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童年逆境对精神病理学的直接和间接影响:通过自我概念清晰度、自尊和对不确定性的不容忍来探究平行中介作用。

Direct and indirect effects of childhood adversity on psychopathology: Investigating parallel mediation via self-concept clarity, self-esteem and intolerance of uncertainty.

作者信息

Sharratt Lindsey, Ridout Nathan

机构信息

School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK.

出版信息

Br J Clin Psychol. 2025 Jun;64(2):539-552. doi: 10.1111/bjc.12523. Epub 2024 Dec 8.

DOI:10.1111/bjc.12523
PMID:39648139
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12057305/
Abstract

OBJECTIVES

The aim was to extend previous work on the identity disruption model (IDM) of adult psychological distress. According to the IDM, aversive childhood experiences (ACEs) disrupt the development of identity, resulting in an unclear sense of self and a reliance on external sources of self-definition, leading to psychological distress in adulthood. In line with this model, self-concept clarity (SCC) in parallel with self-esteem (SE) and intolerance of uncertainty (IU) has been shown to mediate the relationship between childhood adversity and depression and anxiety. The current study examined if SCC, SE and IU mediated the influence of childhood adversity on depression, anxiety and hypomania.

METHODS

A community sample of 159 adults completed online measures of childhood adversity, self-esteem, self-concept clarity, intolerance of uncertainty, depression, anxiety and hypomania. Structured equation modelling using bias corrected bootstrapping was used to test the mediation model.

RESULTS

Direct effects of childhood adversity were found for depression and anxiety, but not hypomania. The influence of ACEs on depression and anxiety was mediated by self-concept clarity and self-esteem. Self-concept clarity also mediated the influence of ACEs on hypomania, which is an important novel finding. The indirect effect of childhood adversity via intolerance of uncertainty was limited to anxiety.

CONCLUSIONS

Results suggest that the identity disruption model generalizes to hypomania. The clinical implications are that interventions to improve clarity of the self-concept might be useful in reducing psychopathology.

摘要

目的

旨在扩展先前关于成人心理困扰的身份认同破坏模型(IDM)的研究。根据IDM,童年期不良经历(ACEs)会破坏身份认同的发展,导致自我认知模糊以及依赖外部自我定义来源,进而在成年期引发心理困扰。与该模型一致的是,自我概念清晰度(SCC)与自尊(SE)以及对不确定性的不耐受(IU)已被证明在童年逆境与抑郁和焦虑之间的关系中起中介作用。本研究考察了SCC、SE和IU是否介导了童年逆境对抑郁、焦虑和轻躁狂的影响。

方法

159名成年人的社区样本完成了关于童年逆境、自尊、自我概念清晰度、对不确定性的不耐受、抑郁、焦虑和轻躁狂的在线测量。使用偏差校正自抽样的结构方程模型来检验中介模型。

结果

发现童年逆境对抑郁和焦虑有直接影响,但对轻躁狂没有直接影响。ACEs对抑郁和焦虑的影响由自我概念清晰度和自尊介导。自我概念清晰度也介导了ACEs对轻躁狂的影响,这是一个重要的新发现。童年逆境通过对不确定性的不耐受产生的间接影响仅限于焦虑。

结论

结果表明身份认同破坏模型可推广到轻躁狂。临床意义在于,提高自我概念清晰度的干预措施可能有助于减轻精神病理学症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6671/12057305/bcd0ea34dafb/BJC-64-539-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6671/12057305/bcd0ea34dafb/BJC-64-539-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6671/12057305/bcd0ea34dafb/BJC-64-539-g001.jpg

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Soc Psychiatry Psychiatr Epidemiol. 2022 Feb;57(2):331-341. doi: 10.1007/s00127-021-02129-2. Epub 2021 Jun 30.
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Association of Social Support During Adolescence With Depression, Anxiety, and Suicidal Ideation in Young Adults.青少年时期社会支持与青年期抑郁、焦虑和自杀意念的关联。
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How might childhood adversity predict adult psychological distress? Applying the Identity Disruption Model to understanding depression and anxiety disorders.
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J Affect Disord. 2020 Mar 15;265:112-119. doi: 10.1016/j.jad.2020.01.036. Epub 2020 Jan 13.
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Self-Clarity and Ways of Coping Among Jewish, Muslim, and Christian Adolescents and Emerging Adults.犹太教、伊斯兰教和基督教青少年及初显期成人的自我认知和应对方式。
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