Baldwin Jessie R, Coleman Oonagh, Francis Emma R, Danese Andrea
Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, United Kingdom.
JAMA Psychiatry. 2024 Aug 1;81(8):769-781. doi: 10.1001/jamapsychiatry.2024.0818.
Prospective and retrospective measures of childhood maltreatment identify largely different groups of individuals. However, it is unclear if these measures are differentially associated with psychopathology.
To analyze the associations of prospective and retrospective measures of childhood maltreatment with psychopathology.
Based on a preregistered protocol, Embase, PsycInfo, and MEDLINE were searched for peer-reviewed studies published by January 1, 2023, that measured the associations of prospective and retrospective measures of child maltreatment with psychopathology.
Titles and abstracts of all articles captured by the search and full texts of potentially eligible studies were independently screened by 2 authors. Observational studies with measures of the association of prospective and retrospective measures of childhood maltreatment with psychopathology were included.
Multiple investigators independently extracted data. Multilevel random-effects meta-analyses were used to pool the results and test predictors of heterogeneity.
Associations between prospective or retrospective measures of child maltreatment and psychopathology, both unadjusted and adjusted (ie, the association between prospective measures of maltreatment and psychopathology adjusted for retrospective measures, and vice versa), and moderation of these associations by preselected variables.
The meta-analyses were based on 24 studies including 15 485 individuals (51.0% female; mean age, 21.3 years at retrospective report). Retrospective measures of childhood maltreatment showed stronger associations with psychopathology relative to prospective measures in both unadjusted analyses (retrospective measures: odds ratio [OR], 2.21; 95%, 1.94-2.42 vs prospective measures: OR, 1.56; 95% CI, 1.39-1.76) and adjusted analyses (retrospective measures: OR, 2.14; 95% CI, 1.90-2.42 vs prospective measures: OR, 1.27; 95% CI, 1.13-1.41). There was no statistically significant moderation of the unadjusted or adjusted associations between prospective measures of child maltreatment and psychopathology. The associations between retrospective measures and psychopathology were stronger when the assessment of psychopathology was based on self-reports and was focused on internalizing or emotional disorders.
Psychopathology is more strongly associated with retrospective measures-which capture the first-person, subjective appraisal of childhood events reflected in memory recall-compared to prospective measures-which essentially capture third-person accounts of such events. Maltreatment-related psychopathology may be driven by subjective interpretations of experiences, distressing memories, and associated schemas, which could be targeted by cognitive interventions.
儿童期虐待的前瞻性和回顾性测量所识别出的个体群体在很大程度上有所不同。然而，尚不清楚这些测量与精神病理学之间是否存在差异关联。
分析儿童期虐待的前瞻性和回顾性测量与精神病理学之间的关联。
根据预先注册的方案，检索了Embase、PsycInfo和MEDLINE数据库，以查找截至2023年1月1日发表的同行评审研究，这些研究测量了儿童虐待的前瞻性和回顾性测量与精神病理学之间的关联。
由2位作者独立筛选检索到的所有文章的标题和摘要以及潜在符合条件研究的全文。纳入了对儿童期虐待的前瞻性和回顾性测量与精神病理学之间关联进行测量的观察性研究。
多名研究人员独立提取数据。采用多水平随机效应荟萃分析来汇总结果并检验异质性的预测因素。
儿童虐待的前瞻性或回顾性测量与精神病理学之间的关联，包括未调整和调整后的关联（即虐待的前瞻性测量与经回顾性测量调整后的精神病理学之间的关联，反之亦然），以及预先选定变量对这些关联的调节作用。
荟萃分析基于24项研究，共纳入15485名个体（女性占51.0%；回顾性报告时的平均年龄为21.3岁）。在未调整分析（回顾性测量：比值比[OR]，2.21；95%可信区间，1.94 - 2.42；前瞻性测量：OR，1.56；95%可信区间，1.39 - 1.76）和调整分析（回顾性测量：OR，2.14；95%可信区间，1.90 - 2.42；前瞻性测量：OR，1.27；95%可信区间，1.13 - 1.41）中，儿童期虐待的回顾性测量与精神病理学的关联均强于前瞻性测量。儿童虐待的前瞻性测量与精神病理学之间未调整或调整后的关联均无统计学上的显著调节作用。当精神病理学评估基于自我报告且侧重于内化或情绪障碍时，回顾性测量与精神病理学之间的关联更强。
与前瞻性测量（基本上是对这类事件的第三人称描述）相比，精神病理学与回顾性测量（反映记忆回忆中对童年事件的第一人称主观评价）的关联更强。与虐待相关的精神病理学可能由对经历的主观解释、痛苦记忆及相关图式所驱动，而认知干预可能针对这些方面。
