Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
Department of Mental Health Center, Xiangya Hospital, Central South University, Changsha, China.
BMC Psychiatry. 2023 Aug 30;23(1):637. doi: 10.1186/s12888-023-05124-w.
Previous studies suggested that childhood maltreatment is associated with poor health outcomes. While not everyone who experiences abuse as a child goes on to experience poor mental health, some traumatized people are grown to be more resilient than others. Few studies have examined the association between childhood maltreatment and adult resilience. This study aimed to determine different relationships between specific types and features of childhood maltreatment with adult resilience among Chinese with Major Depressive Disorder (MDD) and healthy controls (HCs).
A total of 101 patients with MDD and 116 participants in the healthy control (HC) group from Zhumadian Psychiatric Hospital and its nearby communities were included in this analysis. Childhood maltreatment was assessed retrospectively using Childhood Trauma Questionnaire (CTQ). Adults' resilience was assessed by the Connor-Davidson Resilience Scale (CD-RISC). Generalized linear models were applied between childhood maltreatment (specific types and features) and resilience adjusting for covariates.
The total score of CD-RISC and factor scores of strength, optimism, and tenacity in the HC group were higher than those in the MDD group. CTQ total score had a negative association with optimism score among participants in MDD (β=-0.087, P < 0.001) and HC (β=-0.074, P = 0.023) groups. Higher emotional neglect (EN) score (β=-0.169, P = 0.001) and physical neglect (PN) score (β=-0.153, P = 0.043) were related to a worse optimism score in MDD group. Emotional abuse (EA) score was associated with a worse tenacity score (β=-0.674, P = 0.031) in MDD group. For participants in HC group, higher EN and PN scores were related to worse resilience scores (tenacity, strength, and optimism).
Patients with MDD showed lower optimism than HCs. Childhood maltreatment, especially childhood negect, independently contributed to optimism, with more severe childhood maltreatment predictive of worse performance of optimism. EA in childhood was also linked to worse tenacity in adult patients with MDD.
先前的研究表明，儿童期虐待与健康状况不佳有关。虽然并非每个经历过虐待的儿童都会出现心理健康问题，但有些受创伤的人比其他人更有韧性。很少有研究探讨儿童虐待与成人韧性之间的关系。本研究旨在确定中国患有重度抑郁症（MDD）和健康对照（HC）的个体中，特定类型和特征的儿童虐待与成人韧性之间的不同关系。
本研究共纳入 101 名 MDD 患者和来自驻马店精神病院及其附近社区的 116 名健康对照者。采用儿童期创伤问卷（CTQ）回顾性评估儿童期虐待情况。采用Connor-Davidson 韧性量表（CD-RISC）评估成人韧性。在调整协变量后，采用广义线性模型将儿童期虐待（特定类型和特征）与韧性进行关联分析。
HC 组的 CD-RISC 总分和力量、乐观和坚韧因子得分均高于 MDD 组。CTQ 总分与 MDD（β=-0.087，P<0.001）和 HC（β=-0.074，P=0.023）组的乐观评分呈负相关。较高的情感忽视（EN）评分（β=-0.169，P=0.001）和身体忽视（PN）评分（β=-0.153，P=0.043）与 MDD 组的乐观评分较差相关。情感虐待（EA）评分与 MDD 组坚韧评分较差相关（β=-0.674，P=0.031）。对于 HC 组的参与者，较高的 EN 和 PN 评分与较差的韧性评分（坚韧、力量和乐观）相关。
患有 MDD 的患者的乐观程度低于 HC。儿童虐待，尤其是儿童忽视，独立导致乐观程度下降，儿童期虐待越严重，乐观表现越差。儿童期的 EA 也与 MDD 成年患者的坚韧程度较差有关。
