Ko Cheng-Hung, Lu Yung-Chin, Lee Chun-Hung, Liao Yu-Chi
Department of Addiction and Forensic Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare (MOHW), Tainan, Taiwan.
Department of Clinical Psychology, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan.
Front Psychiatry. 2024 May 14;15:1382646. doi: 10.3389/fpsyt.2024.1382646. eCollection 2024.
This investigation aimed to clarify the intricate relationship among depression, cognitive function, adverse childhood experiences (ACEs), and their combined influence on methamphetamine use disorder (MUD).
Utilizing a battery of psychological tests, this study ascertained the impact of ACEs on the condition of 76 people with MUD who meet the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, aged 42.17 on average. The Iowa Gambling Task (IGT), Conners' Continuous Performance-II (CPT-II), the self-report Severity of Dependence Scale (SDS), and the Beck Depression Inventory-II (BDI-II) were used for these evaluations. Individuals involved in the study were categorized into two discrete cohorts, mild (ME) and severe (SE), based on the extent of their ACEs exposure. This study employed the PROCESS regression, the independent t-test andχ2 tests for the analysis.
The findings revealed notable discrepancies in the psychological consequences between the two groups with different degrees of ACEs; however, no substantial differences were observed in the demographic parameters. The SE group exhibited elevated BDI-II scores, more evident indications of MUD, and a higher degree of CPT-II cognitive perseveration. The PROCESS model revealed that cognitive perseveration moderated the impact of depression on ACEs and subjective MUD severity, explaining 20.2% of the variance. The ACEs and depression predicted 28.6% of the variance in MUD symptoms. However, no statistically significant differences were detected between the two groups regarding the parameters in the IGT-2 assessment.
These results indicate that the interaction between cognitive and depressive factors mediates the effect of ACEs on subjective MUD severity but not on MUD symptoms. The ACEs significant impact on mental health severity perception is explained by cognitive and depressive factors. This implies that MUD treatment and rehabilitation should address cognitive dysfunction and developmental trauma.
本研究旨在阐明抑郁症、认知功能、童年不良经历（ACEs）之间的复杂关系，以及它们对甲基苯丙胺使用障碍（MUD）的综合影响。
本研究通过一系列心理测试，确定了ACEs对76名符合《精神疾病诊断与统计手册》（DSM-5）标准的MUD患者状况的影响，这些患者平均年龄为42.17岁。使用爱荷华赌博任务（IGT）、康纳斯连续操作测验第二版（CPT-II）、自我报告的依赖性严重程度量表（SDS）和贝克抑郁量表第二版（BDI-II）进行这些评估。根据ACEs暴露程度，将参与研究的个体分为两个不同的队列，即轻度（ME）和重度（SE）。本研究采用PROCESS回归、独立t检验和χ2检验进行分析。
研究结果显示，两组不同程度ACEs患者的心理后果存在显著差异；然而，在人口统计学参数方面未观察到实质性差异。SE组的BDI-II得分较高，MUD的迹象更明显，CPT-II认知 perseveration程度更高。PROCESS模型显示，认知perseveration调节了抑郁症对ACEs和主观MUD严重程度的影响，解释了20.2%的方差。ACEs和抑郁症预测了MUD症状28.6%的方差。然而，在IGT-2评估的参数方面，两组之间未检测到统计学上的显著差异。
这些结果表明，认知和抑郁因素之间的相互作用介导了ACEs对主观MUD严重程度的影响，但对MUD症状没有影响。认知和抑郁因素解释了ACEs对心理健康严重程度感知的显著影响。这意味着MUD的治疗和康复应解决认知功能障碍和发育性创伤问题。
