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ADHD medication adherence reduces risk of committing minor offenses in adolescents 坚持服用多动症药物可降低青少年轻微犯罪的风险
IF 6.5 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-05-03 DOI: 10.1111/jcpp.13997
Paul T. Rosenau, Andrea Dietrich, Barbara J. van den Hoofdakker, Pieter J. Hoekstra

Background

This study aimed to investigate the association between adolescents’ adherence to attention-deficit/hyperactivity disorder (ADHD) medication and their risk of committing minor offenses.

Methods

Using two Dutch databases, Statistics Netherlands (CBS) and the Foundation for Pharmaceutical Statistics (SFK), we aimed to investigate the association between adherence to ADHD medication and registered minor offenses between 2005 and 2019 of 18,234 adolescents (12–18 years). We used Cox regression analyses to compare the rate of committing minor offenses of adolescents during periods of high ADHD medication adherence compared to periods of low adherence (i.e., periods with or without sufficient amounts of dispensed medication). We additionally tested associations with adherence to selective serotonin reuptake inhibitors (SSRIs) as control medication and analyzed potential reverse causation.

Results

High ADHD medication adherence was associated with a reduced risk of committing a minor offense of between 33% and 38% compared to low adherence periods of ≥3 months (hazard ratio [HR] 0.67, confidence interval [CI] 0.64–0.71) or ≥6 months (HR 0.62, CI 0.59–0.65). The reduction in risk can likely be attributed to ADHD medication, given the absence of effects of SSRIs and no reverse causation. The reduction rate remained between 16% and 55% per sex, stimulant versus non-stimulant medication, different offense categories and further sensitivity analyses.

Conclusions

Among adolescents using ADHD medication, rates of criminality were lower during periods of high medication adherence, suggesting that adherence to ADHD medication may contribute to prevention of minor offenses in adolescents.

方法我们利用荷兰统计局(CBS)和药物统计基金会(SFK)的两个荷兰数据库,调查了2005年至2019年期间18234名青少年(12-18岁)的注意力缺陷/多动障碍(ADHD)药物治疗依从性与登记的轻微犯罪之间的关系。我们使用 Cox 回归分析比较了青少年在多动症药物治疗依从性高的时期与依从性低的时期(即有或没有足量配药的时期)的轻微犯罪率。结果与≥3个月(危险比[HR]0.67,置信区间[CI]0.64-0.71)或≥6个月(HR 0.62,CI 0.59-0.65)的低依从性时期相比,ADHD药物依从性高与轻微犯罪风险降低33%至38%有关。鉴于SSRIs没有影响,也没有反向因果关系,因此风险的降低很可能归因于ADHD药物治疗。结论在使用ADHD药物治疗的青少年中,在药物治疗依从性高的时期犯罪率较低,这表明坚持ADHD药物治疗可能有助于预防青少年轻微犯罪。
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引用次数: 0
Family dysfunction, stressful life events, and mental health problems across development in the offspring of parents with an affective disorder 父母患有情感障碍的后代在整个成长过程中的家庭功能障碍、生活压力事件和心理健康问题
IF 6.5 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-04-29 DOI: 10.1111/jcpp.13991
Tiffany Resendes, Mark A. Ellenbogen, Albertine J. Oldehinkel

Background

Offspring of parents with affective disorders (OAD) are at risk of developing a wide range of mental disorders. Deficits in the rearing environment and high levels of stress are well-known risk factors for negative outcomes in OAD. Building on prior research, we aim to examine the longitudinal relationships between family dysfunction, stressful life events, and mental health in OAD and control offspring of parents with no affective disorder. In the present study, we hypothesized that high levels of family dysfunction would be associated with more internalizing and externalizing problems across time in OAD than in controls, and that family dysfunction would mediate the relationship between stressful life events in adolescence and poor mental health in adulthood, particularly in OAD.

Methods

As part of the TRacking Adolescents' Lives Survey (TRAILS), 2230 participants (51% female, Mage = 11.1 years, SD = 0.6, at baseline) and their parents completed measures across six time points, spanning 15 years. Mental health, family dysfunction, and stressful life events were assessed with the Youth and Adult Self-Report, Family Assessment Device, and an in-house measure, respectively.

