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童年期虐待与跨诊断成年样本对人际威胁的杏仁核反应:特质分离的作用。

Childhood Maltreatment and Amygdala Response to Interpersonal Threat in a Transdiagnostic Adult Sample: The Role of Trait Dissociation.

机构信息

Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany; German Center for Mental Health (DZPG), partner site Mannheim, Heidelberg, Ulm, Germany.

Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

出版信息

Biol Psychiatry Cogn Neurosci Neuroimaging. 2024 Jun;9(6):626-634. doi: 10.1016/j.bpsc.2024.01.003. Epub 2024 Jan 26.

Abstract

BACKGROUND

Childhood maltreatment (CM) confers risk for different mental disorders as well as transdiagnostic symptoms such as dissociation. Aberrant amygdala response to interpersonal threat may link CM to transdiagnostic psychopathology and has recently been shown to depend on type and developmental timing of CM experiences. Still, most studies on CM and threat-related amygdala response employ categorical disorder-specific perspectives and fail to consider type and timing of CM exposure. We aimed to investigate associations between CM, amygdala response to interpersonal threat, and dimensional psychopathological symptoms including trait dissociation in a transdiagnostic adult sample, specifically considering type, timing, and duration of CM.

METHODS

We conducted a cross-sectional neuroimaging study in 141 participants with varying levels of CM, including mostly female participants with major depressive disorder (n = 36), posttraumatic stress disorder (n = 34), and somatic symptom disorder (n = 35) and healthy volunteers (n = 36). Participants underwent functional magnetic resonance imaging during an emotional face-matching task, completed the brief German interview version of the Maltreatment and Abuse Chronology of Exposure scale, and answered self-report measures of transdiagnostic CM-related symptoms including trait dissociation. Data were analyzed using a machine learning-based model comparison procedure.

RESULTS

In our transdiagnostic sample, neither type nor timing or duration of CM predicted amygdala response to interpersonal threat. Instead, trait dissociation predicted blunted bilateral amygdala response and emerged as a possible mediator between CM and amygdala function.

CONCLUSIONS

Trait dissociation may be an important confounder in the widely documented association between CM and threat-related amygdala response, which should be considered in future longitudinal studies.

摘要

背景

儿童期虐待(CM)会增加患不同精神障碍的风险,以及分离等跨诊断症状。杏仁核对人际威胁的反应异常可能将 CM 与跨诊断精神病理学联系起来,最近的研究表明,这取决于 CM 经历的类型和发展时间。然而,大多数关于 CM 和与威胁相关的杏仁核反应的研究都采用了分类障碍特异性的观点,并且没有考虑到 CM 暴露的类型和时间。我们旨在研究 CM、杏仁核对人际威胁的反应,以及跨诊断成年样本中包括特质分离在内的维度性精神病理学症状之间的关联,具体考虑到 CM 的类型、时间和持续时间。

方法

我们在 141 名 CM 程度不同的参与者中进行了一项横断面神经影像学研究,其中包括患有重度抑郁症(n=36)、创伤后应激障碍(n=34)和躯体症状障碍(n=35)的女性参与者和健康志愿者(n=36)。参与者在进行情绪面孔匹配任务时接受了功能磁共振成像,完成了简短的德国版创伤和虐待经历暴露编年史访谈,回答了与 CM 相关的跨诊断症状的特质分离的自我报告量表。使用基于机器学习的模型比较程序进行数据分析。

结果

在我们的跨诊断样本中,CM 的类型、时间或持续时间都不能预测对人际威胁的杏仁核反应。相反,特质分离预测了双侧杏仁核反应迟钝,并且作为 CM 和杏仁核功能之间的一个可能的中介出现。

结论

特质分离可能是 CM 与威胁相关的杏仁核反应之间广泛记录的关联的一个重要混杂因素,应在未来的纵向研究中加以考虑。

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