Department of Psychiatry and Clinical Psychology, University and Polytechnic Hospital La Fe, Valencia, Spain.
University of Southampton, UK; Institute of Psychiatry, London, UK.
Child Abuse Negl. 2017 Nov;73:42-50. doi: 10.1016/j.chiabu.2017.09.020. Epub 2017 Sep 22.
Maltreated children usually show a specific pattern of emotional and behavioral symptoms that exceed those relating to posttraumatic stress disorder (PTSD). These symptoms have been defined as Complex PTSD (CPTSD). The underlying attentional mechanisms of abnormal emotional processing and their relation to the clinical presentation of CPTSD are not well understood. A visual dot-probe paradigm involving pre-attentive (i.e., 500ms) and attentive (i.e., 1500ms) presentation rates of neutral versus emotional (i.e., angry, happy or sad) facial expressions was applied. Twenty-one maltreated CPTSD children were compared with twenty-six controls. The results are as follows: an attention bias away from threatening faces and an attentional bias towards sad faces were observed in maltreated CPTSD children during pre-attentive and attentive processing. Whereas the attentional bias away from angry faces was associated with social problems, the attentional bias towards sad faces was associated with depressive and withdrawn symptoms. Therefore, CPTSD children develop maladaptive negative cognitive styles, which may underlie not only social problems (by a cognitive avoidance of threatening stimuli) but also depressive symptoms (by a cognitive approach to sad stimuli). Attention processing abnormalities should be considered as therapeutic targets for new treatment approaches in this population.
受虐儿童通常表现出特定的情绪和行为症状模式，这些症状超出了创伤后应激障碍（PTSD）的范围。这些症状被定义为复杂性创伤后应激障碍（CPTSD）。异常情绪处理的潜在注意机制及其与 CPTSD 临床表现的关系尚不清楚。采用涉及中性与情绪（即愤怒、快乐或悲伤）面部表情的前注意（即 500ms）和注意（即 1500ms）呈现率的视觉点探测范式，对 21 名受虐 CPTSD 儿童和 26 名对照组进行了比较。结果如下：在受虐 CPTSD 儿童中，无论是在前注意还是注意加工阶段，均观察到对威胁面孔的注意力回避以及对悲伤面孔的注意力偏向。对愤怒面孔的注意力回避与社交问题有关，而对悲伤面孔的注意力偏向与抑郁和退缩症状有关。因此，CPTSD 儿童形成了适应不良的消极认知风格，这不仅可能是社交问题（通过对威胁刺激的认知回避）的基础，也是抑郁症状（通过对悲伤刺激的认知接近）的基础。在该人群中，应考虑将注意力处理异常作为新治疗方法的治疗靶点。