Results

Multi-group structured equation modeling revealed that family dysfunction was linked to internalizing and externalizing problems in OAD, but not controls, across time. Risk status did not moderate family dysfunction's mediation of the relationship between stressful life events and negative outcomes in adulthood.

Conclusions

OAD show high sensitivity to dysfunction in the rearing environment across childhood and adolescence, which supports the use of family based interventions to prevent the development of mental disorders in high-risk youth.

背景父母患有情感障碍(OAD),其子女有可能患上多种精神障碍。众所周知,养育环境的缺陷和高度压力是导致情感障碍后代出现不良后果的风险因素。在以往研究的基础上,我们旨在研究家庭功能障碍、生活压力事件与 OAD 和父母无情感障碍的对照组后代的心理健康之间的纵向关系。在本研究中,我们假设,与对照组相比,高水平的家庭功能障碍将与OAD在不同时期出现更多的内化和外化问题有关,而且家庭功能障碍将介导青少年时期的生活压力事件与成年后不良心理健康之间的关系,尤其是在OAD中。方法作为追踪青少年生活调查(TRAILS)的一部分,2230 名参与者(51% 为女性,基线年龄为 11.1 岁,标准差为 0.6)及其父母完成了横跨 15 年的六个时间点的测量。结果多组结构方程模型显示,在不同时期,家庭功能障碍与OAD的内化和外化问题有关,而与对照组无关。结论OAD在童年和青少年时期对抚养环境中的功能障碍表现出高度敏感性,这支持使用基于家庭的干预措施来预防高危青少年精神障碍的发展。
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引用次数: 0
Childhood behavior problems and adverse economic outcomes: a 30-year population-based study of intergenerational income mobility 童年行为问题与不良经济后果:一项为期 30 年的代际收入流动性人口研究
IF 6.5 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-04-24 DOI: 10.1111/jcpp.13992
Vincent Bégin, Francis Vergunst, Catherine Haeck, Frank Vitaro, Richard E. Tremblay, Sylvana M. Côté, Nathalie M.G. Fontaine

Background

The objectives of this study were to (a) assess the associations between early behavioral problems and intergenerational income mobility (i.e., the degree to which income status is transmitted from one generation to the next), (b) verify whether these associations are moderated by child sex, and (c) explore indirect effects of early behavioral problems on income mobility via high school graduation.

Methods

Data were drawn from the Quebec Longitudinal Study of Kindergarten Children (n = 3,020; 49.17% girls). Participants were followed from age 6 to 37 years. Measures included parents' and teachers' ratings of behavioral problems at age 6 years as well as participants' (ages 30–35 years) and their parents' (when participants were aged 10–19 years) income data obtained from tax return records. Regression models were used to predict upward and downward mobility (i.e., increased or decreased income status from one generation to the next) from attention-deficit/hyperactivity problems, conduct/opposition problems, depression/anxiety problems, prosociality, and the quality of children's relationship with their caregiver. Two-way interaction effects between behavioral problems and child sex were examined and indirect effect models including high school graduation as a mediator of these associations were conducted.

Results

Despite their higher educational attainment, females had lower incomes and experienced lower upward (but higher downward) income mobility than males. For both females and males, higher levels of attention-deficit/hyperactivity and conduct/opposition problems were associated with decreased odds of upward mobility, whereas higher levels of attention-deficit/hyperactivity were associated with increased odds of downward mobility. Attention-deficit/hyperactivity problems, conduct/opposition problems as well as low prosociality were associated with lower educational attainment (no high school diploma), which in turn was associated with increased odds of downward mobility.

Conclusions

Results highlight the importance of providing intensive support to children with early behavioral problems as a means of improving educational attainment and intergenerational income mobility.

