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儿童期虐待与青少年和成年期重性抑郁障碍的临床特征。

Childhood maltreatment and the clinical characteristics of major depressive disorder in adolescence and adulthood.

机构信息

Department of Psychology.

Department of Psychiatry.

出版信息

J Abnorm Psychol. 2020 Jul;129(5):469-479. doi: 10.1037/abn0000521. Epub 2020 Apr 2.

Abstract

Childhood maltreatment is widely implicated as the strongest developmental risk factor for depression onset. The current research is novel in examining the fine-grained associations of childhood emotional versus physical versus sexual maltreatment to indices of the severity, course, and presence of anxiety and trauma-related psychopathology in depression. An amalgamation across 6 previous investigations resulted in a sample of 575 adolescents and adults (76% female; age range 12-70, = 27.88, = 13.58). All participants were in a current episode of a unipolar depressive disorder. Retrospective reports of childhood maltreatment were assessed using a rigorous contextual interview with independent, standardized ratings. Higher levels of emotional maltreatment and/or sexual maltreatment emerged as significantly associated with greater depression severity, number of previous episodes, and risk for posttraumatic stress disorder (PTSD), and were significantly more strongly associated with these characteristics than was physical maltreatment. Further, emotional maltreatment perpetrated by mothers was significantly associated with depression severity and history, whereas emotional maltreatment perpetrated by fathers was significantly associated with a greater risk of PTSD. These latter results suggest that prevention and intervention efforts may need to focus on the unique roles of mothers versus fathers on the development of depressive- versus threat-related psychopathology, respectively. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

摘要

儿童虐待被广泛认为是抑郁发作的最强发展风险因素。目前的研究新颖之处在于,检查了儿童期情绪虐待、身体虐待和性虐待与抑郁严重程度、病程和焦虑及创伤相关精神病理学的存在的细粒度关联。6 项先前研究的综合结果产生了 575 名青少年和成年人的样本(76%为女性;年龄范围为 12-70 岁, = 27.88, = 13.58)。所有参与者均处于单相抑郁障碍的当前发作期。使用严格的情境访谈对儿童期虐待的回顾性报告进行评估,并进行独立的标准化评估。较高水平的情绪虐待和/或性虐待与更严重的抑郁严重程度、更多的既往发作次数和创伤后应激障碍(PTSD)风险显著相关,与这些特征的相关性明显强于身体虐待。此外,母亲实施的情绪虐待与抑郁严重程度和病史显著相关,而父亲实施的情绪虐待与 PTSD 风险增加显著相关。这些结果表明,预防和干预措施可能需要分别关注母亲和父亲在抑郁相关和威胁相关精神病理学发展中的独特作用。(PsycInfo 数据库记录(c)2020 APA,保留所有权利)。

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