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识别将威胁和剥夺与青少年精神病理学联系起来的认知、情感和发展机制。

Identifying cognitive, affective, and developmental mechanisms linking threat and deprivation with adolescent psychopathology.

作者信息

Sadikova Ekaterina, Weissman David G, Rosen Maya L, Robinson Elise, Lengua Liliana J, Sheridan Margaret A, Tiemeier Henning, McLaughlin Katie A

机构信息

Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

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

出版信息

J Child Psychol Psychiatry. 2025 May;66(5):612-623. doi: 10.1111/jcpp.14067. Epub 2024 Oct 31.

Abstract

BACKGROUND

The mechanisms linking early-life adversity with psychopathology over the life-course are complex. In this prospective study, we collectively examined cognitive, affective, and developmental mediators previously found to individually link childhood threat and deprivation experiences to adolescent psychopathology to identify the most potent mechanisms.

METHODS

Data came from a community sample of 227 children (mean child age 11.5 ± 0.5 years, 48.5% female) from the Seattle metro area with recruitment designed to reflect diversity in family income. Candidate mechanisms included self-rated pubertal development and task-measured attention bias to threat, emotion regulation, theory of mind, fear learning, inhibitory control, language ability, reasoning, and reward sensitivity. Using a high-dimensional mediation approach, we determined which mediating pathways linking threat and deprivation to psychopathology persisted after controlling for all candidate mechanisms associated with psychopathology. Models additionally controlled for the child's age, sex, early-childhood emotional and behavioral symptoms, poverty, and maternal depression.

RESULTS

Blunted reward sensitivity mediated the prospective relationship between threat and internalizing psychopathology, explaining 17.25% (95% CI 1.08%, 69.96%) of this association. Advanced pubertal development was associated with increases in internalizing and externalizing symptoms (standardized associations of 0.16 (95% CI 0.03, 0.29) and 0.17 (95% CI 0.05, 0.29), respectively), but not with adversity. Although deprivation was strongly related to psychopathology, no mechanisms were empirically identified.

CONCLUSIONS

In a well-characterized community sample, we isolated reward sensitivity as a robust mediator of the prospective association between early-life threat and adolescent internalizing psychopathology. Interventions aimed at bolstering reward sensitivity may mitigate the impact of early-life threat experiences on internalizing problems.

摘要

背景

将生命早期逆境与整个生命过程中的精神病理学联系起来的机制很复杂。在这项前瞻性研究中,我们共同研究了先前发现的将童年威胁和剥夺经历分别与青少年精神病理学联系起来的认知、情感和发育中介因素,以确定最有效的机制。

方法

数据来自西雅图都会区的227名儿童(儿童平均年龄11.5±0.5岁,48.5%为女性)的社区样本,招募旨在反映家庭收入的多样性。候选机制包括自我评定的青春期发育以及通过任务测量的对威胁的注意偏向、情绪调节、心理理论、恐惧学习、抑制控制、语言能力、推理和奖励敏感性。使用高维中介方法,我们确定了在控制了所有与精神病理学相关的候选机制后,哪些将威胁和剥夺与精神病理学联系起来的中介途径仍然存在。模型还控制了儿童的年龄、性别、幼儿期情绪和行为症状、贫困以及母亲的抑郁情况。

结果

奖励敏感性降低介导了威胁与内化性精神病理学之间的前瞻性关系,解释了这种关联的17.25%(95%置信区间1.08%,69.96%)。青春期发育提前与内化和外化症状的增加相关(标准化关联分别为0.16(95%置信区间0.03,0.29)和0.17(95%置信区间0.05,0.29)),但与逆境无关。尽管剥夺与精神病理学密切相关,但未通过实证确定相关机制。

结论

在一个特征明确的社区样本中,我们确定奖励敏感性是生命早期威胁与青少年内化性精神病理学之间前瞻性关联的有力中介因素。旨在增强奖励敏感性的干预措施可能会减轻生命早期威胁经历对内化问题的影响。

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