背景本研究的目的是:(a)评估早期行为问题与代际收入流动性(即收入状况从一代传给下一代的程度)之间的关联;(b)验证这些关联是否受儿童性别的调节;以及(c)探讨早期行为问题通过高中毕业对收入流动性的间接影响。对参与者从 6 岁到 37 岁进行了跟踪调查。衡量标准包括家长和教师对 6 岁儿童行为问题的评价,以及从纳税申报记录中获得的参与者(30-35 岁)及其父母(参与者 10-19 岁时)的收入数据。回归模型用于预测注意力缺陷/多动问题、行为/对抗问题、抑郁/焦虑问题、亲社会性以及儿童与照顾者关系质量的向上和向下流动性(即一代人与下一代人之间收入状况的增加或减少)。我们还研究了行为问题与儿童性别之间的双向交互效应,并建立了间接效应模型,将高中毕业作为这些关联的中介。结果尽管女性的教育程度较高,但与男性相比,女性的收入较低,收入向上流动性较低(但向下流动性较高)。对于女性和男性来说,注意力缺陷/多动和行为/立场问题水平越高,向上流动的几率就越低,而注意力缺陷/多动水平越高,向下流动的几率就越高。注意缺陷/多动问题、行为/立场问题以及低亲社会性与较低的教育程度(无高中文凭)有关,而较低的教育程度又与较高的向下流动几率有关。
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引用次数: 0
Longitudinal trajectories of suicidal ideation among child welfare-involved 7- to 12-year-old children 涉及儿童福利的 7 至 12 岁儿童自杀意念的纵向轨迹
IF 6.5 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-04-24 DOI: 10.1111/jcpp.13999
Lynsay Ayer, Gabriel Hassler, Elie Ohana, Arielle H. Sheftall, Nathaniel W. Anderson, Beth Ann Griffin

Background

Young children involved in the child welfare system (CWS) are at high risk for suicidal ideation (SI) at a time when overall rates of suicide death in this age group are rising. Yet risk factors for and changes in SI over time are poorly understood in this population.

Method

We combined data from two large representative longitudinal studies of children involved in the United States CWS. We examined patterns of SI among children who were between ages 7 and 12 years at the initial survey wave (N = 2,186), assessed at three waves using a measure of SI in the past 2 weeks. We conducted a multinomial regression to understand the baseline demographic, child maltreatment, and mental health characteristics that distinguish the trajectories.

Results

There were eight different subgroups (Non-Ideators, Late Ideators, Boomerang Ideators, Delayed Ideators, Desisters, Boomerang Non-Ideators, Late Desisters, and Persisters). Differences in race, type of maltreatment, sex, and mental health symptoms were identified when comparing Persisters (SI at all three waves) to other groups.

Conclusions

These findings can help researchers and practitioners to develop strategies for better identifying CWS-involved children who are in greatest need of suicide risk monitoring and intervention.

背景卷入儿童福利系统(CWS)的幼儿是自杀意念(SI)的高风险人群,而这一年龄组的自杀死亡率却在不断上升。然而,人们对这一人群的自杀意念风险因素及其随时间推移而发生的变化却知之甚少。我们研究了最初调查波次时年龄在 7 到 12 岁之间的儿童(N=2,186)的 SI 模式,在三次波次中使用过去两周内的 SI 测量值进行评估。我们进行了多项式回归,以了解区分轨迹的人口统计学、儿童虐待和心理健康基线特征。结果有八个不同的亚组(非意念者、晚期意念者、回旋意念者、延迟意念者、逃避者、回旋非意念者、晚期逃避者和坚持者)。在比较坚持者(三次波次均为 SI)和其他群体时,发现了种族、虐待类型、性别和心理健康症状方面的差异。结论这些发现有助于研究人员和从业人员制定策略,更好地识别最需要自杀风险监测和干预的 CWS 儿童。
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引用次数: 0
Social and joint attention during shared book reading in young autistic children: a potential marker for social development 自闭症幼儿共同阅读图书时的社交注意力和共同注意力:社交发展的潜在标志
IF 6.5 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-04-24 DOI: 10.1111/jcpp.13993
Zahava Ambarchi, Kelsie A. Boulton, Rinku Thapa, Joanne Arciuli, Marilena M. DeMayo, Ian B. Hickie, Emma E. Thomas, Adam J. Guastella

Background

Atypical patterns of social engagement and joint attention behaviors are diagnostic criteria for people with autism spectrum disorder. Experimental tasks using eye-tracking methodologies have, however, shown inconsistent results. The development of tasks with greater ecological validity and relevance for developmentally appropriate social milestones has been identified as important for the field.

