VA San Diego Healthcare System, San Diego, California, USA.
Department of Psychiatry, University of California, San Diego, San Diego, California, USA.
Depress Anxiety. 2022 Oct;39(10-11):706-717. doi: 10.1002/da.23277. Epub 2022 Jul 14.
Recent studies in both human and experimental animals have identified fragmented and unpredictable parental and environmental signals as a novel source of early-life adversity. Early-life unpredictability may be a fundamental developmental factor that impacts brain development, including reward and emotional memory circuits, affecting the risk for psychopathology later in life. Here, we tested the hypothesis that self-reported early-life unpredictability is associated with psychiatric symptoms in adult clinical populations.
Using the newly validated Questionnaire of Unpredictability in Childhood, we assessed early-life unpredictability in 156 trauma-exposed adults, of which 65% sought treatment for mood, anxiety, and/or posttraumatic stress disorder (PTSD) symptoms. All participants completed symptom measures of PTSD, depression and anhedonia, anxiety, alcohol use, and chronic pain. Relative contributions of early-life unpredictability versus childhood trauma and associations with longitudinal outcomes over a 6-month period were determined.
Early-life unpredictability, independent of childhood trauma, was significantly associated with higher depression, anxiety symptoms, and anhedonia, and was related to higher overall symptom ratings across time. Early-life unpredictability was also associated with suicidal ideation, but not alcohol use or pain symptoms.
Early-life unpredictability is an independent and consistent predictor of specific adult psychiatric symptoms, providing impetus for studying mechanisms of its effects on the developing brain that promote risk for psychopathology.
最近在人类和实验动物中的研究表明，碎片化和不可预测的父母和环境信号是早期生活逆境的一个新来源。早期生活的不可预测性可能是一个基本的发育因素，它会影响大脑发育，包括奖励和情绪记忆回路，从而增加日后患精神病理学的风险。在这里，我们测试了这样一个假设，即自我报告的早期生活不可预测性与成年临床人群的精神症状有关。
我们使用新验证的《儿童不可预测性问卷》评估了 156 名经历过创伤的成年人的早期生活不可预测性，其中 65%的人因情绪、焦虑和/或创伤后应激障碍（PTSD）症状寻求治疗。所有参与者都完成了 PTSD、抑郁和快感缺失、焦虑、酒精使用和慢性疼痛的症状测量。确定了早期生活不可预测性与童年创伤的相对贡献以及与 6 个月期间纵向结果的关联。
早期生活不可预测性，独立于童年创伤，与更高的抑郁、焦虑症状和快感缺失显著相关，并与随时间推移的更高的总体症状评分相关。早期生活不可预测性也与自杀意念有关，但与酒精使用或疼痛症状无关。
早期生活不可预测性是特定成年精神症状的独立且一致的预测因子，这为研究其对发育中大脑的影响机制提供了动力，这些机制促进了精神病理学的风险。
