评估儿童期逆境与近期生活应激事件和状况之间的相互作用,预测普通人群成年人的惊恐障碍病理。
Assessing the interplay of childhood adversities with more recent stressful life events and conditions in predicting panic pathology among adults from the general population.
机构信息
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Germany.
Department of Physiological and Clinical Psychology, University of Greifswald, Germany.
出版信息
J Affect Disord. 2018 Jan 1;225:715-722. doi: 10.1016/j.jad.2017.08.050. Epub 2017 Aug 24.
BACKGROUND
Although research suggests that (a) childhood adversities and more recent stressful life events/conditions are risk factors for panic pathology and that (b) early life stress increases vulnerability to later psychopathology, it remains unclear whether childhood adversities amplify the association between more recent stressful life events/conditions and panic pathology.
METHODS
Data were derived from a general population sample (Study of Health in Pomerania, SHIP). Lifetime panic pathology was assessed with the Munich Composite International Diagnostic Interview (M-CIDI). Childhood adversities (emotional, physical and sexual abuse; emotional and physical neglect) were assessed with the Childhood Trauma Questionnaire (CTQ). More recent separation/loss events and long-lasting stressful conditions were assessed with the Stralsund Life Event List (SEL). Individuals with lifetime panic pathology (fearful spell, panic attack or panic disorder, N = 286) were compared to controls without any psychopathology (N = 286, matched for sex and age).
RESULTS
Conditional logistic regressions revealed that childhood adversities as well as more recent separation/loss events and long-lasting stressful conditions were associated with panic pathology (OR 1.1-2.5). Moreover, more recent separation/loss events - but not long-lasting stressful conditions - interacted statistically with each of the examined childhood adversities except for sexual abuse in predicting panic pathology (OR 1.1-1.3). That is, separation/loss events were associated more strongly with panic pathology among individuals with higher childhood adversities.
LIMITATIONS
Data were assessed retrospectively and might be subject to recall biases.
CONCLUSIONS
Findings suggest that early childhood adversities amplify the risk of developing panic pathology after experiencing separation or loss events.
背景
尽管研究表明 (a) 童年逆境和近期压力性生活事件/状况是惊恐病理的危险因素,(b) 早期生活压力会增加后期精神病理学的易感性,但仍不清楚童年逆境是否会放大近期压力性生活事件/状况与惊恐病理之间的关联。
方法
数据来自一般人群样本(什未林健康研究,SHIP)。终身惊恐病理通过慕尼黑综合国际诊断访谈(M-CIDI)进行评估。童年逆境(情感、身体和性虐待;情感和身体忽视)通过儿童创伤问卷(CTQ)进行评估。近期分离/丧失事件和长期压力状况通过斯特拉尔松生活事件清单(SEL)进行评估。有终身惊恐病理(惊恐发作、惊恐障碍,N=286)的个体与无任何精神病理学的对照组(N=286,性别和年龄匹配)进行比较。
结果
条件逻辑回归显示,童年逆境以及近期分离/丧失事件和长期压力状况均与惊恐病理相关(OR 1.1-2.5)。此外,近期分离/丧失事件——但不是长期压力状况——与除性虐待以外的每一种所检查的童年逆境都存在统计学上的相互作用,从而预测惊恐病理(OR 1.1-1.3)。也就是说,在经历分离或丧失事件后,童年逆境较高的个体更易出现惊恐病理。
局限性
数据是回顾性评估的,可能存在回忆偏倚。
结论
研究结果表明,早期童年逆境会放大经历分离或丧失事件后出现惊恐病理的风险。