Methods

We developed a novel, dynamic eye-tracking task emulating a shared book reading (SBR) scenario. Four SBR videos of an adult reader engaging with the viewer while reading a children's picture book and including sequenced bids for joint attention were developed. Participants included 90 children (N = 56 autistic children, N = 34 neurotypical children; aged 3–12). Social attention was also measured in a live free play task between participants and an experimenter.

Results

Compared to neurotypical children, autistic children displayed reduced attention to socially salient stimuli including the reader's face and picture book across SBR videos and during joint attention bids specifically. In contrast, they showed increased attention to nonsalient background stimuli compared to their neurotypical peers. These attention patterns in autistic children were associated with reduced verbal and nonverbal cognitive skills and increased symptoms associated with autism. Interestingly, positive correlations in the frequency of eye gaze between SBR and free play suggested a potential predictive value for social attention in live social interactions.

Conclusions

Findings highlight the utility of SBR eye-tracking tasks in understanding underlying divergences in social engagement and joint attention between autistic and neurotypical children. This commonly practiced early childhood activity may provide insights into the relationship between social engagement and learning to reveal how such attentional patterns might influence broader developmental and educational outcomes.

背景自闭症谱系障碍患者的诊断标准是不典型的社会参与模式和共同注意行为。然而,使用眼动追踪方法进行的实验任务却显示出不一致的结果。我们开发了一种新颖、动态的眼动跟踪任务,模拟共同阅读图书(SBR)的情景。我们制作了四段 SBR 视频,视频中成人读者在阅读儿童图画书时与观众互动,并按顺序请求共同注意。参与者包括 90 名儿童(自闭症儿童 56 名,神经畸形儿童 34 名;年龄 3-12 岁)。结果与神经正常儿童相比,自闭症儿童在观看 SBR 视频时,特别是在联合注意竞标时,对社会突出刺激(包括读者的脸和图画书)的注意力有所下降。相反,与神经畸形儿童相比,自闭症儿童对非显著性背景刺激的注意力却有所增加。自闭症儿童的这些注意力模式与语言和非语言认知技能的下降以及自闭症相关症状的增加有关。有趣的是,SBR 和自由游戏之间的目光注视频率呈正相关,这表明在现场社交互动中社会注意力具有潜在的预测价值。结论研究结果突出表明,SBR 眼动追踪任务有助于了解自闭症儿童和神经症儿童在社会参与和共同注意力方面的潜在差异。这种常见的儿童早期活动可以让我们深入了解社会参与和学习之间的关系,从而揭示这种注意力模式可能会如何影响更广泛的发展和教育成果。
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引用次数: 0
Weekly links among irritability and suicidal thoughts and behaviors in high-risk youth 高危青少年每周易怒与自杀想法和行为之间的联系
IF 6.5 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-04-23 DOI: 10.1111/jcpp.13988
Aleksandra Kaurin, Aidan G.C. Wright, Giovanna Porta, Edward Hamilton, Kimberly Poling, Kelsey Bero, David Brent, Tina R. Goldstein

Background

Previous studies demonstrate a link between irritability and suicidal thoughts and behaviors (STBs) in youth samples. However, they have mostly assessed irritability in community samples and as a largely dispositional (i.e. trait-like) construct. Thus, it remains unclear to what extent links between irritability and STBs reflect within-person processes of elevated risk in clinically meaningful time periods.

Methods

The present study used clinical data from 689 adolescents aged 12–19 years attending a total of 6,128 visits at a specialty Intensive Outpatient Program for depressed and suicidal youth to examine patterns in weekly assessments of irritability and STBs throughout treatment, including associations among trends and fluctuations departing from these trends via multilevel structural equation modeling. Youth completed self-report measures of irritability, depression, and STBs weekly as part of standard IOP clinical care.

Results

Overall, two-thirds of variance in weekly irritable mood was accounted for by between-person differences and the remaining portion by weekly fluctuations. After controlling for depression, during weeks when youth were more irritable they experienced increased STBs. Rates of change in irritability and STBs tended to track together at early stages of treatment, but these effects were generally accounted for by depression severity.

Conclusions

Our results suggest that although changes in STBs are best accounted for by depression, irritability can be understood as a specific, proximal risk factor for youth STBs that exacerbates youth STBs in clinically informative timeframes above and beyond depression.

