Nomura Yoko, Ham Jacob, Pehme Patricia M, Wong Waiman, Pritchett Lexi, Rabinowitz Sima, Foldi Nancy S, Hinton Veronica J, Wickramaratne Priya J, Hurd Yasmin L
Department of Psychology, CUNY Queens College and Graduate Center, Flushing, New York, USA; and Icahn School of Medicine at Mount Sinai, New York, USA.
Icahn School of Medicine at Mount Sinai, New York, USA.
BJPsych Open. 2023 May 26;9(3):e94. doi: 10.1192/bjo.2022.595.
Early-life adverse experiences can elevate the magnitude of the risk of developmental psychopathology, but the potential synergistic effects of multiple factors have not been well studied.
To determine whether prenatal exposures to maternal stress (Superstorm Sandy) and maternal cannabis use synergistically alter the risk of developmental psychopathology.
The study included 163 children (53.4% girls), longitudinally tracked (ages 2-5 years) in relation to the effects of two early-life adverse exposures (Superstorm Sandy and maternal cannabis use). Offspring were grouped by exposure status (neither, only maternal cannabis use, only Superstorm Sandy or both). DSM-IV disorders for offspring were derived from structured clinical interviews; caregiver-reported ratings of family stress and social support were also assessed.
A total of 40.5% had been exposed to Superstorm Sandy and 24.5% to maternal cannabis use. Offspring exposed to both ( = 13, 8.0%), relative to those exposed to neither, had a 31-fold increased risk of disruptive behavioural disorders (DBDs) and a seven-fold increased risk of anxiety disorders. The synergy index demonstrated that offspring with two exposures had synergistic elevation in risk of DBDs (synergy index, 2.06, = 0.03) and anxiety disorders (synergy index, 2.60, = 0.004), compared with the sum of single risks. Offspring with two exposures had the highest parenting stress and lowest social support.
Our findings are consistent with the double-hit model suggesting that offspring with multiple early-life adverse exposures (Superstorm Sandy and maternal cannabis use) have synergistically increased risks of mental health problems. Given the increasing frequency of major natural disasters and cannabis use, especially among women under stress, these findings have significant public health implications.
早年的不良经历会增加发展性精神病理学风险的程度，但多种因素的潜在协同效应尚未得到充分研究。
确定产前暴露于母亲压力（超级风暴桑迪）和母亲使用大麻是否会协同改变发展性精神病理学的风险。
该研究纳入了163名儿童（53.4%为女孩），对其进行纵向跟踪（年龄2至5岁），以研究两种早年不良暴露（超级风暴桑迪和母亲使用大麻）的影响。后代根据暴露状况分组（均未暴露、仅母亲使用大麻、仅暴露于超级风暴桑迪或两者都暴露）。后代的《精神疾病诊断与统计手册》第四版（DSM-IV）障碍由结构化临床访谈得出；还评估了照顾者报告的家庭压力和社会支持评分。
共有40.5%的儿童暴露于超级风暴桑迪，24.5%的儿童暴露于母亲使用大麻。与未暴露于任何一种情况的儿童相比，同时暴露于两者的后代（n = 13，8.0%）出现破坏性行为障碍（DBDs）的风险增加了31倍，出现焦虑障碍的风险增加了7倍。协同指数表明，与单一风险之和相比，同时暴露于两种情况的后代在DBDs风险（协同指数，2.06，P = 0.03）和焦虑障碍风险（协同指数，2.60，P = 0.004）方面有协同性升高。同时暴露于两种情况的后代育儿压力最高，社会支持最低。
我们的研究结果与双重打击模型一致，表明有多种早年不良暴露（超级风暴桑迪和母亲使用大麻）的后代出现心理健康问题的风险协同增加。鉴于重大自然灾害和大麻使用的频率不断增加，尤其是在处于压力下的女性中，这些发现具有重大的公共卫生意义。
