Trauma exposure, incident psychiatric disorders, and disorder transitions in a longitudinal population representative sample.
Trauma exposure, incident psychiatric disorders, and disorder transitions in a longitudinal population representative sample.
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DOI：
10.1016/j.jpsychires.2017.05.001
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发表时间：
2017-09
影响因子：
4.8
通讯作者：
Keyes KM
中科院分区：
文献类型：
--
作者：
Walsh K;McLaughlin KA;Hamilton A;Keyes KM
异型连续性，即个体从一种疾病过渡到另一种疾病，是常见的；然而，检验异型连续性的跨诊断预测因素的纵向研究缺乏。目前的研究在全国样本中调查了童年（虐待）和成年（人际和非人际创伤）期间的创伤暴露是否与异型连续性有关。参加全国酒精及相关疾病调查第一阶段（2001-2002年）和第二阶段（2004-2005年）的男性和女性（N=34,653）完成了关于创伤暴露和精神病理学的面对面访谈。风险比和人口归因风险比（PARPs）量化了第1波和第2波之间儿童虐待和人际和非人际创伤暴露对偶发性障碍和特定类型障碍之间过渡风险的影响。20%的受访者报告了第二波事件障碍。那些有任何第一波障碍的人在第二波时发生情绪障碍（RR范围=1.2-2.1）和焦虑障碍（RR=1.5-2.7）的风险增加。自第一波以来，儿童虐待和人际创伤暴露与大约50%的障碍转变风险相关（RR范围=1.2-2.7）；非人际创伤与30%的障碍转变风险相关（RR范围=1.0-1.7）。研究结果表明，新发疾病在美国成年人中很常见，创伤暴露解释了很大一部分疾病发病率以及从一种疾病到另一种疾病的进展。在生命早期开始的普遍预防工作，而不是针对特定疾病的预防工作，将有助于减轻人口心理健康负担，并防止在整个生命过程中出现一连串的精神障碍。
Heterotypic continuity, whereby individuals transition from one disorder to another, is common; however, longitudinal studies examining transdiagnostic predictors of heterotypic continuity are lacking. The current study examined whether trauma exposure during childhood (maltreatment) and adulthood (interpersonal and non-interpersonal trauma) is associated with heterotypic continuity in a national sample. Men and women (N=34,653) who participated in Waves 1 (2001-2002) and 2 (2004-2005) of the National Survey of Alcohol and Related Conditions (NESARC) completed face-to-face interviews about trauma exposure and psychopathology. Risk ratios and population attributable risk proportions (PARPs) quantified the effects of childhood maltreatment and interpersonal and non-interpersonal trauma exposure between Waves 1 and 2 on risk for incident disorders and transitions between specific types of disorders. Twenty percent of respondents reported a Wave 2 incident disorder. Those with any Wave 1 disorder were at increased risk of incident mood (RR range=1.2-2.1) and anxiety (RR=1.5-2.7) disorders at Wave 2. Child maltreatment and interpersonal trauma exposure since Wave 1 were associated with roughly 50% of the risk for disorder transitions (RR range=1.2-2.7); non-interpersonal trauma was associated with 30% of the risk for disorder transitions (RR range=1.0-1.7). Findings suggest that new onset disorders were common in U.S. adults and trauma exposure explained a large proportion of disorder incidence as well as progression from one disorder to another. Universal prevention efforts that begin early in life, rather than those targeted at specific disorders, would be fruitful for reducing the burden of population mental health and preventing a cascade of mental disorders over the life course.
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作者：
KESSLER, RC;SONNEGA, A;NELSON, CB
通讯作者：
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影响因子：
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