背景以往的研究表明,在青少年样本中,易怒与自杀想法和行为(STBs)之间存在联系。然而,这些研究大多是在社区样本中对易怒性进行评估,而且主要是将易怒性作为一种倾向性(即类似特质)的结构。本研究使用了 689 名 12-19 岁青少年的临床数据,这些青少年在抑郁和有自杀倾向的青少年专科强化门诊项目共就诊 6128 次,通过多层次结构方程模型研究了整个治疗过程中每周评估的易怒性和 STB 的模式,包括趋势之间的关联和偏离这些趋势的波动。作为 IOP 标准临床治疗的一部分,青少年每周都要完成烦躁、抑郁和 STB 的自我报告测量。结果总的来说,每周烦躁情绪的三分之二差异是由人与人之间的差异造成的,其余部分是由每周的波动造成的。在控制了抑郁因素后,在青少年更易怒的几周内,他们的 STB 增加了。结论我们的研究结果表明,虽然 STBs 的变化最好由抑郁来解释,但易怒可以被理解为青少年 STBs 的一个特殊的、近端风险因素,它在临床上会在抑郁之外的时间范围内加剧青少年的 STBs。
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引用次数: 0
Contamination bias in the estimation of child maltreatment causal effects on adolescent internalizing and externalizing behavior problems 估计儿童虐待对青少年内化和外化行为问题的因果影响时的污染偏差
IF 6.5 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-04-18 DOI: 10.1111/jcpp.13990
John M. Felt, Ulziimaa Chimed-Ochir, Kenneth A. Shores, Anneke E. Olson, Yanling Li, Zachary F. Fisher, Nilam Ram, Chad E. Shenk

Background

When unaddressed, contamination in child maltreatment research, in which some proportion of children recruited for a nonmaltreated comparison group are exposed to maltreatment, downwardly biases the significance and magnitude of effect size estimates. This study extends previous contamination research by investigating how a dual-measurement strategy of detecting and controlling contamination impacts causal effect size estimates of child behavior problems.

Methods

This study included 634 children from the LONGSCAN study with 63 cases of confirmed child maltreatment after age 8 and 571 cases without confirmed child maltreatment. Confirmed child maltreatment and internalizing and externalizing behaviors were recorded every 2 years between ages 4 and 16. Contamination in the nonmaltreated comparison group was identified and controlled by either a prospective self-report assessment at ages 12, 14, and 16 or by a one-time retrospective self-report assessment at age 18. Synthetic control methods were used to establish causal effects and quantify the impact of contamination when it was not controlled, when it was controlled for by prospective self-reports, and when it was controlled for by retrospective self-reports.

Results

Rates of contamination ranged from 62% to 67%. Without controlling for contamination, causal effect size estimates for internalizing behaviors were not statistically significant. Causal effects only became statistically significant after controlling contamination identified from either prospective or retrospective reports and effect sizes increased by between 17% and 54%. Controlling contamination had a smaller impact on effect size increases for externalizing behaviors but did produce a statistically significant overall effect, relative to the model ignoring contamination, when prospective methods were used.

Conclusions

The presence of contamination in a nonmaltreated comparison group can underestimate the magnitude and statistical significance of causal effect size estimates, especially when investigating internalizing behavior problems. Addressing contamination can facilitate the replication of results across studies.

背景儿童虐待研究中的污染问题如果不加以解决,就会使效应大小估计值的显著性和幅度向下偏移。本研究扩展了之前的污染研究,调查了检测和控制污染的双重测量策略如何影响儿童行为问题的因果效应大小估计值。方法本研究纳入了 LONGSCAN 研究中的 634 名儿童,其中 63 名儿童在 8 岁后证实受到虐待,571 名儿童未证实受到虐待。在儿童4至16岁期间,每两年记录一次经证实的虐待儿童行为以及内化和外化行为。通过在 12、14 和 16 岁时进行前瞻性自我报告评估,或在 18 岁时进行一次性回顾性自我报告评估,确定并控制未受虐待对比组中的污染情况。在未控制污染、通过前瞻性自我报告控制污染以及通过回顾性自我报告控制污染的情况下,采用合成控制法确定因果效应并量化污染的影响。在不控制污染的情况下,内化行为的因果效应估计值在统计上并不显著。只有在控制了前瞻性或回顾性报告中发现的污染后,因果效应才具有统计学意义,效应大小增加了 17% 至 54%。在使用前瞻性方法时,控制污染对外化行为效应大小增加的影响较小,但与忽略污染的模型相比,确实产生了具有统计学意义的总体效应。结论未经驯化的对比组中存在污染会低估因果效应大小估计的幅度和统计学意义,尤其是在调查内化行为问题时。解决污染问题有助于在不同研究中重复结果。
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引用次数: 0
Editorial: Are government early years learning and development frameworks evidence-based? A scientist's perspective 社论:政府的幼儿学习与发展框架是否以证据为基础?科学家的视角
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-04-17 DOI: 10.1111/jcpp.13983
Angelica Ronald

