.07.022. Epub 2017 Aug 5.
Accumulated evidence provides support that childhood emotional abuse (CEA) is related to adult major depressive disorder (MDD) outcomes. However, the psychological mechanisms of this relation are still not well understood. Changes in personality and emotion regulation are indicated to play a mediating role what should be examined in this paper. A sample of 123 MDD inpatients was examined in a prospective observational study with two times of measurement. Patients provided data on childhood trauma history, personality disorder (PD) traits and emotion acceptance. Self- and expert-ratings of depressive symptoms were assessed at baseline and at the end of treatment. Treatment duration as an objective indicator of treatment outcome was additionally considered. Partial correlation analyses revealed associations between CEA and self-ratings of MDD symptom severity and symptom improvement independent of sexual and physical abuse. Expert-ratings of depression and treatment duration were not related to CEA. Mediation analyses revealed that particularly the factors borderline psychopathology as well as acceptance of pleasant emotions mediated the association of CEA and self-rated MDD symptoms. Passive-aggressive PD traits mediated the link between CEA and a lower self-rated symptom improvement. CEA affect specific personality traits and acceptance of emotions. This association may play a critical role for self-reported depressive symptoms with implications for prevention, psychoeducation, and treatment of MDD.
累积的证据表明，儿童期情感虐待（CEA）与成年期重度抑郁症（MDD）结局有关。然而，这种关系的心理机制仍未得到很好的理解。人格和情绪调节的变化被认为起到了中介作用，这在本文中应该进行检验。本研究采用前瞻性观察研究，对 123 名 MDD 住院患者进行了样本检测，共进行了两次测量。患者提供了儿童创伤史、人格障碍（PD）特征和情绪接受方面的数据。在基线和治疗结束时，对自我和专家评估的抑郁症状进行了评估。治疗时间作为治疗结果的客观指标也被考虑在内。偏相关分析显示，CEA 与 MDD 症状严重程度和症状改善的自我评估呈独立相关，与性虐待和身体虐待无关。专家评估的抑郁程度和治疗时间与 CEA 无关。中介分析显示，边缘型精神病理学以及对愉快情绪的接受程度这两个因素尤其可以中介 CEA 与自我评估的 MDD 症状之间的关联。被动攻击型 PD 特征可以中介 CEA 与自我评估症状改善程度较低之间的联系。CEA 影响特定的人格特质和情绪的接受程度。这种关联可能对自我报告的抑郁症状具有重要作用，对 MDD 的预防、心理教育和治疗具有启示意义。
