Wang Weiliang, Zhang Jun, Zheng Xinzhu, Li Guohua, Zhou Yuqiu
School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China.
School of Nursing, Harbin Medical University, Harbin, Heilongjiang, China.
Front Psychiatry. 2023 May 15;14:1082000. doi: 10.3389/fpsyt.2023.1082000. eCollection 2023.
As a group with a high incidence of childhood trauma, the differential characteristics of resilience in schizophrenia and its relationship with childhood trauma are still unclear.
A total of 626 individuals diagnosed with schizophrenia were selected from four psychiatric hospitals in northern China. Childhood trauma and resilience were measured using the Childhood Trauma Questionnaire-short form (CTQ-SF) and Connor-Davidson Resilience Scale (CD-RISC), respectively. Latent profile analysis (LPA) was used to identify the potential classes of resilience. A generalized additive mixed model (GAMM) and restricted cubic spline (RCS) was used to explore and determine the shape of the relationship between childhood trauma and resilience.
Model fits of LPA showed three heterogeneous classes of resilience: moderate resilience levels ( = 312; 49.06%); high resilience levels ( = 171; 26.89%) and low resilience levels ( = 153; 24.06%). Resilience scores fluctuated depending on amount of exposure to childhood trauma. The GAMM results verified the non-linear relationship between resilience and childhood trauma, with an estimated degree of freedom higher than 1 (4.573) and = 0.003. RCS fitted for ordinary least square (OLS) regression models determined a smooth continuous cubic curve of resilience across childhood trauma levels, and the two turning points of the curve line were 41.04 and 54.74 for childhood trauma.
Our findings confirm the people-specific differences in the level of resilience in schizophrenia and describe the cubic curvilinear relationship between childhood trauma and resilience, which provides data support for mechanistic research and intervention in related fields.
作为童年创伤高发群体，精神分裂症患者心理韧性的差异特征及其与童年创伤的关系尚不清楚。
从中国北方四家精神病医院选取626例精神分裂症患者。分别采用儿童创伤问卷简版（CTQ-SF）和康纳-戴维森心理韧性量表（CD-RISC）测量童年创伤和心理韧性。采用潜在剖面分析（LPA）确定心理韧性的潜在类别。采用广义相加混合模型（GAMM）和受限立方样条（RCS）探讨并确定童年创伤与心理韧性之间关系的形状。
LPA模型拟合显示出三类不同的心理韧性：中等心理韧性水平（n = 312；49.06%）；高心理韧性水平（n = 171；26.89%）和低心理韧性水平（n = 153；24.06%）。心理韧性得分随童年创伤暴露量而波动。GAMM结果证实了心理韧性与童年创伤之间的非线性关系，估计自由度大于1（4.573），P = 0.003。为普通最小二乘（OLS）回归模型拟合的RCS确定了童年创伤水平上心理韧性的平滑连续三次曲线，曲线的两个转折点在童年创伤方面分别为41.04和54.74。
我们的研究结果证实了精神分裂症患者心理韧性水平存在个体差异，并描述了童年创伤与心理韧性之间的三次曲线关系，为相关领域的机制研究和干预提供了数据支持。
