Early childhood factors associated with the development of post-traumatic stress disorder: results from a longitudinal birth cohort
Early childhood factors associated with the development of post-traumatic stress disorder: results from a longitudinal birth cohort
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DOI：
10.1017/s0033291706009019
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发表时间：
2007-02-01
影响因子：
6.9
通讯作者：
Caspi, Avshalom
中科院分区：
文献类型：
--
作者：
Koenen, Karestan C.;Moffitt, Terrie E.;Caspi, Avshalom
背景童年因素与创伤后应激障碍（PTSD）的风险增加有关。以前的研究仅回顾性评估了有限数量的儿童因素。我们研究了11岁以前评估的儿童神经发育、气质、行为和家庭环境特征与32岁以前出生队列中PTSD发展之间的关联。1972-73年新西兰出生队列的成员（n = 1037）在26岁和32岁时进行了评估，根据DSM-IV定义的PTSD。我们确定了两组儿童风险因素。第一组风险因素与创伤暴露风险增加和26岁时评估的PTSD相关。这些因素包括儿童时期的外部特征和家庭环境压力，特别是母亲的痛苦和失去父母。第二组风险因素仅影响PTSD的风险，包括低智商和长期环境逆境。累积的童年因素对26岁时PTSD风险的影响是巨大的;在三个发展因素的最高风险四分位数中，超过58%的队列成员患有PTSD，相比之下，只有25%的人没有任何因素的高风险。5岁时的低智商、反社会行为和11岁之前的贫困继续预测与26 - 32岁之间发生的创伤事件相关的PTSD。幼儿期的发育能力和条件可能会增加创伤暴露的风险和个人对创伤暴露作出不利反应的风险。PTSD不仅仅是对创伤的反应，它可能有发展的起源。
Background. Childhood factors have been associated with increased risk of developing post-traumatic stress disorder (PTSD). Previous studies assessed only a limited number of childhood factors retrospectively. We examined the association between childhood neurodevelopmental, temperamental, behavioral and family environmental characteristics assessed before age 11 years and the development of PTSD up to age 32 years in a birth cohort.Method. Members of a 1972-73 New Zealand birth cohort (n = 1037) who were assessed at ages 26 and 32 years for PTSD as defined by DSM-IV.Results. We identified two sets of childhood risk factors. The first set of risk factors was associated both with increased risk of trauma exposure and with PTSD assessed at age 26. These included childhood externalizing characteristics and family environmental stressors, specifically maternal distress and loss of a parent. The second set of risk factors affected risk for PTSD only and included low IQ and chronic environmental adversity. The effect of cumulative childhood factors on risk of PTSD at age 26 was substantial; over 58% of cohort members in the highest risk quartile for three developmental factors had PTSD as compared to only 25% of those not at high risk on any factors. Low IQ at age 5, antisocial behavior, and poverty before age 11 continued to predict PTSD related to traumatic events that occurred between the ages of 26 and 32.Conclusions. Developmental capacities and conditions of early childhood may increase both risk of trauma exposure and the risk that individuals will respond adversely to traumatic exposures. Rather than being solely a response to trauma, PTSD may have developmental origins.