Ferger Marc D, Sigrist Christine, Brodesser Susanne, Kaess Michael, Koenig Julian
University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany.
Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
Transl Psychiatry. 2024 Dec 18;14(1):491. doi: 10.1038/s41398-024-03205-2.
Non-suicidal self-injury (NSSI) is a highly prevalent phenomenon in adolescence, often associated with prior traumatic experiences. The development and maintenance of NSSI is associated with dysregulation of the stress response, and evidence suggests that the hypothalamic-pituitary-adrenal (HPA) axis plays an important role. The endocannabinoid system is a neuromodulatory system in close functional interaction with the HPA axis. Several studies have reported alterations of the endocannabinoid system in adult patients with post-traumatic stress disorder. However, the role of the endocannabinoid system in children and adolescents with NSSI is less clear, and previously no study examined endocannabinoids in youth with experiences of maltreatment. N-arachidonyl ethanolamide (AEA) and 2-arachidonyl glycerol (2-AG) were quantified alongside sociodemographic and clinical characteristics in n = 148 adolescents (12-17 years of age). Analyses addressed group differences comparing healthy controls (HC, n = 38), patients with NSSI without (NSSI - CMT, n = 42) and with a history of childhood maltreatment (NSSI + CMT, n = 68). We show that AEA is reduced in adolescents with NSSI independent of childhood maltreatment. Further, we present first evidence for a negative association between AEA and NSSI frequency as well as AEA and the severity of childhood maltreatment. This is the first study providing evidence for alterations in the endocannabinoid system in children and adolescents engaging in repetitive NSSI. Findings from the study support current endocannabinoid-hypotheses on the neurobiology of trauma and adversity, extending existing findings of altered endocannabinoid signaling following exposure to traumatic events to a well-powered sample of children and adolescents.
非自杀性自伤(NSSI)在青少年中是一种高度普遍的现象,常与既往创伤经历相关。NSSI的发生和维持与应激反应失调有关,有证据表明下丘脑-垂体-肾上腺(HPA)轴起重要作用。内源性大麻素系统是一个与HPA轴存在密切功能相互作用的神经调节系统。多项研究报告了成年创伤后应激障碍患者内源性大麻素系统的改变。然而,内源性大麻素系统在有NSSI的儿童和青少年中的作用尚不清楚,此前也没有研究调查过有虐待经历的青少年的内源性大麻素。在148名青少年(12 - 17岁)中,对N-花生四烯酸乙醇胺(AEA)和2-花生四烯酸甘油(2-AG)以及社会人口学和临床特征进行了量化。分析比较了健康对照组(HC,n = 38)、无童年虐待史的NSSI患者(NSSI - CMT,n = 42)和有童年虐待史的NSSI患者(NSSI + CMT,n = 68)之间的组间差异。我们发现,有NSSI的青少年中AEA减少,与童年虐待无关。此外,我们首次提供证据表明AEA与NSSI频率以及AEA与童年虐待严重程度之间存在负相关。这是第一项为反复进行NSSI的儿童和青少年内源性大麻素系统改变提供证据的研究。该研究结果支持了当前关于创伤和逆境神经生物学的内源性大麻素假说,将暴露于创伤事件后内源性大麻素信号改变的现有研究结果扩展到了一个样本量充足的儿童和青少年群体。