Department of Educational Sciences, University of Genoa, Genoa, Italy.
Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy.
J Clin Psychol. 2024 Nov;80(11):2228-2246. doi: 10.1002/jclp.23733. Epub 2024 Aug 5.
Adverse childhood experiences (ACEs) are psychosocial factors acknowledged as significant contributors to health consequences later in adolescence, including psychological maladjustment. The research suggests that, at a transdiagnostic and transtheoretical level, working on restoring epistemic trust (ET), mentalized affectivity (MA), and reflective functioning (RF) in adolescents with ACEs assumes a central role in the therapeutic process. However, there are still few studies that attempted to investigate the specific role of these sociocognitive factors in the detrimental positive association between levels of experienced ACEs during childhood and psychological maladjustment in nonclinical adolescents.
A community sample of 306 Italian cisgender adolescents (61.4% assigned females at birth; age range 13-19 years old; M = 16.1, SD = 1.64) self-reported ACEs (Childhood Trauma Questionnaire-Short Form), psychological maladjustment (Strengths and Difficulties Questionnaire), ET (Epistemic Trust, Mistrust and Credulity Questionnaire), MA (Brief-Mentalized Affectivity Scale for Adolescence), and RF (Reflective Functioning Questionnaire). A multiple mediation regression analysis has been performed to explore the association between ACEs and psychological maladjustment through the interaction with socio-cognitive factors.
ACEs are positive predictors of psychological maladjustment later in adolescence. Regardless of gender differences, epistemic mistrust and credulity, processing and expressing emotions, and uncertainty about mental states mediated this association, while epistemic trust, identifying emotions, and certainty about mental states did not configure as significant mediators.
Findings suggest that ET disruptions and deficits in RF are risk factors, while MA is a protective factor within the link between ACEs and psychological maladjustment in adolescence. These links help to specify the role of sociocognitive factors in the development of mental problems in adolescents who have been exposed to adverse experiences in childhood.
不良的童年经历（ACEs）是公认的对青少年后期健康后果有重大影响的心理社会因素，包括心理适应不良。研究表明，在跨诊断和跨理论水平上，致力于恢复青少年 ACEs 中的认知信任（ET）、心理化情感（MA）和反思功能（RF）在治疗过程中起着核心作用。然而，仍然很少有研究试图调查这些社会认知因素在童年时期经历的 ACEs 水平与非临床青少年心理适应不良之间的不利正相关中的特定作用。
本研究采用意大利社区样本，共 306 名跨性别青少年（61.4%出生时被指定为女性；年龄在 13-19 岁之间；M=16.1，SD=1.64）自我报告 ACEs（儿童创伤问卷-短式）、心理失调（长处和困难问卷）、ET（认知信任、不信任和轻信问卷）、MA（青少年简要心理化情感量表）和 RF（反思功能问卷）。进行了多次中介回归分析，以探索 ACEs 与心理失调之间的关联，通过与社会认知因素的相互作用进行探索。
ACEs 是青少年后期心理失调的正向预测因子。无论性别差异如何，认知不信任和轻信、情绪加工和表达以及对心理状态的不确定性均介导了这种关联，而认知信任、识别情绪和对心理状态的确定性则没有配置为显著的中介。
研究结果表明，ET 破坏和 RF 缺陷是风险因素，而 MA 是 ACEs 与青少年心理失调之间的保护因素。这些联系有助于明确社会认知因素在经历过童年逆境的青少年中发展心理问题的作用。
