Piechaczek Charlotte Elisabeth, Pehl Verena, Feldmann Lisa, Haberstroh Stefan, Allgaier Antje-Kathrin, Freisleder Franz Joseph, Schulte-Körne Gerd, Greimel Ellen
1Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Waltherstr. 23, 80337 Munich, Germany.
2Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Pettenkoferstr. 8A, 80336 Munich, Germany.
Child Adolesc Psychiatry Ment Health. 2020 Feb 8;14:6. doi: 10.1186/s13034-020-0312-1. eCollection 2020.
Severe adverse life events, such as traumatic experiences, are well-known stressors implicated in (youth) major depression (MD). However, to date, far less is known about the role of more common psychosocial stressors in the context of MD, which are part of everyday life during youth. In addition, it is not well-understood whether and how distinct stressors interact with protective factors in youths diagnosed with MD. Thus, the present study aimed at examining several specific psychosocial stressors implicated in a first-episode juvenile MD and addressed the question whether protective factors might moderate the relationship between stressors and a diagnosis of MD.
One-hundred male and female youths with MD and 101 typically developing (TD) controls (10-18 years) were included. A large number of qualitatively different psychosocial stressors occurring in various areas of life were assessed via self-report. Moreover, we also investigated sociodemographic and pre- and postnatal stressors, as well as the presence of familial affective disorders via parental-report. Social support and a positive family climate were conceptualized as protective factors and were assessed via self-report.
Results showed that the proportion of youths experiencing specific psychosocial stressors was higher in the MD than in the TD group. In particular, the proportion of youths indicating changes at home or at school, experiences of violence, delinquent behavior, as well as the proportion of youths who were exposed to sociodemographic stressors was higher in the MD than in the TD group. Moreover, the percentage of youths with a family history of an affective disorder, or whose mothers experienced psychological burdens during/after pregnancy was elevated in the MD group. Youths with MD experienced less social support and a less positive family climate than their TD peers. These factors, however, did not buffer the influence of specific stressors on MD.
We could show that next to more severe adverse life events, more common psychosocial stressors are linked to youth MD. Importantly, by identifying distinct stressors in youth MD, our results can increase treatment and prevention efforts aiming to improve the outcomes in youths affected by MD or in at-risk individuals.
严重的不良生活事件，如创伤经历，是众所周知的与（青少年）重度抑郁症（MD）相关的应激源。然而，迄今为止，对于更常见的心理社会应激源在MD背景下的作用知之甚少，而这些应激源是青少年日常生活的一部分。此外，对于患有MD的青少年中不同的应激源是否以及如何与保护因素相互作用，人们还没有很好地理解。因此，本研究旨在探讨与首次发作的青少年MD相关的几种特定心理社会应激源，并解决保护因素是否可能缓和应激源与MD诊断之间关系的问题。
纳入了100名患有MD的青少年（年龄在10至18岁之间）和101名发育正常（TD）的对照青少年。通过自我报告评估了生活各个领域中大量性质不同的心理社会应激源。此外，我们还通过父母报告调查了社会人口统计学以及产前和产后应激源，以及家族情感障碍的存在情况。社会支持和积极的家庭氛围被概念化为保护因素，并通过自我报告进行评估。
结果显示，经历特定心理社会应激源的青少年比例在MD组中高于TD组。特别是，表明在家中或学校发生变化、暴力经历、违法行为的青少年比例，以及暴露于社会人口统计学应激源的青少年比例在MD组中高于TD组。此外，MD组中有情感障碍家族史的青少年比例，或其母亲在怀孕期间/产后经历心理负担的青少年比例有所升高。患有MD的青少年比其TD同龄人获得的社会支持更少，家庭氛围也不那么积极。然而，这些因素并没有缓冲特定应激源对MD的影响。
我们可以证明，除了更严重的不良生活事件外，更常见的心理社会应激源也与青少年MD有关。重要的是，通过识别青少年MD中的不同应激源，我们的结果可以加强治疗和预防工作，旨在改善受MD影响的青少年或高危个体的结局。
