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基于社区的队列研究中的儿童期创伤和青少年精神病性体验:积极特质作为保护因素的潜在作用。

Childhood trauma and adolescent psychotic experiences in a community-based cohort: The potential role of positive attributes as a protective factor.

机构信息

Department of Psychiatry, Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo, São Paulo, Brazil; National Institute of Developmental Psychiatry, São Paulo, Brazil.

Department of Psychiatry, Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo, São Paulo, Brazil; National Institute of Developmental Psychiatry, São Paulo, Brazil.

出版信息

Schizophr Res. 2019 Mar;205:23-29. doi: 10.1016/j.schres.2018.06.044. Epub 2018 Jun 28.

Abstract

OBJECTIVE

To investigate how a set of positive social and personality characteristics called 'positive attributes' affects the emergence and persistence of Psychotic Experiences (PE) in adolescence.

METHOD

We used data from a community-based Brazilian High-Risk Cohort (HRC). 2511 6-12 year-old children were evaluated at baseline, and 80.05% completed a 3-year follow-up interview. At baseline, childhood trauma was assessed using parent- and self-report, and positive attributes were assessed by parent-report. Trained psychologists rated self-reported PE at both time points. Linear models evaluated the effect of childhood trauma and positive attributes on PE at follow-up. Mediation models tested i.) the indirect effect of positive attributes on the association between childhood trauma and follow-up PE and, ii.) the indirect effect of childhood trauma and positive attributes on the relationship between PE at baseline and follow-up.

RESULTS

Higher levels of baseline PE (B = 0.157, p < .001) and higher childhood trauma (B = 0.110, p < .001) were associated with increased follow-up PE. Higher positive attributes predicted lower PE after 3 years, adjusting for the prevalence of baseline PE and childhood trauma (B = -0.042, p < .022). Positive attributes partially mediated the relationship between childhood trauma and follow-up PE. The indirect pathway of childhood trauma and positive attributes mediated the association between baseline and follow-up PE.

CONCLUSIONS

Higher levels of positive social and behavioral traits in childhood may diminish the subsequent emergence of PE. As these attributes can be promoted, our findings suggest that positive attributes may represent a novel target for preventive interventions in children at risk of developing PE.

摘要

目的

探究一组被称为“积极属性”的积极社会和人格特征如何影响青少年精神体验(PE)的出现和持续。

方法

我们使用了一项基于社区的巴西高危队列(HRC)的数据。在基线评估时,对 2511 名 6-12 岁的儿童进行了评估,其中 80.05%完成了为期 3 年的随访访谈。在基线时,使用父母和自我报告评估儿童创伤,使用父母报告评估积极属性。经过培训的心理学家在两个时间点对自我报告的 PE 进行了评估。线性模型评估了童年创伤和积极属性对随访时 PE 的影响。中介模型测试了 i)积极属性对童年创伤与随访 PE 之间关联的间接效应,以及 ii)童年创伤和积极属性对基线和随访 PE 之间关系的间接效应。

结果

基线时更高的 PE 水平(B=0.157,p<0.001)和更高的童年创伤(B=0.110,p<0.001)与随访时 PE 的增加相关。更高的积极属性预测 3 年后 PE 降低,调整基线 PE 和童年创伤的患病率后(B=-0.042,p<0.022)。积极属性部分中介了童年创伤和随访 PE 之间的关系。童年创伤和积极属性的间接途径中介了基线和随访 PE 之间的关联。

结论

童年时期更高水平的积极社会和行为特征可能会减少随后 PE 的出现。由于这些属性可以被促进,我们的研究结果表明,积极属性可能代表了一种针对有发展 PE 风险的儿童的新型预防干预靶点。

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