Departments of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada; Homewood Research Institute, Guelph, ON, Canada.
Homewood Research Institute, Guelph, ON, Canada; Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Child Abuse Negl. 2022 Jan;123:105394. doi: 10.1016/j.chiabu.2021.105394. Epub 2021 Nov 19.
Adverse Childhood Experiences (ACEs) increase risk for negative mental health outcomes in adulthood; however, the mechanisms through which ACEs exert their influence on adult mental health are poorly understood. This is particularly true for Public Safety Personnel (PSP; e.g., police, firefighters, paramedics, etc.), a group with unique vulnerability to negative psychiatric sequalae given their chronic exposure to potentially traumatic, work-related events.
To examine the role of moral injury (MI) and emotion regulation in the relation between ACEs and adult mental health symptoms in adulthood.
Participants (N = 294) included a community sample of Canadian and American PSP members aged 22 to 65.
The current study uses cross-sectional data collection via retrospective self-report questionnaires administered between November, 2018 and November, 2019 to assess level of ACEs (ACE-Q), emotion regulation difficulties (DERS) and symptoms of post-traumatic stress (PCL-5), dissociation (MDI), depression, stress, and anxiety (DASS-21). Additionally, participants completed the Moral Injury Assessment for Public Safety Personnel, the first measure of MI developed specifically for PSP.
Path analysis revealed that ACEs significantly predicted adverse mental health symptoms in adulthood; this effect was mediated by symptoms of MI and moderated by difficulties with emotion regulation.
This study is the first to identify MI as a mechanism involved in the relation between ACEs and adult psychopathology and highlights the protective role of emotion regulation skills. These findings can inform the development of future research and clinical interventions in PSP populations.
童年逆境经历（ACEs）会增加成年人心理健康不良的风险；然而，ACEs 对成年人心理健康产生影响的机制仍知之甚少。对于公共安全人员（PSP；例如警察、消防员、护理人员等）来说尤其如此，由于他们长期接触潜在的创伤性、与工作相关的事件，他们对负面精神后遗症具有独特的易感性。
探讨道德伤害（MI）和情绪调节在 ACEs 与成年人心理健康症状之间的关系中的作用。
参与者（N=294）包括年龄在 22 岁至 65 岁之间的加拿大和美国 PSP 成员的社区样本。
本研究使用横断面数据收集，通过 2018 年 11 月至 2019 年 11 月之间进行的回顾性自我报告问卷调查，评估 ACEs（ACE-Q）、情绪调节困难（DERS）和创伤后应激（PCL-5）、分离（MDI）、抑郁、压力和焦虑（DASS-21）的症状。此外，参与者完成了公共安全人员道德伤害评估，这是专为 PSP 开发的第一个 MI 测量工具。
路径分析显示，ACEs 显著预测了成年人的不良心理健康症状；这种影响是通过 MI 症状介导的，并且受到情绪调节困难的调节。
这项研究首次确定 MI 是 ACEs 与成年人心理病理学之间关系的一个机制，并强调了情绪调节技能的保护作用。这些发现可以为 PSP 人群的未来研究和临床干预提供信息。
