Zhang Lu, Cropley Vanessa L, Whittle Sarah, Rakesh Divyangana
Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Parkville, Australia.
Centre for Youth Mental Health, University of Melbourne, Parkville, Australia.
Psychol Med. 2024 Oct 14;54(13):1-11. doi: 10.1017/S0033291724001806.
The COVID-19 pandemic introduced unique stressors that posed significant threats to adolescent mental health. However, limited research has examined the impact of trauma exposure on vulnerability to subsequent stressor-related mental health outcomes in adolescents. Furthermore, it is unclear whether there are protective factors that promote resilience against the negative impacts of COVID-19 stressors in adolescents with prior trauma exposure. This preregistered study aimed to investigate the impact of trauma on COVID-19 stressor-related mental health difficulties in adolescents, in addition to the role of protective factors.
Aims were investigated in a sample of 9696 adolescents (mean age 12.85 ± 0.88 years) from the Adolescent Brain Cognitive Development Study. Linear mixed-effects models were employed to examine (a) the associations of early trauma exposure (exposed non-exposed), COVID-19 stressors, and perceived stress, sadness, and positive affect levels during the pandemic period in the US, and (b) the role of protective factors (physical activity, parental support, and improvements in family and peer relationships) in these associations.
There was a positive association between COVID-19 stressors and sadness, which was enhanced in trauma-exposed adolescents. Improvements in family and peer relationships mitigated the association between COVID-19 stressors and poor mental health outcomes, regardless of prior traumatic experience.
These findings support the hypothesis that prior trauma elevates risk of mental health difficulties in the face of future stressors. Results underscore the protective role of enhanced social relationships as targets for early prevention and intervention in those experiencing acute stressors, regardless of prior traumatic experiences.
新冠疫情带来了独特的压力源，对青少年心理健康构成了重大威胁。然而，针对创伤暴露对青少年后续与压力源相关的心理健康结果易感性的影响的研究有限。此外，尚不清楚在有既往创伤暴露的青少年中，是否存在促进其抵御新冠疫情压力源负面影响的保护因素。这项预先注册的研究旨在调查创伤对青少年与新冠疫情压力源相关的心理健康问题的影响，以及保护因素的作用。
在青少年大脑认知发展研究的9696名青少年样本（平均年龄12.85±0.88岁）中对研究目的进行了调查。采用线性混合效应模型来检验：（a）早期创伤暴露（暴露组与未暴露组）、新冠疫情压力源与美国疫情期间的感知压力、悲伤情绪和积极情绪水平之间的关联；（b）保护因素（体育活动、父母支持以及家庭和同伴关系的改善）在这些关联中的作用。
新冠疫情压力源与悲伤情绪之间存在正相关，在有创伤暴露的青少年中这种关联更强。家庭和同伴关系的改善减轻了新冠疫情压力源与不良心理健康结果之间的关联，无论其既往是否有创伤经历。
这些发现支持了这样的假设，即既往创伤会增加面对未来压力源时出现心理健康问题的风险。结果强调了增强社会关系作为对经历急性压力源的人群进行早期预防和干预目标的保护作用，无论其既往是否有创伤经历。
