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童年期虐待和忽视与成人自主神经调节及与情绪相关病理的差异关联。

Differential Associations of Childhood Abuse and Neglect With Adult Autonomic Regulation and Mood-Related Pathology.

机构信息

From the Department of Psychological Science, University of California-Irvine, Irvine, California.

出版信息

Psychosom Med. 2023 Oct 1;85(8):682-690. doi: 10.1097/PSY.0000000000001239. Epub 2023 Jul 25.

Abstract

OBJECTIVE

This study assessed whether different types of childhood maltreatment (i.e., abuse versus neglect) had differential relationships with heart rate variability (HRV) and baroreflex sensitivity. In addition, this study tested the indirect effect of maltreatment subtypes on adult mood-related psychopathology via HRV, and whether these relationships differed in those with HRV above and below established clinical cutoffs.

METHODS

Secondary analysis was performed using the Midlife Development in the United States data set ( N = 967; Mage = 55; 58.4% female; 75.9% White). In a single study visit, autonomic measurements were captured at rest, during two cognitive stressors (Stroop and MATH tasks), and during recovery after the tasks. Structural equation modeling was used to assess the relationships between key variables during all three measurement periods.

RESULTS

Resting pathways from abuse and neglect to baroreflex sensitivity were nonsignificant, as was the pathway from HRV to mood-related pathology. Notably, greater abuse was significantly predictive of lower HRV (standardized β = -0.42, p = .009), whereas greater neglect was significantly predictive of higher HRV (standardized β = 0.32, p = .034). In addition, higher abuse was significantly predictive of greater adult symptoms (standardized β = 0.39, p < .001), but neglect was not found to be related to adult mood-related pathology. Significant relationships between variables were only found in those with low HRV.

CONCLUSIONS

Although cross-sectional, our findings provide further evidence that low HRV may be a transdiagnostic endophenotype for mood-related pathology and suggest that greater differentiation between abuse and neglect is appropriate when investigating the impact of childhood maltreatment on adult health outcomes.

摘要

目的

本研究旨在评估不同类型的儿童期虐待(即虐待与忽视)与心率变异性(HRV)和压力反射敏感性的关系是否不同。此外,本研究还通过 HRV 检验了虐待亚型对成年期与情绪相关的精神病理学的间接影响,以及这些关系在 HRV 高于和低于既定临床临界值的人群中是否存在差异。

方法

使用美国中年发展数据(Midlife Development in the United States data set,N=967;Mage=55;58.4%为女性;75.9%为白人)进行二次分析。在一次研究访问中,在静息状态、两项认知应激任务(Stroop 和 MATH 任务)期间以及任务后恢复期间采集自主测量数据。结构方程模型用于评估所有三个测量期内关键变量之间的关系。

结果

虐待和忽视与压力反射敏感性之间的静息途径无统计学意义,HRV 与情绪相关病理之间的途径也无统计学意义。值得注意的是,更多的虐待显著预测 HRV 降低(标准化β=-0.42,p=.009),而更多的忽视显著预测 HRV 升高(标准化β=0.32,p=.034)。此外,更多的虐待显著预测更大的成年症状(标准化β=0.39,p<.001),但忽视与成年情绪相关病理无关。仅在 HRV 较低的人群中发现变量之间存在显著关系。

结论

尽管是横断面研究,但本研究结果进一步表明,低 HRV 可能是与情绪相关病理的跨诊断内表型,并表明在研究儿童期虐待对成年健康结果的影响时,对虐待和忽视进行更细致的区分是恰当的。

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