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失调的潜在心理生理学:与儿童失调相关的静息心率和心率反应性。

Underlying Psychophysiology of Dysregulation: Resting Heart Rate and Heart Rate Reactivity in Relation to Childhood Dysregulation.

机构信息

Utrecht University, The Netherlands.

Texas A&M University, College Station, The Netherlands.

出版信息

J Am Acad Child Adolesc Psychiatry. 2019 Jun;58(6):589-599. doi: 10.1016/j.jaac.2018.09.434. Epub 2018 Oct 31.

DOI:10.1016/j.jaac.2018.09.434
PMID:30768409
Abstract

OBJECTIVE

High co-occurrence of externalizing and internalizing problems could underlie inconsistent findings regarding the relation between heart rate (HR) and psychopathology. In this study, HR measures were examined in relation to a general dysregulation profile studied from variable- and person-centered approaches.

METHOD

The sample (N = 182) consisted of 8- to 12-year-old children referred for externalizing behaviors and typically developing children (mean age 9.70, SD 1.26; 75.8% boys). Resting HR (HR) was assessed during a 3-minute resting period. HR reactivity (HR) was assessed during an emotionally evoking go/no-go task.

RESULTS

From a variable-centered approach, a bifactor model was fitted with a general factor of dysregulation underlying symptoms of anxiety/depression, aggression, and attention problems. HR was positively associated with dysregulation and specific aggression. From a person-centered approach, a latent profile analysis was used to identify different psychopathology classes: normative (n = 92), predominantly aggressive (n = 69), and dysregulated (n = 14). The latter was characterized by co-occurring increased levels of anxiety/depression, aggression, and attention problems. HR was increased in the predominantly aggressive class and HR was increased in the dysregulated class.

CONCLUSION

High HR, or (trait-like) over-arousal, seems to be associated with dysregulation rather than uniquely associated with low externalizing or high internalizing symptomatology. In addition, HR predicted greater aggression and HR was increased in the predominantly aggressive class. High HR, or enhanced emotional reactivity, might be characteristic for a clinically relevant dysregulated subgroup. Assessment of HR could provide additional knowledge on individual differences that can help refine diagnostics and intervention efforts.

摘要

目的

外在问题和内在问题的高度共发可能是导致心率(HR)与精神病理学之间关系的研究结果不一致的原因。在这项研究中,从变量和个体中心的方法研究了一般失调的概况,对 HR 指标进行了检查。

方法

该样本(N=182)包括因外在行为问题而被转介的 8 至 12 岁儿童和正常发育的儿童(平均年龄 9.70,SD 1.26;75.8%为男孩)。在 3 分钟的休息期间评估静息 HR(HR)。在情绪唤起的 Go/No-Go 任务中评估 HR 反应性(HRR)。

结果

从变量中心的方法来看,使用一般失调的双因素模型来拟合焦虑/抑郁、攻击和注意力问题的症状。HR 与失调和特定攻击呈正相关。从个体中心的方法来看,使用潜在剖面分析来识别不同的精神病理学类别:正常(n=92)、主要攻击性(n=69)和失调(n=14)。后者的特点是同时出现焦虑/抑郁、攻击和注意力问题水平升高。主要攻击性类别中的 HR 升高,而失调类别中的 HR 升高。

结论

高 HR,或(特质样)过度兴奋,似乎与失调有关,而不是与低外在或高内在症状独特相关。此外,HR 预测更大的攻击性,且主要攻击性类别中的 HR 升高。高 HR,或增强的情绪反应性,可能是具有临床相关性的失调亚组的特征。HR 的评估可以提供有关个体差异的额外知识,有助于细化诊断和干预措施。

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