Not all young children attend nurseries, childminders or other group settings before they start school, but many do. It is common for countries to set out a framework to guide practice for early years providers (such as nurseries) to follow. The conundrum regarding these frameworks for young children is that proving evidence of a causal link between early environments and later outcomes is very challenging scientifically. So how do governments choose what learning and development practices and goals to make mandatory for childcare providers? And is it realistic to expect early years providers to meet the legal requirements that these frameworks impose? We do not know which learning and development practices impact positively on later outcomes, and we certainly do not know if there is a one-size-fits-all approach for an early years framework that is guaranteed to work.

并非所有幼儿在入学前都会去幼儿园、托儿所或其他集体机构,但很多幼儿都会这样做。各国通常会制定一个框架来指导幼儿教育机构(如托儿所)的实践。这些幼儿框架的难题在于,要证明早期环境与日后结果之间的因果关系,在科学上是非常具有挑战性的。那么,政府如何选择哪些学习与发展实践和目标是托儿所必须遵守的呢?期望幼儿保育机构达到这些框架所规定的法律要求是否现实?我们不知道哪些学习与发展实践会对日后的结果产生积极影响,我们当然也不知道是否有一种 "放之四海而皆准 "的方法可以保证幼儿教育框架行之有效。
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引用次数: 0
Brain structure and functional connectivity linking childhood cumulative trauma to COVID-19 vicarious traumatization 将童年累积性创伤与 COVID-19 转承性创伤联系起来的大脑结构和功能连通性
IF 6.5 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-04-17 DOI: 10.1111/jcpp.13989
Xiqin Liu, Yajun Zhao, Jingguang Li, Xueling Suo, Qiyong Gong, Song Wang

Background

The COVID-19 pandemic has caused some individuals to experience vicarious traumatization (VT), an adverse psychological reaction to those who are primarily traumatized, which may negatively impact one's mental health and well-being and has been demonstrated to vary with personal trauma history. The neural mechanism of VT and how past trauma history affects current VT remain largely unknown. This study aimed to identify neurobiological markers that track individual differences in VT and reveal the neural link between childhood cumulative trauma (CCT) and VT.

Methods

We used structural and resting-state functional magnetic resonance imaging before the pandemic to identify prospective brain markers for COVID-related VT by correlating individuals' VT levels during the pandemic with the gray matter volume (GMV) and seed-based resting-state functional connectivity (RSFC) and examined how these brain markers linked CCT to VT in a sample of general young adults (N = 115/100).

Results

Whole-brain GMV–behavior correlation analysis showed that VT was positively associated with GMV in the right dorsolateral prefrontal gyrus (DLPFC). Using the cluster derived from the GMV–behavior correlation analysis as the seed region, we further revealed that the RSFC between the right DLPFC and right precuneus was negatively associated with VT. Importantly, the right DLPFC volume and DLPFC-precuneus RSFC mediated the effect of CCT on VT. These findings remained unaffected by factors such as family socioeconomic status, other stressful life events, and general mental health.

Conclusions

Overall, our study presents structural and functional brain markers for VT and highlights these brain-based markers as a potential neural mechanism linking CCT to COVID-related VT, which has implications for treating and preventing the development of trauma-related mental disorders.

