Childhood adversity, adult stress, and the risk of major depression or generalized anxiety disorder in US soldiers: a test of the stress sensitization hypothesis.
Childhood adversity, adult stress, and the risk of major depression or generalized anxiety disorder in US soldiers: a test of the stress sensitization hypothesis.
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DOI：
10.1017/s0033291717001064
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发表时间：
2017-10
影响因子：
6.9
通讯作者：
Stein MB
中科院分区：
文献类型：
--
作者：
Bandoli G;Campbell-Sills L;Kessler RC;Heeringa SG;Nock MK;Rosellini AJ;Sampson NA;Schoenbaum M;Ursano RJ;Stein MB
压力敏感理论假设，暴露于童年逆境的个体更容易受到近端压力源的精神障碍的影响。我们的目的是测试这一理论的风险，30天的抑郁症发作（MDE）和广泛性焦虑症（GAD）的新的美国陆军士兵。该样本包括30，436名参加陆军风险和复原力评估研究（陆军STARRS）的新兵。建立广义线性模型，并分析儿童期虐待概况和12个月的压力经历水平对30天MDE和GAD风险的加性交互作用。在过去30天的MDE（χ28=17.6，p=0.025）和GAD（χ28=26.8，p=0.001）模型中观察到应激致敏。这种敏感化只发生在高水平（3+）的12个月的压力经验报告。在30天MDE风险的成对比较中，3+压力经历和无压力经历之间的风险差异在所有虐待特征中均显著大于无虐待。30天GAD的风险也发现了类似的结果，除了发作性情感虐待和性虐待的风险差异，这与无虐待没有统计学差异。如果新士兵在儿童时期遭受虐待，那么在最近的压力经历后，他们患30天MDE或GAD的风险会增加。特别是在具有丰富独特压力源的军队中，尝试识别这一人群并改善压力管理可能有助于降低精神障碍的风险。
The stress sensitization theory hypothesizes that individuals exposed to childhood adversity will be more vulnerable to mental disorders from proximal stressors. We aimed to test this theory with respect to risk of 30-day major depressive episode (MDE) and generalized anxiety disorder (GAD) among new U.S. Army soldiers. The sample consisted of 30,436 new soldier recruits in the Army Study to Assess Risk and Resilience (Army STARRS). Generalized linear models were constructed, and additive interactions between childhood maltreatment profiles and level of 12-month stressful experiences on the risk of 30-day MDE and GAD were analyzed. Stress sensitization was observed in models of past 30-day MDE (χ28=17.6, p=0.025) and GAD (χ28=26.8, p=0.001). This sensitization only occurred at high (3+) levels of reported 12-month stressful experiences. In pairwise comparisons for the risk of 30-day MDE, the risk difference between 3+ stressful experiences and no stressful experiences was significantly greater for all maltreatment profiles relative to No Maltreatment. Similar results were found with the risk for 30-day GAD with the exception of the risk difference for Episodic Emotional and Sexual Abuse, which did not differ statistically from No Maltreatment. New soldiers are at an increased risk of 30-day MDE or GAD following recent stressful experiences if they were exposed to childhood maltreatment. Particularly in the military with an abundance of unique stressors, attempts to identify this population and improve stress management may be useful in the effort to reduce the risk of mental disorders.