人际创伤及其与儿童精神病态特征的关系：ADHD 和 ODD 对此有何影响？
Interpersonal trauma and its relation to childhood psychopathic traits: what does ADHD and ODD add to the equation?
机构信息
Institute of Health and WellbeingUniversity of Glasgow, Glasgow, UK.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
出版信息
BMC Psychiatry. 2021 Dec 18;21(1):630. doi: 10.1186/s12888-021-03610-7.
BACKGROUND
Childhood trauma has demonstrated associations with callous-unemotional traits (e.g., reflecting lack of remorse and guilt, unconcern about own performance). Less is known about associations between trauma and multiple domains of child psychopathic traits. There has also been limited focus on the role of co-occurring disorders to psychopathy traits among children, namely, attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) and how they interact with childhood trauma.
METHODS
We examined to what degree childhood interpersonal trauma can predict parent-rated psychopathic traits in a large population based Swedish twin sample (N = 5057), using a stringent definition of interpersonal trauma occurring before age 10. Two hundred and fifty-one participants met the interpersonal trauma criteria for analysis. The study explored the additional impact of traits of attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD).
RESULTS
Linear regressions demonstrated statistically significant but clinically negligible effects of interpersonal trauma on total and subscale scores of parent-rated psychopathic traits. When exploring interaction effects of ADHD and ODD into the model, the effect increased. There were interaction effects between ODD and trauma in relation to psychopathic traits, suggesting a moderating role of ODD. Having been exposed to trauma before age 10 was significantly associated with higher parent rated psychopathy traits as measured by The Child Problematic Traits Inventory-Short Version (CPTI-SV), however the explained variance was small (0.3-0.9%).
CONCLUSIONS
The results challenge the notion of association between interpersonal trauma and youth psychopathic traits. They also highlight the need to gain an improved understanding of overlap between psychopathic traits, ADHD and ODD for clinical screening purposes and the underlying developmental mechanisms.
背景
童年创伤与无情无义特征（例如，反映缺乏悔恨和内疚、不关心自己的表现）有关。人们对创伤与儿童多种精神病特征领域之间的关联了解较少。对于同时发生的疾病对儿童精神病特征的作用，即注意力缺陷多动障碍（ADHD）和对立违抗性障碍（ODD），以及它们如何与童年创伤相互作用，关注也很有限。
方法
我们使用严格的 10 岁前发生的人际创伤定义，在一个大型瑞典双胞胎样本（N=5057）中，检查童年人际创伤在多大程度上可以预测父母评定的精神病特征。251 名参与者符合人际创伤分析标准。该研究探讨了注意力缺陷多动障碍（ADHD）和对立违抗性障碍（ODD）特征的额外影响。
结果
线性回归表明，人际创伤对父母评定的精神病特征的总分和子量表得分具有统计学上显著但临床上微不足道的影响。当探索 ADHD 和 ODD 对模型的交互效应时，影响增加了。在与精神病特征相关的 ODD 和创伤之间存在交互效应，表明 ODD 起调节作用。10 岁前经历过创伤与父母评定的精神病特征较高（通过儿童问题特征量表-短版（CPTI-SV）测量）显著相关，然而，解释方差较小（0.3-0.9%）。
结论
结果挑战了人际创伤与青年精神病特征之间存在关联的观点。它们还强调了需要更好地理解精神病特征、ADHD 和 ODD 之间的重叠，以便进行临床筛查，并了解潜在的发展机制。
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