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幼儿期创伤及其对认知和情感发展的长期影响:一项系统综述和荟萃分析。

Early childhood trauma and its long-term impact on cognitive and emotional development: a systematic review and meta-analysis.

作者信息

Fan Linlin, Kang Tinghu

机构信息

Department of School of Nursing, Gansu University of Traditional Chinese Medicine/Department of School of Education Science, Northwest Normal University, Lanzhou, China.

Department of School of Psychology, Northwest Normal University, Lanzhou, China.

出版信息

Ann Med. 2025 Dec;57(1):2536199. doi: 10.1080/07853890.2025.2536199. Epub 2025 Jul 29.

Abstract

BACKGROUND

Childhood trauma has profound, long-term effects on cognitive and emotional development. This systematic review and meta-analysis sought to synthesis the evidence around the long-term impact of human childhood trauma on domains of cognition and emotion in order to inform interventions and public health strategies.

METHODS

We systematically reviewed 465 studies from PubMed, Cochrane Library, and Google Scholar, 9 studies were included after duplicates were removed and inclusion and exclusion criteria were applied, and all 9 studies were aimed at low-income people in the United States. Data on study design, trauma types, and cognitive/emotional outcomes were extracted. Study quality was assessed using the Newcastle-Ottawa Scale (NOS) and Cochrane Risk of Bias Tool (RoB 2). Random-effects meta-analysis and subgroup analyses (processing speed, attention, working memory, emotion regulation, executive function) were conducted using R software.

RESULTS

Childhood trauma was associated with significant deficits in: Attention (SMD = 2.37, 95% CI: [5.75, 10.50]) Working memory (SMD = 3.55, 95% CI: [2.18, 9.28]) Emotion regulation (SMD = 1.25, 95% CI: [1.12, 3.62]) Executive function (SMD = 1.61, 95% CI: [0.06, 3.28]) Processing speed showed smaller deficits (SMD = -0.48, 95% CI: [-1.91, 0.94]). High heterogeneity (I: 77-98%) reflected variability in trauma types and assessments. The pooled effect size (SMD = 1.57, 95% CI: [-0.12, 3.26]) highlighted trauma's pervasive impact.

CONCLUSION

Childhood trauma disproportionately impairs attention and working memory. These findings, however, point to the importance of early screening, trauma-informed care and targeted interventions to ameliorate the long-term consequences of trauma, even with high heterogeneity. Methodological variability should be addressed to inform prevention and treatment strategies in future research, as well as resilience factors explored.

摘要

背景

童年创伤对认知和情感发展具有深远的长期影响。本系统评价和荟萃分析旨在综合有关人类童年创伤对认知和情感领域长期影响的证据,以为干预措施和公共卫生策略提供参考。

方法

我们系统检索了来自PubMed、Cochrane图书馆和谷歌学术的465项研究,在去除重复项并应用纳入和排除标准后,纳入了9项研究,所有9项研究均针对美国的低收入人群。提取了关于研究设计、创伤类型和认知/情感结果的数据。使用纽卡斯尔-渥太华量表(NOS)和Cochrane偏倚风险工具(RoB 2)评估研究质量。使用R软件进行随机效应荟萃分析和亚组分析(处理速度、注意力、工作记忆、情绪调节、执行功能)。

结果

童年创伤与以下方面的显著缺陷相关:注意力(标准化均数差[SMD]=2.37,95%可信区间:[5.75,10.50])、工作记忆(SMD=3.55,95%可信区间:[2.18,9.28])、情绪调节(SMD=1.25,95%可信区间:[1.12,3.62])、执行功能(SMD=1.61,95%可信区间:[0.06,3.28])。处理速度的缺陷较小(SMD=-0.48,95%可信区间:[-1.91,0.94])。高异质性(I:77-98%)反映了创伤类型和评估的变异性。合并效应量(SMD=1.57,95%可信区间:[-0.12,3.26])突出了创伤的普遍影响。

结论

童年创伤对注意力和工作记忆的损害尤为严重。然而,这些发现指出了早期筛查、创伤知情护理和针对性干预措施的重要性,以改善创伤的长期后果,即使存在高异质性。应解决方法学变异性问题,为未来研究中的预防和治疗策略提供参考,并探索复原力因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e114/12308860/c56213e47853/IANN_A_2536199_F0001_B.jpg

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