Karam Elie, Al Barathie Josleen, Saab Dahlia, Karam Aimee Nasser, Fayyad John
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon.
Department of Psychiatry and Clinical Psychology, University of Balamand Faculty of Medicine, Beirut, Lebanon.
Clin Pract Epidemiol Ment Health. 2023 Nov 7;19:e17450179216651. doi: 10.2174/0117450179216651231106072824. eCollection 2023.
There is evidence that some childhood trauma increases the risk of the first onset of mental disorders and for the first time into adulthood. There are no studies that assessed whether exposure to war has this delayed long-term effect.
To fill this gap by investigating the comparative roles of war and non-war trauma on the first onset of adulthood mood and anxiety disorders.
A nationally representative sample of 2,857 Lebanese was assessed using the World Health Organization Composite International Diagnostic Interview 3.0. with the onset of exposure to trauma and of first onset of mood and anxiety disorders.
Non-war childhood traumata especially those belonging to family malfunctioning continue to exert their effect for the first time well beyond their occurrence as they were the most universal predictors for adult onset of both mood and anxiety disorders. War trauma during childhood predicted mood anxiety and mood (anxiety only in males) only below age 18 y. war childhood trauma predicts the first onset of mood and anxiety disorders before age 18 y in females, but only anxiety in males.
Childhood traumata are not equal in predicting the first onset of mood and anxiety disorders into adulthood. Family malfunctioning looks to carry the longest such risk and war more of shorter immediate effects. This might change though with re-exposure to war in adulthood which might unravel dormant vulnerability.
有证据表明,一些童年创伤会增加首次出现精神障碍的风险,且这种影响会首次持续到成年期。尚无研究评估接触战争是否具有这种延迟的长期影响。
通过调查战争创伤和非战争创伤在成年期情绪及焦虑障碍首次发作中的相对作用来填补这一空白。
使用世界卫生组织综合国际诊断访谈3.0对2857名具有全国代表性的黎巴嫩人样本进行评估,记录创伤暴露起始时间以及情绪和焦虑障碍首次发作时间。
非战争童年创伤,尤其是那些与家庭功能失调相关的创伤,在其发生很久之后仍首次持续发挥作用,因为它们是成年期情绪和焦虑障碍最普遍的预测因素。童年时期的战争创伤仅在18岁以下时可预测情绪焦虑和情绪障碍(仅男性中的焦虑障碍)。童年战争创伤在女性中可预测18岁之前情绪和焦虑障碍的首次发作,但在男性中仅可预测焦虑障碍。
童年创伤在预测成年期情绪和焦虑障碍的首次发作方面并不相同。家庭功能失调似乎具有最长的此类风险,而战争创伤的直接影响时间则较短。不过,这可能会因成年后再次接触战争而改变,这可能会揭示潜在的易感性。