Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA.
University of Maryland Baltimore County, Department of Psychology and University of California Irvine, Department of Psychology.
Br J Psychiatry. 2023 Jul;223(1):273-279. doi: 10.1192/bjp.2022.185.
Evidence suggests that both childhood trauma and perceived stress are risk factors for the development of psychosis, as well as negative symptoms such as anhedonia. Previous findings link increases in perceived stress to anhedonia in individuals at clinical high risk for psychosis (CHR) and depression; however, the role of childhood trauma in this relationship has not yet been explored, despite consistent evidence that it is associated with sensitisation to later stress.
To examine whether perceived stress mediates the relationship between childhood trauma and anhedonia in a group of youth at CHR as well as in controls (groups with depression and with no diagnosed mental health concerns).
The study used multigroup mediation to examine the indirect effects of childhood trauma on anhedonia via perceived stress in CHR ( = 117) and depression groups ( = 284) and non-psychiatric controls ( = 124).
Perceived stress mediated the relationship between childhood trauma and consummatory anhedonia regardless of group status. Perceived stress mediated the relationship between childhood trauma and anticipatory anhedonia for the CHR and depression groups, but not for non-psychiatric controls. Further, groups differed in the magnitude of this relationship, with the effects trending towards stronger for those in the CHR group.
Our findings suggest a potential transdiagnostic pathway through which childhood trauma contributes to anhedonia across severe mental illness.
有证据表明，童年创伤和感知压力都是精神分裂症发展的风险因素，也是快感缺失等阴性症状的风险因素。先前的研究结果表明，感知压力的增加与精神病高危个体（CHR）和抑郁症患者的快感缺失有关；然而，尽管有一致的证据表明它与对后期压力的敏感有关，但童年创伤在这种关系中的作用尚未得到探索。
在 CHR 组以及对照组（抑郁症组和无诊断性心理健康问题组）中，研究感知压力是否在童年创伤与快感缺失之间起中介作用。
该研究采用多组中介分析，以检验 CHR（n = 117）和抑郁症组（n = 284）以及非精神病对照组（n = 124）中，童年创伤对快感缺失的间接影响是否通过感知压力。
无论组间状态如何，感知压力都中介了童年创伤与 consummatory 快感缺失之间的关系。感知压力中介了 CHR 和抑郁症组中童年创伤与预期快感缺失之间的关系，但在非精神病对照组中没有。此外，各组之间的这种关系存在差异，CHR 组的效应趋势更强。
我们的研究结果表明，童年创伤可能是一种跨诊断途径，通过该途径导致严重精神疾病患者出现快感缺失。
