Hutson Lauren M, Dan Rotem, Brown Aliza R, Esfand Shiba M, Ruberto Valerie, Johns Emily, Null Kaylee E, Ohashi Kyoko, Khan Alaptagin, Du Fei, Teicher Martin H, Pizzagalli Diego A
Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA 02478, USA.
Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.
Psychol Med. 2024 Dec 2;54(15):1-11. doi: 10.1017/S003329172400268X.
Childhood sexual abuse (CSA) and emotional maltreatment are salient risk factors for the development of major depressive disorder (MDD) in women. However, the type- and timing-specific effects of emotional maltreatment experienced during adolescence on future depressive symptomatology in women with CSA have not been explored. The goal of this study was to fill this gap.
In total, 203 women (ages 20-32) with current depressive symptoms and CSA (MDD/CSA), remitted depressive symptoms and CSA (rMDD/CSA), and current depressive symptoms without CSA (MDD/no CSA) were recruited from the community and completed self-report measures. Depressive symptoms were assessed using the Beck Depression Inventory (BDI-II) and a detailed maltreatment history was collected using the Maltreatment and Abuse Chronology of Exposure (MACE). Differences in maltreatment exposure characteristics, including multiplicity and severity of maltreatment, as well as the chronologies of emotional maltreatment subtypes were compared among groups. A random forest machine-learning algorithm was utilized to assess the impact of exposure to emotional maltreatment subtypes at specific ages on current depressive symptoms.
MDD/CSA women reported greater prevalence and severity of emotional maltreatment relative to rMDD/CSA and MDD/no CSA women [ = 9.33, < 0.001], specifically from ages 12 to 18. The strongest predictor of current depressive symptoms was parental verbal abuse at age 18 for both MDD/CSA women (variable importance [VI] = 1.08, = 0.006) and MDD/no CSA women (VI = 0.68, = 0.004).
Targeting emotional maltreatment during late adolescence might prove beneficial for future intervention efforts for MDD following CSA.
儿童期性虐待（CSA）和情感虐待是女性患重度抑郁症（MDD）的显著风险因素。然而，青春期经历的情感虐待对有CSA经历的女性未来抑郁症状的类型和特定时间影响尚未得到探讨。本研究的目的是填补这一空白。
总共从社区招募了203名有当前抑郁症状且有CSA经历（MDD/CSA）、已缓解抑郁症状且有CSA经历（rMDD/CSA）以及有当前抑郁症状但无CSA经历（MDD/无CSA）的女性（年龄20 - 32岁），并让她们完成自我报告测量。使用贝克抑郁量表（BDI-II）评估抑郁症状，并使用暴露于虐待和忽视的时间顺序（MACE）收集详细的虐待史。比较了各组在虐待暴露特征方面的差异，包括虐待的多重性和严重程度，以及情感虐待亚型的时间顺序。利用随机森林机器学习算法评估特定年龄暴露于情感虐待亚型对当前抑郁症状的影响。
与rMDD/CSA和MDD/无CSA的女性相比，MDD/CSA的女性报告情感虐待的发生率和严重程度更高[ = 9.33， < 0.001]，特别是在12至18岁之间。对于MDD/CSA的女性（变量重要性[VI] = 1.08， = 0.006）和MDD/无CSA的女性（VI = 0.68， = 0.004），当前抑郁症状的最强预测因素都是18岁时父母的言语虐待。
针对青春期后期的情感虐待进行干预可能对CSA后MDD的未来干预措施有益。