背景COVID-19大流行使一些人经历了替代性创伤(VT),这是一种对那些主要受到创伤的人的不良心理反应,可能会对个人的心理健康和幸福产生负面影响,并且已被证明与个人创伤史有关。VT的神经机制以及过去的创伤史如何影响当前的VT,在很大程度上仍是未知数。本研究旨在确定跟踪 VT 个体差异的神经生物学标记,并揭示童年累积性创伤(CCT)与 VT 之间的神经联系。方法我们在大流行前使用结构和静息态功能磁共振成像技术,通过将个人在大流行期间的 VT 水平与灰质体积(GMV)和基于种子的静息态功能连通性(RSFC)相关联,来识别 COVID 相关 VT 的前瞻性大脑标记物,并在普通青壮年样本(N = 115/100)中研究了这些大脑标记物如何将 CCT 与 VT 联系起来。结果全脑 GMV 行为相关性分析表明,VT 与右侧背外侧前额叶回 (DLPFC) 的 GMV 呈正相关。以 GMV 行为相关分析得出的聚类为种子区域,我们进一步发现右侧 DLPFC 和右侧楔前回之间的 RSFC 与 VT 负相关。重要的是,右侧 DLPFC 的体积和 DLPFC 与楔前肌之间的 RSFC 在 CCT 对 VT 的影响中起中介作用。总之,我们的研究提出了VT的大脑结构和功能标记,并强调这些基于大脑的标记是连接CCT与COVID相关VT的潜在神经机制,这对治疗和预防创伤相关精神障碍的发展具有重要意义。
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引用次数: 0
Do traumatic events and substance use co-occur during adolescence? Testing three causal etiologic hypotheses 创伤事件和药物使用会在青春期同时发生吗?检验三种因果病因假设
IF 6.5 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-04-15 DOI: 10.1111/jcpp.13985
Herry Patel, Susan F. Tapert, Sandra A. Brown, Sonya B. Norman, William E. Pelham III

Background

Why do potentially traumatic events (PTEs) and substance use (SU) so commonly co-occur during adolescence? Causal hypotheses developed from the study of posttraumatic stress disorder (PTSD) and substance use disorder (SUD) among adults have not yet been subject to rigorous theoretical analysis or empirical tests among adolescents with the precursors to these disorders: PTEs and SU. Establishing causality demands accounting for various factors (e.g. genetics, parent education, race/ethnicity) that distinguish youth endorsing PTEs and SU from those who do not, a step often overlooked in previous research.

Methods

We leveraged nationwide data from a sociodemographically diverse sample of youth (N = 11,468) in the Adolescent Brain and Cognitive Development Study. PTEs and substance use prevalence were assessed annually. To account for the many pre-existing differences between youth with and without PTE/SU (i.e. confounding bias) and provide rigorous tests of causal hypotheses, we linked within-person changes in PTEs and SU (alcohol, cannabis, nicotine) across repeated measurements and adjusted for time-varying factors (e.g. age, internalizing symptoms, externalizing symptoms, and friends' use of substances).

Results

Before adjusting for confounding using within-person modeling, PTEs and SU exhibited significant concurrent associations (βs = .46–1.26, ps < .05) and PTEs prospectively predicted greater SU (βs = .55–1.43, ps < .05) but not vice versa. After adjustment for confounding, the PTEs exhibited significant concurrent associations for alcohol (βs = .14–.23, ps < .05) and nicotine (βs = .16, ps < .05) but not cannabis (βs = -.01, ps > .05) and PTEs prospectively predicted greater SU (βs = .28–.55, ps > .05) but not vice versa.

Conclusions

When tested rigorously in a nationwide sample of adolescents, we find support for a model in which PTEs are followed by SU but not for a model in which SU is followed by PTEs. Explanations for why PTSD and SUD co-occur in adults may need further theoretical analysis and adaptation before extension to adolescents.

为什么潜在创伤事件(PTE)和药物使用(SU)在青春期如此常见地同时发生?从研究成人创伤后应激障碍(PTSD)和药物使用障碍(SUD)中得出的因果假设,尚未在患有这些障碍前兆的青少年中进行严格的理论分析或实证检验:PTEs 和 SU。要确定因果关系,就必须考虑到各种因素(如遗传、父母教育、种族/民族),这些因素会将患有 PTEs 和 SU 的青少年与未患有 PTEs 和 SU 的青少年区分开来,而以往的研究往往忽略了这一步骤。
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引用次数: 0
期刊
Journal of Child Psychology and Psychiatry
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