Department of Psychiatry, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA.
Neuroscience Training Program, University of Wisconsin, Madison, WI, USA.
Psychol Med. 2022 Jul;52(10):1883-1891. doi: 10.1017/S0033291720003712. Epub 2020 Nov 9.
Childhood exposure to interpersonal violence (IPV) may be linked to distinct manifestations of mental illness, yet the nature of this change remains poorly understood. Network analysis can provide unique insights by contrasting the interrelatedness of symptoms underlying psychopathology across exposed and non-exposed youth, with potential clinical implications for a treatment-resistant population. We anticipated marked differences in symptom associations among IPV-exposed youth, particularly in terms of 'hub' symptoms holding outsized influence over the network, as well as formation and influence of communities of highly interconnected symptoms.
Participants from a population-representative sample of youth ( = 4433; ages 11-18 years) completed a comprehensive structured clinical interview assessing mental health symptoms, diagnostic status, and history of violence exposure. Network analytic methods were used to model the pattern of associations between symptoms, quantify differences across diagnosed youth with (IPV+) and without (IPV-) IPV exposure, and identify transdiagnostic 'bridge' symptoms linking multiple disorders.
Symptoms organized into six 'disorder' communities (e.g. ), that exhibited considerably greater interconnectivity in IPV+ youth. Five symptoms emerged in IPV+ youth as highly trafficked 'bridges' between symptom communities (11 in IPV- youth).
IPV exposure may alter mutually reinforcing symptom co-occurrence in youth, thus contributing to greater psychiatric comorbidity and treatment resistance. The presence of a condensed and unique set of bridge symptoms suggests trauma-enriched nodes which could be therapeutically targeted to improve outcomes in violence-exposed youth.
儿童时期遭受人际暴力(IPV)可能与精神疾病的不同表现形式有关,但这种变化的性质仍知之甚少。网络分析可以通过对比暴露和非暴露青少年精神病理学潜在症状的相关性,为治疗抵抗人群提供潜在的临床意义,从而提供独特的见解。我们预计 IPV 暴露青少年的症状关联会有明显差异,特别是在“枢纽”症状对网络的影响过大,以及高度相互关联的症状社区的形成和影响方面。
来自具有代表性的青少年人群样本(= 4433;年龄 11-18 岁)的参与者完成了一项全面的结构化临床访谈,评估心理健康症状、诊断状况和暴力暴露史。网络分析方法用于模拟症状之间的关联模式,量化具有(IPV+)和不具有(IPV-)IPV 暴露的诊断青少年之间的差异,并识别连接多种疾病的跨诊断“桥梁”症状。
症状组织成六个“疾病”社区(例如),在 IPV+ 青少年中表现出更高的相互连接性。五个症状在 IPV+ 青少年中作为高度繁忙的“桥梁”出现在症状社区之间(在 IPV- 青少年中出现 11 个)。
IPV 暴露可能会改变青少年中相互增强的症状共同发生,从而导致更多的精神共病和治疗抵抗。存在一组浓缩且独特的桥梁症状表明,受创伤影响的节点可以作为治疗目标,以改善创伤暴露青少年的预后。