Department of Psychiatry, University of Turku, Turku, Finland.
University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
J Ment Health. 2020 Aug;29(4):376-384. doi: 10.1080/09638237.2018.1521940. Epub 2019 Jan 24.
Childhood adversities and trauma (CAT) are associated with adult mental disorders. Nevertheless, although CAT of different domains mostly co-occurs, and co-morbidity is common, the associations between CAT and mental disorders, when taking these interrelations into account, are not well known. We aimed to study differential associations between the five core domains of CAT and current axis-I disorders, taking into consideration their interrelations.: Four hundred and fifteen outpatients attending adult primary ( = 255) and psychiatric care ( = 160) were assessed with the Trauma and Distress Scale (TADS) and the Mini International Neuropsychiatric Interview (MINI). Associations between CAT core domains and diagnostic categories were examined by path analyses. At least some infrequent experience of CAT (83.6%), mostly of neglect, and current mental disorders (49.4%), mostly depression, was frequent, as were co-morbidities and co-occurrence of CAT domains. Considering these interrelations in a path model of excellent fit, physical abuse predicted depressive, manic, psychotic and anxiety disorders, whereas emotional neglect predicted depressive, anxiety and substance misuse disorders. Of all five CAT core domains, physical abuse and emotional neglect had the strongest association with adult psychiatric disorders and might have transmitted earlier reported main effects of other CAT domains onto mental disorders.
儿童期逆境和创伤 (CAT) 与成年精神障碍有关。然而,尽管不同领域的 CAT 大多同时发生,且共病很常见,但考虑到这些相互关系,CAT 与精神障碍之间的关联并不为人所知。我们旨在研究 CAT 的五个核心领域与当前轴 I 障碍之间的差异关联,同时考虑到它们的相互关系。
四百一十五名成年初级( = 255)和精神科就诊患者( = 160)接受了创伤和痛苦量表(TADS)和迷你国际神经精神访谈(MINI)的评估。通过路径分析检查了 CAT 核心领域与诊断类别的关联。至少有一些 CAT 的罕见经历(83.6%),主要是忽视,以及当前的精神障碍(49.4%),主要是抑郁,很常见,同时也存在共病和 CAT 领域的同时发生。在一个拟合良好的路径模型中考虑这些相互关系,身体虐待预测了抑郁、躁狂、精神病和焦虑障碍,而情感忽视预测了抑郁、焦虑和物质使用障碍。在 CAT 的所有五个核心领域中,身体虐待和情感忽视与成年精神障碍的关联最强,可能将之前报告的其他 CAT 领域的主要影响传递到精神障碍上。