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创伤后应激障碍和情感症状在具有童年创伤亚型的大样本中的共病:网络分析。

Co-occurrence of PTSD and affective symptoms in a large sample with childhood trauma subtypes: A network analysis.

机构信息

College of Education for the Future, Beijing Normal University, Beijing, China.

Northeast Asian Research Center, Jilin University, Changchun, China.

出版信息

Front Public Health. 2023 Mar 7;11:1093687. doi: 10.3389/fpubh.2023.1093687. eCollection 2023.

Abstract

BACKGROUND

Exposure to childhood trauma (CT) is associated with various deleterious mental health outcomes, increasing the risk of suicidal behaviors. The objective of this study is to investigate the different effects of three forms of CT, including emotional abuse (EA), physical abuse (PA), and sexual abuse (SA), on potential psychopathological symptoms among college students.

METHODS

A total of 117,769 students from 63 Chinese colleges participated in this study. There were 1,191 participants in the EA group (1.24%; 95% CI: 1.17-1.31%), 1,272 participants in the PA group (1.32%; 95% CI: 1.25-1.40%), and 3,479 participants in the SA group (3.62%; 95% CI: 3.50-3.73%). CT was measured by the Childhood Trauma Questionnaire-Short Form. Psychopathological symptoms (i.e., depression, anxiety, and PTSD) were measured by the PHQ-9, GAD-7, and Trauma Screening Questionnaire, respectively. Network analysis was applied to analyze psychopathological symptoms between three CT subgroups (EA, PA, and SA). The associations and centralities of the networks were calculated, and the network characteristics of the three subgroups were contrasted.

RESULTS

The main symptoms across all three groups are uncontrollable worry, sad mood, irritability, and fatigue, which indicates these core symptoms play essential roles in maintaining the whole psychological symptoms network. Furthermore, there are significant differences in symptom associations between the three groups. The comparison of network structures of the three groups shows that the SA group reports more PTSD symptoms, the EA group reports more suicide-related symptoms, and the PA group reports more anxiety symptoms.

CONCLUSION

Specific symptoms were disclosed across each group by the distinctive core psychopathological symptoms found in the CT subgroup networks. The present study's findings show different associations between CT and psychopathology and may help classify potential diagnostic processes. Therefore, local governments and academic institutions are recommended for early intervention to promote the psychological well-being of CT survivors.

摘要

背景

儿童期创伤(CT)暴露与各种不良心理健康结果相关,增加了自杀行为的风险。本研究旨在探讨三种 CT 形式,包括情感虐待(EA)、身体虐待(PA)和性虐待(SA),对大学生潜在心理病理症状的不同影响。

方法

共有来自中国 63 所高校的 117769 名学生参与了这项研究。EA 组有 1191 名参与者(1.24%;95%置信区间:1.17-1.31%),PA 组有 1272 名参与者(1.32%;95%置信区间:1.25-1.40%),SA 组有 3479 名参与者(3.62%;95%置信区间:3.50-3.73%)。CT 采用儿童创伤问卷-短式量表进行测量。心理病理症状(即抑郁、焦虑和 PTSD)分别采用 PHQ-9、GAD-7 和创伤筛查问卷进行测量。采用网络分析分析三组 CT(EA、PA 和 SA)之间的心理病理症状。计算网络的关联和中心性,并对比三组的网络特征。

结果

三组的主要症状都是无法控制的担忧、悲伤情绪、烦躁和疲劳,这表明这些核心症状在维持整个心理症状网络中起着重要作用。此外,三组之间的症状关联存在显著差异。三组网络结构的比较表明,SA 组报告的 PTSD 症状更多,EA 组报告的与自杀相关的症状更多,PA 组报告的焦虑症状更多。

结论

通过 CT 亚组网络中发现的独特核心心理病理症状,揭示了每个组的特定症状。本研究的结果表明 CT 与精神病理学之间存在不同的关联,这可能有助于对潜在的诊断过程进行分类。因此,建议地方政府和学术机构进行早期干预,以促进 CT 幸存者的心理健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f18/10028141/ae3057296276/fpubh-11-1093687-g0001.jpg

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