Caught in a web of trauma: Network analysis of childhood adversity and adult mental ill-health
Caught in a web of trauma: Network analysis of childhood adversity and adult mental ill-health
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DOI：
10.1016/j.chiabu.2020.104534
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发表时间：
2020-09-01
影响因子：
4.8
通讯作者：
Westermair, Anna Lisa
中科院分区：
文献类型：
--
作者：
Breuer, Fabian;Greggersen, Wiebke;Westermair, Anna Lisa
背景资料：目前针对不良童年经历的干预措施效果有限。我们试图确定针对不良童年经历（ACE）的新干预措施的最佳目标，即ACE在儿童逆境网络中如此重要，以至于抑制它们也可能影响其他类型的逆境，和B）对于儿童期逆境和成人期精神疾病之间的联系至关重要，因此，抑制它们可能会防止这种负面的长期影响的发展。结果：ACE与成人精神障碍有两个聚类：与儿童的直接交互和通过不良环境造成的间接创伤。当控制的相互关联性，协会的性虐待与创伤后应激障碍和边缘型人格障碍的ACE和成人精神disorders.Conclusions之间的唯一直接联系：忽视和暴力侵害母亲是最有影响力的ACE，遏制他们很可能会破坏整个网络的逆境。因此，对母亲的忽视和暴力行为本身就成为制定新干预措施的候选目标。由于性虐待是童年逆境和成年精神疾病之间的唯一联系，因此针对性虐待的干预措施似乎最有可能防止这种负面的长期影响。此外，理想的前瞻性，研究需要证实这些发现。
Background: Current interventions for adverse childhood experiences have only limited effectiveness.Objective: We sought to identify optimal targets for the development of new interventions against adverse childhood experiences (ACE), that is, ACEs that a) are so central in the network of childhood adversity that curbing them is likely to impact other types of adversity, too, and b) are so central to the link of childhood adversity and adult mental ill-health that curbing them is likely to prevent this negative long-term effect from developing.Participants and setting: 384 adult psychiatric inpatients.Methods: Using the R packages qgraph and IsingFit,we analyzed the ACE network and the common network of ACEs and adult mental disorders.Results: We found two clusters of ACEs: direct interactions with the child and indirect traumatization via adverse circumstances. When controlling for interrelatedness, the associations of sexual abuse with posttraumatic stress disorder and borderline personality disorder were the only direct links between ACEs and adult mental disorders.Conclusions: As neglect and violence against the mother were the most influential ACEs, curbing them is likely to destabilize the whole network of adversity. Thus, neglect and violence against the mother lend themselves as candidate targets for the development of new interventions. As sexual abuse was the only link between childhood adversity and adult mental ill-health, interventions against it seem most likely to keep this negative long-term effect from developing. Further, ideally prospective, research is needed to corroborate these findings.