Turk Psikiyatri Derg. 2021 Spring;32(1):8-16. doi: 10.5080/u23415.
Cognitive development is susceptible to environmental distress, leading to cognitive distortions. Cognitive distortions may affect clinical course of psychiatric disorders. We aimed to assess whether childhood maltreatment and emotion dysregulation impair automatic thoughts (ATs) and meta-cognitions (MCs) in Bipolar Disorder (BD) and Major Depressive Disorder - Recurrent (MDB-RE) in this study.
85 patients with BD, 81 MDD-RE in remission and 86 healthy participants were enrolled. Automatic Thoughts Scale (ATS), Metacognition Questionnaire (MCQ-30), Childhood Trauma Questionnaire (CTQ- 28), Difficulties in Emotion Regulation Strategies Scale (DERS) were the measures used.
ATs were determined by CTQ physical abuse (β=0.34, p<0.01), DERS goals (β=-0.37, p<0.01), impulse (β=0.53, p<0.01) and non-accept (β=0.23, p<0.05) subscales in BD (F=21.08, p<0.01) and CTQ emotional neglect (β=0.22, p<0.05), DERS strategies (β=0.39, p<0.05) in MDD-RE (F=9.97, p<0.05). MCs were predicted by sexual abuse (β=0.46, p<0.01) in BD (F=4.88, p<0.01), and emotional abuse (B=-0.30, p<0.05) in MDD-RE (F= 7.02, p<0.01).
These results suggest that emotion dysregulation and childhood adversities are associated with cognitive processes such as MCs and ATs in MDD-RE and BD. Cognitive processes can cause various clinical manifestations and emotion dysregulation and childhood traumas should be considered as psychopathological components that can affect the course of mood disorders via various components. Further follow-up studies and larger samples are needed to better understand the effects of these components.
认知发展易受环境压力影响，导致认知扭曲。认知扭曲可能会影响精神疾病的临床病程。本研究旨在评估儿童期虐待和情绪失调是否会损害双相情感障碍（BD）和复发性重度抑郁障碍（MDB-RE）患者的自动思维（ATs）和元认知（MCs）。
共纳入 85 例 BD 患者、81 例缓解期 MDD-RE 患者和 86 名健康对照者。采用自动思维量表（ATS）、元认知问卷（MCQ-30）、儿童期创伤问卷（CTQ-28）、情绪调节困难量表（DERS）进行评估。
BD 患者的 ATs 由 CTQ 躯体虐待（β=0.34，p<0.01）、DERS 目标（β=-0.37，p<0.01）、冲动（β=0.53，p<0.01）和非接受（β=0.23，p<0.05）分量表以及 CTQ 情感忽视（β=0.22，p<0.05）、DERS 策略（β=0.39，p<0.05）预测（F=21.08，p<0.01）；MDD-RE 患者的 MCs 由性虐待（β=0.46，p<0.01）预测（F=4.88，p<0.01），以及情绪虐待（β=-0.30，p<0.05）预测（F=7.02，p<0.01）。
这些结果表明，情绪失调和儿童期逆境与 MDD-RE 和 BD 中的 MCs 和 ATs 等认知过程有关。认知过程可导致各种临床表现，情绪失调和儿童期创伤应被视为可能通过各种成分影响心境障碍病程的精神病理学成分。需要进一步的随访研究和更大的样本量来更好地理解这些成分的影响。
