童年创伤与精神病理学的跨诊断网络分析
A Transdiagnostic Network Analysis of Childhood Trauma and Psychopathology.
作者信息
Huang Yi-Hang, Liu Chao, Zhang Jian-Biao, Li Shuai-Biao, Wang Ling-Ling, Hu Hui-Xin, Cai Yuan, Zhu Zhenhua, Chu Min-Yi, Wang Yi, Lv Qin-Yu, Lui Simon S Y, Yi Zheng-Hui, Hui Li, Chan Raymond C K
机构信息
Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
出版信息
Schizophr Bull. 2025 May 8;51(3):792-803. doi: 10.1093/schbul/sbae137.
BACKGROUND AND HYPOTHESIS
Psychiatric comorbidities suggest that symptoms overlap across different diagnoses; the transdiagnostic network approach is valuable for studying psychopathology. Childhood trauma is a common transdiagnostic risk factor for psychiatric disorders, but the complex relationship between childhood trauma and psychopathology has seldom been investigated using a large cross-sectional transdiagnostic sample.
STUDY DESIGN
This study recruited 869 patients with different diagnoses, including 418 schizophrenia, 215 bipolar disorder, and 236 major depressive disorder. Participants completed psychiatric interviews and self-report questionnaires. We constructed dimension- and item-level Least Absolute Shrinkage and Selection Operator-based (LASSO) networks to explore the relationship between childhood trauma, psychopathology, and duration of illness. Moreover, we constructed directed acyclic graphs (DAGs) to tentatively clarify the potential directions of associations among these variables. Network Comparison Tests (NCTs) were conducted for different diagnostic groups and gender-stratified groups.
STUDY RESULTS
The transdiagnostic LASSO networks showed that different types of childhood trauma exerted distinct impacts on various psychopathological dimensions. Emotional abuse was linked to depressive symptoms, physical abuse to excited symptoms, sexual abuse to positive and disorganized symptoms, emotional neglect to depressive symptoms and motivation and pleasure (MAP) deficits factor of negative symptoms, and physical neglect to MAP factor. The DAG findings generally concurred with the LASSO network. The NCT showed comparable networks.
CONCLUSIONS
Our findings suggest that childhood trauma is significantly associated with the development of psychopathology across different diagnostic groups. The affective pathway model suggests that early identification and tailored interventions would be needed for people with a history of childhood trauma.
背景与假设
精神共病表明不同诊断之间存在症状重叠；跨诊断网络方法对于研究精神病理学具有重要价值。童年创伤是精神障碍常见的跨诊断风险因素，但很少使用大型横断面跨诊断样本研究童年创伤与精神病理学之间的复杂关系。
研究设计
本研究招募了869名患有不同诊断的患者，包括418名精神分裂症患者、215名双相情感障碍患者和236名重度抑郁症患者。参与者完成了精神科访谈和自我报告问卷。我们构建了基于维度和项目层面的最小绝对收缩和选择算子（LASSO）网络，以探索童年创伤、精神病理学和病程之间的关系。此外，我们构建了有向无环图（DAG），以初步阐明这些变量之间关联的潜在方向。对不同诊断组和性别分层组进行了网络比较测试（NCT）。
研究结果
跨诊断LASSO网络显示，不同类型的童年创伤对各种精神病理维度产生了不同的影响。情感虐待与抑郁症状相关，身体虐待与兴奋症状相关，性虐待与阳性和紊乱症状相关，情感忽视与抑郁症状以及阴性症状的动机和愉悦（MAP）缺陷因子相关，身体忽视与MAP因子相关。DAG的结果与LASSO网络基本一致。NCT显示网络具有可比性。
结论
我们的研究结果表明，童年创伤与不同诊断组的精神病理学发展显著相关。情感通路模型表明，对于有童年创伤史的人，需要早期识别和针对性干预。
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