Dochnal Roberta, Vetró Ágnes, Kiss Enikö, Baji Ildikó, Lefkovics Eszter, Bylsma Lauren M, Yaroslavsky Ilya, Rottenberg Jonathan, Kovacs Maria, Kapornai Krisztina
Department of Child and Adolescent Psychiatry, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary.
Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
Front Psychiatry. 2019 Oct 7;10:722. doi: 10.3389/fpsyt.2019.00722. eCollection 2019.
Both depression and anxiety (two of the most common internalizing psychopathologies among youths) are associated with difficulties in emotion regulation (ER). Little is known about whether anxiety as a comorbid condition has an effect on the habitual use of different ER strategies in youngsters with depression histories. We aimed 1) to compare ER in adolescents with histories of childhood onset major depressive disorder (MDD) with and without comorbid anxiety and 2) to examine whether certain ER response clusters (Cognitive, Social, and Behavioral/Physical) characterize comorbid children and adolescents. We analyzed data on 217 youth (11-18 years old) with depression history: 85 subjects with lifetime anxiety comorbidity (comorbid group) and 132 without lifetime anxiety (non-comorbid group). Psychiatric diagnosis was established by a comprehensive (DSM) IV-based diagnostic procedure. ER strategies were examined the self-rated "Feelings and Me" Child version questionnaire (FAM-C). The comorbid group used maladaptive ER strategies significantly more frequently than the non-comorbid youngsters. The Behavioral/Physical and Social ER skills, especially those reflecting social withdrawal and self-harm, were responsible for the higher maladaptive scores. Because our study is a cross-sectional analysis, we have no information about the development or the onset of maladaptive ER strategies. Therefore, we were unable to examine whether maladaptive ER was a risk factor or a consequence of the internalizing psychopathology and comorbidity. Comorbid anxiety worsens the impaired use of ER strategies in depression-prone youths. Further longitudinal research is needed to explore the causal role of dysfunctional ER in the development of internalizing psychopathology.
抑郁症和焦虑症（青少年中两种最常见的内化性精神病理学问题）都与情绪调节困难有关。对于焦虑症作为一种共病情况是否会影响有抑郁病史的青少年对不同情绪调节策略的习惯性使用，我们知之甚少。我们的目标是：1）比较有儿童期起病的重度抑郁症（MDD）病史且伴有或不伴有共病焦虑症的青少年的情绪调节情况；2）研究某些情绪调节反应簇（认知、社交和行为/身体）是否是共病儿童和青少年的特征。我们分析了217名有抑郁病史的青少年（11 - 18岁）的数据：85名有终生焦虑共病的受试者（共病组）和132名无终生焦虑的受试者（非共病组）。通过基于全面的（DSM）IV诊断程序确定精神科诊断。使用自评的“感受与我”儿童版问卷（FAM - C）来检查情绪调节策略。共病组比非共病的青少年更频繁地使用适应不良的情绪调节策略。行为/身体和社交情绪调节技能，尤其是那些反映社交退缩和自我伤害的技能，导致了更高的适应不良得分。由于我们的研究是横断面分析，我们没有关于适应不良情绪调节策略的发展或起始的信息。因此，我们无法检查适应不良的情绪调节是内化性精神病理学和共病的危险因素还是后果。共病焦虑会使易患抑郁症的青少年对情绪调节策略的受损使用情况恶化。需要进一步的纵向研究来探索功能失调的情绪调节在内化性精神病理学发展中的因果作用。
