Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.
Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
Child Abuse Negl. 2020 Sep;107:104534. doi: 10.1016/j.chiabu.2020.104534. Epub 2020 Jun 17.
Current interventions for adverse childhood experiences have only limited effectiveness.
We sought to identify optimal targets for the development of new interventions against adverse childhood experiences (ACE), that is, ACEs that a) are so central in the network of childhood adversity that curbing them is likely to impact other types of adversity, too, and b) are so central to the link of childhood adversity and adult mental ill-health that curbing them is likely to prevent this negative long-term effect from developing.
384 adult psychiatric inpatients.
Using the R packages qgraph and IsingFit, we analyzed the ACE network and the common network of ACEs and adult mental disorders.
We found two clusters of ACEs: direct interactions with the child and indirect traumatization via adverse circumstances. When controlling for interrelatedness, the associations of sexual abuse with posttraumatic stress disorder and borderline personality disorder were the only direct links between ACEs and adult mental disorders.
As neglect and violence against the mother were the most influential ACEs, curbing them is likely to destabilize the whole network of adversity. Thus, neglect and violence against the mother lend themselves as candidate targets for the development of new interventions. As sexual abuse was the only link between childhood adversity and adult mental ill-health, interventions against it seem most likely to keep this negative long-term effect from developing. Further, ideally prospective, research is needed to corroborate these findings.
目前针对不良童年经历的干预措施效果有限。
我们试图确定新的干预不良童年经历（ACE）的最佳目标，即：a）在儿童逆境网络中处于核心地位，抑制它们可能会对其他类型的逆境产生影响；b）在儿童逆境与成人心理健康不良的联系中处于核心地位，抑制它们可能会防止这种负面的长期影响的发展。
384 名成年精神科住院患者。
使用 R 包 qgraph 和 IsingFit，我们分析了 ACE 网络和 ACEs 与成人精神障碍的共同网络。
我们发现了两个 ACE 集群：与儿童的直接互动和通过不利环境的间接创伤。在控制相互关系的情况下，性虐待与创伤后应激障碍和边缘型人格障碍之间的关联是 ACEs 与成人精神障碍之间唯一的直接联系。
由于忽视和对母亲的暴力行为是最有影响力的 ACEs，抑制它们可能会破坏整个逆境网络的稳定。因此，忽视和对母亲的暴力行为适合作为开发新干预措施的候选目标。由于性虐待是儿童逆境与成人心理健康不良之间唯一的联系，因此针对它的干预措施似乎最有可能防止这种负面的长期影响的发展。此外，需要进行前瞻性研究来验证这些发现。
