The relationship between childhood adversity and affective instability across psychiatric disorders: A meta-analysis.

IF 5.3 2区医学 Q1 PSYCHIATRY Acta Psychiatrica Scandinavica Pub Date : 2024-08-11 DOI:10.1111/acps.13745

Jasper Palmier-Claus, Rebecca Golby, Laura-Jean Stokes, Christopher W N Saville, Kyriakos Velemis, Filippo Varese, Steven Marwaha, Elizabeth Tyler, Peter Taylor

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Abstract

Introduction: Affective instability represents an important, transdiagnostic biobehavioural dimension of mental ill health and clinical outcome. The causes of affective instability remain unclear. This systematic review and meta-analysis evaluated the extent to which exposure to childhood adversity is associated with affective instability across psychiatric disorders, and which forms of adversity are most strongly associated with affective instability.

Methods: The review followed a published protocol (PROSPERO: CRD42020168676). Searches in Medline, Embase and PsychInfo identified studies using quantitative measures of childhood adversity and affective instability, published between January 1980 and July 2023. Data were analysed using a random effects meta-analysis separately for each outcome, namely affective lability, emotion dysregulation, and rapid cycling. The Mixed-Methods Appraisal Tool was used to appraise the quality of the literature.

Results: The search identified 36 studies involving 8431 participants. All reports focused on cross-sectional associations. We did not identify any prospective longitudinal research. The analysis showed small, but statistically significant effects of childhood adversity on affective lability (r = 0.09, 95% CI 0.02, 0.17), emotion dysregulation (r = 0.25, 95% CI 0.19, 0.32), and rapid cycling (OR = 1.39; 95% CI 1.14, 1.70). When considering adversity subtypes, emotional abuse showed the strongest effect on affective lability (r = 0.16, 95% CI 0.07, 0.24) and emotion dysregulation (r = 0.32, 95% CI 0.19, 0.44). Quality assessment scores were generally low. Most studies failed to control for confounding factors or offer assurances around the representativeness of the samples.

Conclusions: The findings suggest that childhood adversity, particularly emotional abuse, is associated emotional instability in adulthood, but further prospective longitudinal research is needed to confirm causality. The findings have implications for the prevention and treatment of affective instability across psychiatric disorders.

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童年逆境与各种精神障碍的情感不稳定性之间的关系：荟萃分析

简介情绪不稳定是精神疾病和临床结果的一个重要的跨诊断生物行为维度。情绪不稳定的原因尚不清楚。本系统综述和荟萃分析评估了童年逆境与各种精神疾病的情感不稳定性的相关程度，以及哪种形式的逆境与情感不稳定性的关系最为密切：综述遵循已发布的协议（PROSPERO：CRD42020168676）。在Medline、Embase和PsychInfo中进行检索，确定了1980年1月至2023年7月期间发表的使用定量测量童年逆境和情感不稳定性的研究。采用随机效应荟萃分析法分别对每种结果（即情感不稳定性、情绪失调和快速循环）进行数据分析。采用混合方法评估工具对文献质量进行评估：搜索发现了 36 项研究，涉及 8431 名参与者。所有报告都侧重于横断面关联。我们没有发现任何前瞻性纵向研究。分析表明，童年逆境对情绪易变性（r = 0.09，95% CI 0.02，0.17）、情绪失调（r = 0.25，95% CI 0.19，0.32）和快速循环（OR = 1.39；95% CI 1.14，1.70）的影响较小，但具有统计学意义。在考虑逆境亚型时，情感虐待对情绪易变（r = 0.16，95% CI 0.07，0.24）和情绪失调（r = 0.32，95% CI 0.19，0.44）的影响最大。质量评估得分普遍较低。大多数研究未能控制混杂因素或保证样本的代表性：研究结果表明，童年时期的逆境，尤其是情感虐待，与成年后的情绪不稳定性有关，但需要进一步的前瞻性纵向研究来确认因果关系。这些研究结果对预防和治疗各种精神疾病的情绪不稳定性具有重要意义。

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来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.