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情绪调节困难作为一种跨诊断机制,将儿童虐待与精神病理学的出现联系起来。

Difficulties with emotion regulation as a transdiagnostic mechanism linking child maltreatment with the emergence of psychopathology.

机构信息

Department of Psychology,Harvard University,Cambridge,MA,USA.

Department of Psychology,University of Washington,Seattle,WA,USA.

出版信息

Dev Psychopathol. 2019 Aug;31(3):899-915. doi: 10.1017/S0954579419000348. Epub 2019 Apr 8.

Abstract

Childhood maltreatment is associated with increased risk for most forms of psychopathology. We examine emotion dysregulation as a transdiagnostic mechanism linking maltreatment with general psychopathology. A sample of 262 children and adolescents participated; 162 (61.8%) experienced abuse or exposure to domestic violence. We assessed four emotion regulation processes (cognitive reappraisal, attention bias to threat, expressive suppression, and rumination) and emotional reactivity. Psychopathology symptoms were assessed concurrently and at a 2-year longitudinal follow-up. A general psychopathology factor (p factor), representing co-occurrence of psychopathology symptoms across multiple internalizing and externalizing domains, was estimated using confirmatory factor analysis. Maltreatment was associated with heightened emotional reactivity and greater use of expressive suppression and rumination. The association of maltreatment with attention bias varied across development, with maltreated children exhibiting a bias toward threat and adolescents a bias away from threat. Greater emotional reactivity and engagement in rumination mediated the longitudinal association between maltreatment and increased general psychopathology over time. Emotion dysregulation following childhood maltreatment occurs at multiple stages of the emotion generation process, in some cases varies across development, and serves as a transdiagnostic mechanism linking child maltreatment with general psychopathology.

摘要

儿童虐待与大多数形式的精神病理学风险增加有关。我们研究了情绪调节障碍作为将虐待与一般精神病理学联系起来的一种跨诊断机制。共有 262 名儿童和青少年参与了研究;其中 162 名(61.8%)经历过虐待或家庭暴力。我们评估了四种情绪调节过程(认知重评、对威胁的注意偏向、表达抑制和反刍)和情绪反应。同时评估了精神病理学症状,并进行了为期 2 年的纵向随访。使用验证性因素分析估计了一般精神病理学因素(p 因素),代表多个内在和外在领域的精神病理学症状的同时发生。虐待与情绪反应增强以及更多地使用表达抑制和反刍有关。虐待与注意力偏向的关联在发展过程中有所不同,受虐待的儿童表现出对威胁的偏向,而青少年则表现出对威胁的回避。更大的情绪反应和反刍参与中介了虐待与随时间推移增加的一般精神病理学之间的纵向关联。儿童虐待后的情绪失调发生在情绪产生过程的多个阶段,在某些情况下因发展而异,是将儿童虐待与一般精神病理学联系起来的跨诊断机制。

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