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恐惧学习的改变作为童年期暴露于暴力与创伤后应激障碍症状之间的一种联系机制:一项纵向研究。

Alterations in fear learning as a mechanism linking childhood exposure to violence with PTSD symptoms: a longitudinal study.

作者信息

Machlin Laura, Sheridan Margaret A, Lurie Lucy A, Kasparek Steven W, Kim Stephanie Gyuri, Peverill Matthew, France John McClellan, Robertson Madeline M, Jovanovic Tanja, Lengua Liliana J, McLaughlin Katie A

机构信息

Department of Psychology, Harvard University, Cambridge, MA, USA.

Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, NC, USA.

出版信息

Psychol Med. 2024 Sep 9:1-9. doi: 10.1017/S0033291724001569.

Abstract

BACKGROUND

Fear learning is a core component of conceptual models of how adverse experiences may influence psychopathology. Specifically, existing theories posit that childhood experiences involving childhood trauma are associated with altered fear learning processes, while experiences involving deprivation are not. Several studies have found altered fear acquisition in youth exposed to trauma, but not deprivation, although the specific patterns have varied across studies. The present study utilizes a longitudinal sample of children with variability in adversity experiences to examine associations among childhood trauma, fear learning, and psychopathology in youth.

METHODS

The sample includes 170 youths aged 10-13 years ( 11.56, s.d. = 0.47, 48.24% female). Children completed a fear conditioning task while skin conductance responses (SCR) were obtained, which included both acquisition and extinction. Childhood trauma and deprivation severity were measured using both parent and youth report. Symptoms of anxiety, externalizing problems, and post-traumatic stress disorder (PTSD) were assessed at baseline and again two-years later.

RESULTS

Greater trauma-related experiences were associated with greater SCR to the threat cue (CS+) relative to the safety cue (CS-) in early fear acquisition, controlling for deprivation, age, and sex. Deprivation was unrelated to fear learning. Greater SCR to the threat cue during early acquisition was associated with increased PTSD symptoms over time controlling for baseline symptoms and mediated the relationship between trauma and prospective changes in PTSD symptoms.

CONCLUSIONS

Childhood trauma is associated with altered fear learning in youth, which may be one mechanism linking exposure to violence with the emergence of PTSD symptoms in adolescence.

摘要

背景

恐惧学习是关于不良经历如何影响精神病理学概念模型的核心组成部分。具体而言,现有理论认为,涉及童年创伤的童年经历与恐惧学习过程的改变有关,而涉及剥夺的经历则不然。多项研究发现,遭受创伤而非剥夺的青少年的恐惧习得发生了改变,尽管具体模式在不同研究中有所不同。本研究利用了一个逆境经历具有变异性的儿童纵向样本,以检验童年创伤、恐惧学习和青少年精神病理学之间的关联。

方法

样本包括170名10 - 13岁的青少年(平均年龄11.56岁,标准差 = 0.47,48.24%为女性)。孩子们在完成恐惧条件反射任务的同时获取皮肤电传导反应(SCR),该任务包括习得和消退阶段。童年创伤和剥夺严重程度通过父母和青少年的报告来衡量。在基线时以及两年后评估焦虑症状、外化问题和创伤后应激障碍(PTSD)症状。

结果

在早期恐惧习得过程中,相对于安全线索(CS -),与创伤相关的经历越多,对威胁线索(CS +)的皮肤电传导反应越强,同时控制了剥夺、年龄和性别。剥夺与恐惧学习无关。在早期习得过程中对威胁线索的皮肤电传导反应越强,随着时间的推移,创伤后应激障碍症状增加,同时控制基线症状,并且这介导了创伤与创伤后应激障碍症状的前瞻性变化之间的关系。

结论

童年创伤与青少年恐惧学习的改变有关,这可能是将接触暴力与青少年创伤后应激障碍症状出现联系起来的一种机制。

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