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童年创伤和亚临床创伤后应激障碍症状预示着在两项针对活动性抑郁症的正念疗法中会产生不良影响和更糟糕的结果。

Childhood trauma and subclinical PTSD symptoms predict adverse effects and worse outcomes across two mindfulness-based programs for active depression.

作者信息

Canby Nicholas K, Cosby Elizabeth A, Palitsky Roman, Kaplan Deanna M, Lee Josie, Mahdavi Golnoosh, Lopez Adrian A, Goldman Roberta E, Eichel Kristina, Lindahl Jared R, Britton Willoughby B

机构信息

Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, United States of America.

Department of Religious Studies, Brown University, Providence, RI, United States of America.

出版信息

PLoS One. 2025 Jan 30;20(1):e0318499. doi: 10.1371/journal.pone.0318499. eCollection 2025.

Abstract

Within mindfulness-based programs (MBPs), mixed results have been found for the role of childhood trauma as a moderator of depression outcomes. Furthermore, childhood trauma and PTSD symptoms have been identified as possible risk factors for the occurrence of meditation-related adverse effects (MRAE). The present research examined multiple forms of childhood trauma and PTSD symptoms as predictors of depression treatment outcomes and MRAEs. Various forms of childhood trauma (e.g., abuse and neglect) were examined as predictors of depression treatment outcomes and participant attrition using secondary analyses of two MBP clinical trials (N = 52 and 104, respectively). Study 2 also examined meditation-related side effects (MRSE) and MRAE as outcomes and current subclinical and past PTSD symptoms as predictors. Childhood trauma led to worse depression outcomes across both study 1 and study 2, such that total childhood trauma and childhood sexual abuse were significant predictors across both studies. Childhood sexual abuse predicted attrition in study 2. Finally, multiple forms of childhood trauma and PTSD symptoms predicted MRSE, while total childhood trauma, childhood emotional abuse, and subclinical PTSD symptoms predicted lasting MRAE. Childhood trauma and PTSD symptoms may lead to worse outcomes and a greater occurrence of adverse effects within MBPs for active depression. These results call for further trauma-sensitive modifications, safety monitoring, participant screening, and provider education when implementing these programs.

摘要

在基于正念的项目(MBPs)中,关于童年创伤作为抑郁症治疗结果调节因素的作用,研究结果不一。此外,童年创伤和创伤后应激障碍(PTSD)症状已被确定为冥想相关不良反应(MRAE)发生的可能风险因素。本研究考察了多种形式的童年创伤和PTSD症状,将其作为抑郁症治疗结果和MRAE的预测因素。使用两项MBP临床试验的二次分析(分别为N = 52和104),考察了各种形式的童年创伤(如虐待和忽视)作为抑郁症治疗结果和参与者脱落的预测因素。研究2还考察了冥想相关副作用(MRSE)和MRAE作为结果,以及当前亚临床和过去的PTSD症状作为预测因素。在研究1和研究2中,童年创伤都导致了更差的抑郁症治疗结果,因此,总的童年创伤和童年性虐待在两项研究中都是显著的预测因素。童年性虐待在研究2中预测了参与者脱落。最后,多种形式的童年创伤和PTSD症状预测了MRSE,而总的童年创伤、童年情感虐待和亚临床PTSD症状预测了持续的MRAE。童年创伤和PTSD症状可能会导致在针对活动性抑郁症的MBPs中出现更差的治疗结果和更高发生率的不良反应。这些结果呼吁在实施这些项目时,进一步进行对创伤敏感的调整、安全监测、参与者筛查和提供者教育。

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