Psychotic-spectrum symptoms, cumulative adversity exposure and substance use among high-risk girls.
Psychotic-spectrum symptoms, cumulative adversity exposure and substance use among high-risk girls.
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高危女孩的精神病谱系症状、累积的逆境暴露和药物使用。
DOI：
10.1111/eip.12533
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发表时间：
2018
影响因子：
2
通讯作者：
Beck,AudreyN
中科院分区：
文献类型：
--
作者：
Lansing,AmyE;Plante,WendyY;Fennema-Notestine,Christine;Golshan,Shahrokh;Beck,AudreyN
目的精神病谱系症状与创伤、物质/酒精使用 (SAU)、犯罪/暴力和功能不良结果相关，支持对弱势群体进行早期检测的需要。为了更好地了解高危女孩的心理健康状况，我们评估了：（1）精神病谱系症状； （2）累积创伤、逆境和损失暴露（C-TALE）和逆境指标（症状、适应不良的应对方式、压力源反应性）；和 SAU 风险因素； (3) 精神病谱系症状、逆境指标和 SAU 危险因素之间的关系。方法我们对 158 名青少年犯罪女孩进行了精神病谱系、创伤和失落谱系的结构化临床访谈。结果女孩的精神病谱系概况与之前报告的成年精神病患者相似，其特征是典型症状（幻觉/妄想，报告很大程度上与 SAU 无关）、人际关系敏感性、精神分裂症特征和偏执狂（过度解释、愤怒过度反应、过度警惕）。幻听/幻视（55.7%）、妄想（92.4%）、参照观念（96.8%）和逆境（90.0% ≥10/24 C-TALE-类型）很常见。平均损失 (4) 和创伤 (8) 发病年龄发生在 SAU 发病 (12) 之前。精神病谱症状、应激反应性、C-TALE、逆境指标之间发现显着正相关；以及 SAU 类型的数量；精神病谱系症状与较早开始饮酒之间存在负相关。在控制 SAU 类型的数量后，压力源反应性和逆境相关麻木与总精神病谱症状的关联最大 (b= 2.6-4.3)。女孩平均有超过 4 种适应不良的应对策略（例如 24.8% 的女孩试图自杀）来应对逆境，从而扩大了潜在的健康差异。精神病谱系症状没有出现种族/民族差异。结论青春期的这一症状群可能会干扰社会和学业功能。无论是代表前驱期、创伤反应还是交叉诊断精神病理学，对精神病谱系症状进行准确的早期检测和适当的治疗都有助于改善弱势群体的功能结果。
AimPsychotic‐spectrum symptoms are linked to trauma, substance/alcohol use (SAU), criminality/violence and poor functional outcomes, supporting the need for early detection in vulnerable populations. To better understand high‐risk girls’ mental health, we assessed: (1) psychotic‐spectrum symptoms; (2) cumulative trauma, adversity and loss exposures (C‐TALE) and adversity‐indicators (symptoms, maladaptive coping, stressor‐reactivity); and SAU risk‐factors; and (3) relationships among psychotic‐spectrum symptoms, adversity‐indicators and SAU risk‐factors.MethodsWe administered the Structured Clinical Interviews for Psychotic Spectrum, and Trauma and Loss Spectrum to 158 adolescent delinquent girls.ResultsGirls’ psychotic‐spectrum profiles were similar to previously reported adult psychotic patients and characterized by typical symptoms (hallucinations/delusions, reported largely SAU‐independent), interpersonal sensitivity, schizoid traits and paranoia (over‐interpretation, anger over‐reactivity, hypervigilance). Auditory/visual hallucinations (55.7%), delusions (92.4%), ideas of reference (96.8%) and adversity (90.0% ≥10/24 C‐TALE‐types) were common. Mean loss (4) and trauma (8) onset‐age occurred before SAU‐onset (12). Significant positive correlations were found among psychotic‐spectrum symptoms, stressor‐reactivity, C‐TALE, adversity‐indicators; and number of SAU‐types; and a negative correlation occurred between psychotic‐spectrum symptoms and earlier alcohol use onset. After controlling for number of SAU‐types, stressor‐reactivity and adversity‐related numbing individually had the largest associations with total psychotic‐spectrum symptoms (b= 2.6‐4.3). Girls averaged more than 4 maladaptive coping strategies (e.g., 24.8% attempted suicide)in response to adversity, amplifying potential health‐disparities. No racial/ethnic differences emerged on psychotic‐spectrum symptoms.ConclusionsThis symptom constellation during adolescence likely interferes with social and academic functioning. Whether representing a prodromal phase, trauma‐response or cross‐diagnostic psychopathology, accurate early detection and appropriate treatment of psychotic‐spectrum symptoms are warranted to improve functional outcomes in vulnerable populations.