The relationship of childhood abuse to impulsivity and suicidal behavior in adults with major depression
The relationship of childhood abuse to impulsivity and suicidal behavior in adults with major depression
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DOI：
10.1176/appi.ajp.158.11.1871
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发表时间：
2001-11-01
影响因子：
17.7
通讯作者：
Mann, JJ
中科院分区：
文献类型：
--
作者：
Brodsky, BS;Oquendo, M;Mann, JJ
目的：本研究调查了具有较高水平的冲动性、攻击性和自杀行为的抑郁成人是否会出现较高频率的童年创伤报告。方法：在 136 名抑郁成人住院患者中，作者评估了冲动性、攻击性历史和一生自杀企图的次数，以及与最致命的企图相关的医疗致死率和死亡意图。然后将这些变量在有和没有童年身体或性虐待史的受试者之间进行比较。结果：与没有报告虐待史的受试者相比，报告有虐待史的受试者更有可能尝试自杀，并且冲动性和攻击性得分显着更高。有至少一次自杀企图史的受试者的冲动和攻击性得分显着较高。逻辑回归分析显示，在调整冲动、攻击史和边缘性人格障碍后，虐待史仍然与自杀未遂状态显着相关。在那些试图自杀的人中，有和没有童年虐待史的人的自杀行为严重程度没有显着差异。结论：童年时期的虐待可能构成冲动和攻击性特质的发展以及抑郁成人自杀企图的环境危险因素。另外，冲动和攻击性可能是童年虐待和成年期自杀行为的遗传特征。需要进行更多的研究来估计遗传和环境经历对冲动、攻击性和自杀行为的发展的相对贡献。
Objective: This study investigated whether a higher frequency of reported childhood trauma would be found in depressed adults with higher levels of trait impulsivity, aggression, and suicidal behavior.Method: In 136 depressed adult inpatients, the authors assessed trait impulsivity, aggression history, and number of lifetime suicide attempts as well as the medical lethality and the intent to die associated with the most lethal attempt. These variables were then compared between those with and those without a reported history of, childhood physical or sexual abuse.Results: Subjects who reported an abuse history were more likely to have made a suicide attempt and had significantly higher impulsivity and aggression scores than those who did not report an abuse history. Impulsivity and aggression scores were significantly higher in subjects with a history of at least one suicide attempt. A logistic regression analysis revealed that abuse history remained significantly associated with suicide attempt status after adjustment for impulsivity, aggression history, and presence of borderline personality disorder. Among those who attempted suicide, there were no significant differences in severity of suicidal behavior between those with and without a childhood history of abuse.Conclusions: Abuse in childhood may constitute an environmental risk factor for the development of trait impulsivity and aggression as well as suicide attempts in depressed adults. Alternatively, impulsivity and aggression may be inherited traits underlying both childhood abuse and suicidal behavior in adulthood disorders. Additional research is needed to estimate the relative contributions of heredity and environmental experience to the development of impulsivity, aggression, and suicidal behavior.