童年期虐待后，杏仁核反应增强和应激产生增加可预测成年人的内化症状。
Heightened amygdala reactivity and increased stress generation predict internalizing symptoms in adults following childhood maltreatment.
机构信息
Division of Psychology and Language Science, Department of Clinical Educational and Health Psychology, University College London, London, UK.
Anna Freud National Centre for Children and Families, London, UK.
出版信息
J Child Psychol Psychiatry. 2019 Jul;60(7):752-761. doi: 10.1111/jcpp.13041. Epub 2019 Apr 1.
BACKGROUND
Childhood maltreatment is one of the most potent predictors of future psychopathology, including internalizing disorders. It remains unclear whether heightened amygdala reactivity to threat and elevated stress exposure may be implicated in the pathogenesis and maintenance of internalizing disorders among individuals with a history of childhood maltreatment.
METHODS
Using data from a sample of 1,144 young adults, we investigated the contribution of baseline threat-related amygdala reactivity and prospective major stressful life events to internalizing symptoms severity 1 year later (on average) in individuals with a history of maltreatment (n = 100) and propensity score matched nonmaltreated peers (n = 96).
RESULTS
Even after stringently matching for several potentially confounding variables - including baseline internalizing symptoms, socioeconomic status and IQ - childhood maltreatment status predicted increased amygdala reactivity at baseline, elevated post-baseline exposure to major stressful life events and internalizing symptoms at follow-up. We also showed, for the first time, that amygdala reactivity at baseline and also post-baseline exposure to major stressful life events mediated the association between a history of maltreatment and future internalizing symptoms.
CONCLUSIONS
These findings provide support for the view that maltreatment is a potent developmental insult leading to long-lasting neurocognitive recalibrations of the threat processing system. It is possible that such alterations, over time, may impact mental health functioning by compromising the ability to effectively negotiate everyday challenges (stress susceptibility). These alterations were not, however, found to sensitize an individual to the impact of major stressful life events. The results of this study also lend compelling support to the view that increased psychiatric risk, in the context of childhood maltreatment, follows from an increased propensity to experience major stressful life events (stress generation).
背景
儿童期虐待是未来精神病理学（包括内化障碍）的最强预测因素之一。目前尚不清楚，对于有儿童期虐待史的个体，杏仁核对威胁的反应性增强和应激暴露增加是否与内化障碍的发病机制和维持有关。
方法
我们使用了 1144 名年轻成年人的数据，调查了基线时与威胁相关的杏仁核反应性和前瞻性重大生活应激事件对有虐待史（n=100）和倾向评分匹配的未受虐待同龄人（n=96）在 1 年后（平均）内化症状严重程度的影响。
结果
即使在严格匹配了几个潜在的混杂变量（包括基线时的内化症状、社会经济地位和智商）后，儿童期虐待状况仍能预测基线时杏仁核反应性增强、基线后重大生活应激事件暴露增加和随访时的内化症状。我们还首次表明，基线时的杏仁核反应性和基线后的重大生活应激事件暴露都介导了虐待史与未来内化症状之间的关联。
结论
这些发现为以下观点提供了支持，即虐待是一种强烈的发育性伤害，导致威胁处理系统的长期神经认知重新校准。随着时间的推移，这种改变可能会通过损害有效应对日常挑战（应激易感性）的能力，从而影响心理健康功能。然而，这些改变并没有使个体对重大生活应激事件的影响变得敏感。本研究的结果还强烈支持这样一种观点，即在儿童期虐待的背景下，增加的精神疾病风险源于经历重大生活应激事件的倾向增加（应激产生）。
Zotero 插件