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童年逆境的严重程度调节了适应性心理变化与杏仁核体积变化之间的关联,这些变化是对行为干预的反应。

Childhood adversity severity modulates the associations between adaptive psychological changes and amygdala volumetric changes in response to behavioral interventions.

作者信息

Joss Diane, Lu Junjie, Teicher Martin H, Lazar Sara W

机构信息

Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA.

Department of Psychiatry, Massachusetts General Hospital, USA.

出版信息

J Affect Disord Rep. 2024 Jan;15. doi: 10.1016/j.jadr.2023.100714. Epub 2023 Dec 30.

Abstract

BACKGROUND

Adverse Childhood Experience (ACE) has been shown to have detrimental impact on amygdala structure. Prior research found that adaptive psychological changes after Mindfulness-Based Interventions (MBI) were associated with amygdala volumetric changes. The present study aims to further investigate whether such effects also occur among ACE survivors and whether the effects are unique to MBI.

METHODS

A total of 64 young adult childhood adversity survivors were randomized to an eight-week MBI or Stress Management Education (SME) as an active control condition. Anatomical MRI and questionnaires on mindfulness, stress and psychological health were collected at baseline and post-intervention. Due to subject dropout, the final sample included 39 subjects (MBI:20, SME:19).

RESULTS

Both groups showed increased mindfulness levels, reduced stress, and improved psychological symptoms (depression, anxiety, and somatization), with no significant group by time interaction effect. There was no significant group difference on amygdala volumetric changes. Within the MBI group, childhood maltreatment severity was a significant mediator between changes of mindfulness levels and amygdala volumetric changes. Across pooled sample of both groups, childhood maltreatment was a significant moderator for the effect of trait anxiety level changes on amygdala volumetric changes.

LIMITATIONS

Modest sample size, relatively low retention rates, suboptimal monitoring of home practice.

CONCLUSIONS

MBI did not demonstrate overall better clinical effects than SME. Psychological-change-dependent amygdala volumetric change was not specific to MBI. Childhood maltreatment severity modulated the relationships between adaptive psychological changes and amygdala volumetric changes.

摘要

背景

童年不良经历(ACE)已被证明会对杏仁核结构产生有害影响。先前的研究发现,基于正念的干预措施(MBI)后适应性心理变化与杏仁核体积变化有关。本研究旨在进一步调查这种影响是否也发生在ACE幸存者中,以及这种影响是否是MBI所特有的。

方法

共有64名成年期童年逆境幸存者被随机分为为期八周的MBI组或作为积极对照条件的压力管理教育(SME)组。在基线和干预后收集解剖学MRI以及关于正念、压力和心理健康的问卷。由于受试者退出,最终样本包括39名受试者(MBI组:20名,SME组:19名)。

结果

两组均显示正念水平提高、压力减轻以及心理症状(抑郁、焦虑和躯体化)改善,且无显著的组×时间交互效应。杏仁核体积变化方面无显著组间差异。在MBI组中,童年虐待严重程度是正念水平变化与杏仁核体积变化之间的显著中介变量。在两组的合并样本中,童年虐待是特质焦虑水平变化对杏仁核体积变化影响的显著调节变量。

局限性

样本量适中、保留率相对较低、对家庭练习的监测欠佳。

结论

MBI并未显示出总体上比SME更好的临床效果。依赖心理变化的杏仁核体积变化并非MBI所特有。童年虐待严重程度调节了适应性心理变化与杏仁核体积变化之间的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7924/10836063/1e43a24f2dc0/nihms-1959173-f0001.jpg

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