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压力的体验、表达和生理模式与青少年的抑郁症状和自伤想法及行为有关:一种基于个体的方法。

Patterns of experience, expression, and physiology of stress relate to depressive symptoms and self-injurious thoughts and behaviors in adolescents: a person-centered approach.

机构信息

Department of Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA.

Department of Psychology, The Pennsylvania State University, University Park Campus, University Park, PA, USA.

出版信息

Psychol Med. 2023 Dec;53(16):7902-7912. doi: 10.1017/S0033291723002003. Epub 2023 Aug 23.


DOI:10.1017/S0033291723002003
PMID:37609891
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10755230/
Abstract

BACKGROUND: Preliminary evidence shows that discordance in stress experience, expression, and physiology (EEP) in adolescents is linked to depression, suicidal ideation (SI), non-suicidal self-injury (NSSI), and brain functioning. This study employs person-centered analysis to probe the relationship between stress responses, psychopathology, and neural patterns in female adolescents who are oversampled for engagement in NSSI. METHODS: Adolescent females ( = 109, ages 12-17) underwent a social stress test from which self-report measures of stress experience, observer ratings of stress expression, and physiological metrics of stress (via salivary cortisol) were obtained. Multi-trajectory modeling was employed to identify concordant and discordant stress EEP groups. Depressive symptoms, SI and attempt, NSSI engagement, frontal and limbic activation to emotional stimuli, and resting state fronto-limbic connectivity were examined in the EEP groups derived from the multi-trajectory models. RESULTS: Four groups were identified, three of which demonstrated relatively concordant EEP and one which demonstrated discordant EEP (). Further, replicating past research, the discordant group exhibited higher depressive symptoms, SI, suicide attempt, and NSSI episodes (only for sensitivity analyses based on past year) relative to other EEP groups. No significant group differences in brain functioning emerged. CONCLUSION: Results indicate that within-person, multi-level patterns in stress responding capture risk for dysfunction including depression and self-injurious thoughts and behaviors. Further interrogating of system-level stress functioning may better inform assessment and intervention efforts.

摘要

背景:初步证据表明,青少年在压力体验、表达和生理方面的不和谐(EEP)与抑郁、自杀意念(SI)、非自杀性自我伤害(NSSI)和大脑功能有关。本研究采用以人为中心的分析方法,探讨了在 NSSI 参与度较高的女性青少年中,压力反应、精神病理学和神经模式之间的关系。

方法:109 名 12-17 岁的青少年女性参加了一项社会压力测试,从中获得了压力体验的自我报告测量、观察者对压力表达的评分以及压力的生理指标(通过唾液皮质醇)。采用多轨迹建模来识别一致和不一致的 EEP 组。在从多轨迹模型中得出的 EEP 组中,检查了抑郁症状、SI 和尝试、NSSI 参与、情绪刺激的额叶和边缘激活以及静息状态的额-边缘连接。

结果:确定了四个组,其中三个表现出相对一致的 EEP,一个表现出不一致的 EEP()。此外,与其他 EEP 组相比,复制了过去的研究,不一致的组表现出更高的抑郁症状、SI、自杀尝试和 NSSI 发作(仅基于过去一年的敏感性分析)。在大脑功能方面没有出现显著的组间差异。

结论:结果表明,个体内在、多层次的压力反应模式可以捕捉包括抑郁和自我伤害思想和行为在内的功能障碍风险。进一步研究系统水平的压力功能可能会更好地为评估和干预工作提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/618a/10755230/7b9ed9f31d60/S0033291723002003_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/618a/10755230/7b9ed9f31d60/S0033291723002003_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/618a/10755230/7b9ed9f31d60/S0033291723002003_fig1.jpg

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本文引用的文献

[1]
Multi-trajectory analysis uncovers latent associations between psychological and physiological acute stress response patterns.

Psychoneuroendocrinology. 2022-11

[2]
Adolescent stress experience-expression-physiology correspondence: Links to depression, self-injurious thoughts and behaviors, and frontolimbic neural circuity.

J Affect Disord. 2022-3-1

[3]
Depression, Non-Suicidal Self-Injury, and Suicidality in Adolescents: Common and Distinct Precursors, Correlates, and Outcomes.

J Psychiatr Brain Sci. 2021

[4]
Stress management intervention to enhance adolescent resilience: a randomized controlled trial.

EMBnet J. 2021

[5]
How we ask matters: The impact of question wording in single-item measurement of suicidal thoughts and behaviors.

Prev Med. 2021-11

[6]
Multimodal assessment of sustained threat in adolescents with nonsuicidal self-injury.

Dev Psychopathol. 2021-12

[7]
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Neurosci Biobehav Rev. 2021-11

[8]
Linking post-stressor interpersonal processes in adolescent girls' close friendships with acute HPA stress responses.

J Adolesc. 2021-10

[9]
Adolescent girls' stress responses as prospective predictors of self-injurious thoughts and behaviors: A person-centered, multilevel study.

Dev Psychopathol. 2022-10

[10]
Mechanism for differential recruitment of orbitostriatal transmission during actions and outcomes following chronic alcohol exposure.

Elife. 2021-3-17

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