Brown Amy, Bennet Joanna, Rapee Ronald M, Hirshfeld-Becker Dina R, Bayer Jordana K
School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
Centre for Emotional Health, Macquarie University, Sydney, Australia.
BMC Pediatr. 2020 May 29;20(1):264. doi: 10.1186/s12887-020-02159-w.
This study explored whether temperamentally inhibited children who experience early trauma are vulnerable to developing internalizing problems in the face of later life-stressors.
A validated screen for temperamental inhibition was distributed to parents of young children attending preschools in six government regions of Melbourne, Australia. Screening identified 11% of children as inhibited (703 of 6347 screened) and eligible for a prevention study. Participants were 545 parents of inhibited preschoolers (78% uptake), of whom 84% were followed into mid childhood (age 7-10 years: wave 1, n = 446; wave 2, n = 427; wave 3, n = 426). Parents and children then completed questionnaires for child internalizing (anxious and depressive) symptoms, and parents received a diagnostic interview for child anxiety disorder. In mid-childhood parents also completed questionnaires annually to describe recent life-stressors experienced by their child, and any potentially traumatic events in the first four years of life.
Only one in 14 temperamentally inhibited children had experienced a potentially traumatic event in early childhood. In mid childhood 56% experienced recent life-stressors. Inhibited children who had early life trauma experienced slightly more anxiety disorder and symptoms in mid childhood. Those children with more recent life-stressors in mid childhood also had slightly more symptoms of anxiety and depression. In contrast to stress sensitization, inhibited children with early trauma plus recent stressors did not show especially high mid-childhood internalizing difficulties.
Early life trauma and recent life-stressors each convey a small risk for children with an inhibited temperament to develop internalizing problems. Nevertheless, early life stress may not always result in negative sensitization for children in the general population.
本研究探讨了经历早期创伤的气质性抑制儿童在面对后期生活压力源时是否易出现内化问题。
对澳大利亚墨尔本六个政府辖区内就读幼儿园的幼儿家长发放经过验证的气质性抑制筛查问卷。筛查确定11%的儿童为抑制型（6347名接受筛查儿童中的703名），有资格参与一项预防研究。参与者为545名抑制型学龄前儿童的家长（参与率78%），其中84%的儿童被追踪至童年中期（7至10岁：第1波，n = 446；第2波，n = 427；第3波，n = 426）。家长和儿童随后完成关于儿童内化（焦虑和抑郁）症状的问卷，家长还接受了儿童焦虑症的诊断访谈。在童年中期，家长每年还需完成问卷，描述其孩子近期经历的生活压力源，以及孩子生命头四年内任何潜在的创伤性事件。
在气质性抑制儿童中，每14名儿童中只有1名在幼儿期经历过潜在的创伤性事件。在童年中期，56%的儿童经历过近期生活压力源。童年早期有创伤经历的抑制型儿童在童年中期出现焦虑症和症状的情况略多。童年中期有更多近期生活压力源的儿童，其焦虑和抑郁症状也略多。与应激敏感化相反，童年早期有创伤且近期有压力源的抑制型儿童在童年中期并未表现出特别高的内化困难。
早期生活创伤和近期生活压力源分别使气质性抑制儿童出现内化问题的风险略有增加。然而，早期生活压力未必总会导致一般人群中的儿童出现负面敏感化。
