Klingelhöfer-Jens Maren, Hutterer Katharina, Schiele Miriam A, Leehr Elisabeth J, Schümann Dirk, Rosenkranz Karoline, Böhnlein Joscha, Repple Jonathan, Deckert Jürgen, Domschke Katharina, Dannlowski Udo, Lueken Ulrike, Reif Andreas, Romanos Marcel, Zwanzger Peter, Pauli Paul, Gamer Matthias, Lonsdorf Tina B
Institute for Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, University of Würzburg, Würzburg, Germany.
Elife. 2025 Feb 20;12:RP91425. doi: 10.7554/eLife.91425.
Childhood adversity is a strong predictor of developing psychopathological conditions. Multiple theories on the mechanisms underlying this association have been suggested which, however, differ in the operationalization of 'exposure.' Altered (threat) learning mechanisms represent central mechanisms by which environmental inputs shape emotional and cognitive processes and ultimately behavior. 1402 healthy participants underwent a fear conditioning paradigm (acquisition training, generalization), while acquiring skin conductance responses (SCRs) and ratings (arousal, valence, and contingency). Childhood adversity was operationalized as (1) dichotomization, and following (2) the specificity model, (3) the cumulative risk model, and (4) the dimensional model. Individuals exposed to childhood adversity showed blunted physiological reactivity in SCRs, but not ratings, and reduced CS+/CS- discrimination during both phases, mainly driven by attenuated CS+ responding. The latter was evident across different operationalizations of 'exposure' following the different theories. None of the theories tested showed clear explanatory superiority. Notably, a remarkably different pattern of increased responding to the CS- is reported in the literature for anxiety patients, suggesting that individuals exposed to childhood adversity may represent a specific sub-sample. We highlight that theories linking childhood adversity to (vulnerability to) psychopathology need refinement.
童年逆境是心理病理状况发展的一个强有力的预测指标。关于这种关联背后机制的多种理论已被提出，然而，这些理论在“暴露”的操作化定义方面存在差异。改变的（威胁）学习机制是环境输入塑造情绪和认知过程并最终影响行为的核心机制。1402名健康参与者接受了恐惧条件反射范式（习得训练、泛化），同时获取皮肤电导率反应（SCR）和评分（唤醒、效价和偶然性）。童年逆境的操作化定义为：（1）二分法，以及随后的（2）特异性模型、（3）累积风险模型和（4）维度模型。暴露于童年逆境的个体在SCR中表现出生理反应迟钝，但在评分中未表现出，并且在两个阶段中CS+/CS-辨别能力降低，主要是由CS+反应减弱驱动的。在遵循不同理论的“暴露”的不同操作化定义中，后者都是明显的。所测试的理论均未显示出明显的解释优势。值得注意的是，文献中报道焦虑症患者对CS-的反应增加模式明显不同，这表明暴露于童年逆境的个体可能代表一个特定的亚样本。我们强调，将童年逆境与心理病理学（易感性）联系起来的理论需要完善。
