童年创伤对易怒症状的影响

JCPP advances Pub Date : 2024-07-01 DOI:10.1002/jcv2.12260
L. Grasser, Ruiyu Yang, M. Brotman, J. Wiggins
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摘要

易怒是一种跨诊断的精神病表型,被定义为相对于同龄人更容易发怒。创伤被定义为实际或威胁的死亡、严重伤害或性暴力,而逆境更广泛地描述了困难或具有挑战性的情况,包括虐待、忽视和家庭功能失调。暴躁[或攻击性]是创伤后应激障碍(PTSD)的症状,可能是对创伤或创伤事件的反应。对早期负面生活经历的反应可能会因接触类型的不同而不同,例如威胁(虐待)与剥夺(忽视),这对精神病理学的发展有影响。因此,本研究旨在调查以西班牙裔/拉丁裔为主的样本中暴露于威胁和剥夺与易怒之间的关系。我们调查了童年创伤的威胁性和剥夺性方面(在每个维度内)与日后易怒性之间的关系,研究对象是根据创伤暴露程度招募的 n = 48(26F)名 9-19 岁的青少年(Mage = 14.89,SD = 2.04)。多变量回归测试了威胁和匮乏(测量方法:童年创伤问卷)对易怒性(测量方法:情感反应指数)的独特影响。在控制了过度影响值和不显著的性别影响(B = 0.25,t = 1.88,p = 0.067)后,研究结果仍然显著。在对威胁的独特影响进行调整后,威胁与烦躁之间的关系仍然显著,B = 0.35,t = 2.45,p = 0.019。贫困与易怒之间没有明显关系,F(1,46) = 3.35, B = 0.26, R2 = 0.05, p = 0.074。在评估和治疗患有临床损伤性暴躁症的青少年时,应考虑其早年的生活经历。对于有创伤暴露但不符合创伤后应激障碍标准的青少年,应测试针对易怒的跨诊断治疗。
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The contribution of childhood trauma to irritability symptoms
Irritability is a transdiagnostic psychiatric phenotype defined as an increased proneness to anger relative to peers. Trauma is defined as actual or threatened death, serious injury, or sexual violence while adversity more broadly describes difficult or challenging situations including abuse, neglect, and household dysfunction. Irritability [or aggression] is symptom of posttraumatic stress disorder (PTSD) and may arise in response to trauma or traumatic events. Responses to negative early life experiences may differ based on the type of exposure, for example, threat (abuse) versus deprivation (neglect), with implications for development of psychopathology. Therefore, the objective of this study was to investigate the relation between exposure to threat and deprivation, and irritability in a predominantly Hispanic/Latin sample. We hypothesized unique effects of threat versus deprivation on irritability.We investigated relations between threat and deprivation aspects of childhood trauma (within each dimension) and later irritability in a sample of n = 48 (26F) youth ages 9–19 (Mage = 14.89, SD = 2.04) recruited based on trauma exposure. Multivariate regression tested the unique effects of threat and deprivation (measurement: Childhood Trauma Questionnaire) on irritability (measurement: Affective Reactivity Index).Greater threat exposure was associated with more severe self‐reported irritability, F(1,46) = 8.64, B = 0.40, R2 = 0.14, p = 0.005. Findings remained significant after controlling for values of excessive influence and the non‐significant effect of gender (B = 0.25, t = 1.88, p = 0.067). When looking at the unique effects of threat adjusted for deprivation, the relation between threat and irritability remained significant, B = 0.35, t = 2.45, p = 0.019. There was no significant association between deprivation and irritability, F(1,46) = 3.35, B = 0.26, R2 = 0.05, p = 0.074.Exposure to threat, but not deprivation, may increase risk for irritability in youth. Early life experiences should be considered in assessment and treatment of youth with clinically impairing irritability. Transdiagnostic treatments targeting irritability should be tested for youth with trauma exposure who do not meet criteria for post‐traumatic stress disorder.
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