Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
J Affect Disord. 2022 Oct 15;315:17-26. doi: 10.1016/j.jad.2022.07.042. Epub 2022 Jul 23.
Different types of childhood maltreatment (CM) are key risk factors for psychopathology. Specifically, there is evidence for a unique role of emotional abuse in affective psychopathology in children and youth; however, its predictive power for depressive symptomatology in adulthood is still unknown. Additionally, emotional abuse encompasses several facets, but the strength of their individual contribution to depressive affect has not been examined.
Here, we used a machine learning (ML) approach based on Random Forests to assess the performance of domain scores and individual items from the Childhood Trauma Questionnaire (CTQ) in predicting self-reported levels of depressive affect in an adult general population sample. Models were generated in a training sample (N = 769) and validated in an independent test sample (N = 466). Using state-of-the-art methods from interpretable ML, we identified the most predictive domains and facets of CM for adult depressive affect.
Models based on individual CM items explained more variance in the independent test sample than models based on CM domain scores (R = 7.6 % vs. 6.4 %). Emotional abuse, particularly its more subjective components such as reactions to and appraisal of the abuse, emerged as the strongest predictors of adult depressive affect.
Assessment of CM was retrospective and lacked information on timing and duration. Moreover, reported rates of CM and depressive affect were comparatively low.
Our findings corroborate the strong role of subjective experience in CM-related psychopathology across the lifespan that necessitates greater attention in research, policy, and clinical practice.
不同类型的儿童期虐待(CM)是精神病理学的关键风险因素。具体而言,有证据表明情绪虐待在儿童和青少年的情感精神病理学中具有独特作用;然而,其对成年期抑郁症状的预测能力尚不清楚。此外,情绪虐待包含几个方面,但它们对抑郁影响的个体贡献的强度尚未得到检验。
在这里,我们使用基于随机森林的机器学习(ML)方法来评估童年创伤问卷(CTQ)的领域评分和个体项目在预测成年普通人群样本中自我报告的抑郁影响水平方面的表现。模型在训练样本(N=769)中生成,并在独立测试样本(N=466)中进行验证。使用来自可解释性 ML 的最先进方法,我们确定了 CM 对成年抑郁影响最具预测性的领域和方面。
基于个体 CM 项目的模型比基于 CM 领域评分的模型在独立测试样本中解释了更多的方差(R=7.6%对 6.4%)。情绪虐待,特别是其更主观的成分,如对虐待的反应和评估,是成年抑郁影响的最强预测因素。
CM 的评估是回顾性的,缺乏关于时间和持续时间的信息。此外,报告的 CM 和抑郁发生率相对较低。
我们的研究结果证实了主观体验在 CM 相关精神病理学中的重要作用,这在研究、政策和临床实践中需要给予更多关注。