When Emotional Pain Becomes Physical: Adverse Childhood Experiences, Pain, and the Role of Mood and Anxiety Disorders.
When Emotional Pain Becomes Physical: Adverse Childhood Experiences, Pain, and the Role of Mood and Anxiety Disorders.
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当情感上的痛苦变成身体上的：不良童年经历、疼痛以及情绪和焦虑症的作用。
DOI：
10.1002/jclp.22444
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发表时间：
2017
影响因子：
3
通讯作者：
Preacher,KristopherJ
中科院分区：
文献类型：
--
作者：
Sachs-Ericsson,NatalieJ;Sheffler,JuliaL;Stanley,IanH;Piazza,JenniferR;Preacher,KristopherJ
我们研究了不良童年经历（ACE）和痛苦的医疗条件之间的关联。我们还研究了调解和调节作用的情绪和焦虑障碍的ACE疼痛的医疗conditions relationship.Methodten-year纵向数据从全国科摩罗调查（NCS-1，NCS-2;N= 5001）。NCS-1获得了ACE、当前健康状况、当前疼痛严重程度以及情绪和焦虑障碍的报告。NCS-2评估了疼痛性疾病（例如，关节炎/风湿病，慢性背部/颈部问题，严重头痛，其他慢性疼痛）。言语和性虐待、父母精神病理学和早期失去父母）与痛苦的医疗条件有关。基线测量的抑郁症、双相情感障碍和创伤后应激障碍也与疼痛性疾病的数量相关。焦虑和情绪障碍被发现部分调解ACE疼痛的医疗条件的关系。我们通过中介分析确定，ACE与焦虑和情绪障碍的增加有关，而焦虑和情绪障碍又与痛苦的医疗条件数量的增加有关。我们确定通过适度分析，ACE有效果增加痛苦的医疗条件在高和低水平的焦虑和情绪障碍;虽然，令人惊讶的是，效果是更大的参与者在较低水平的情绪和焦虑disorders.ConclusionThere是有害的影响ACE跨精神和身体域。下丘脑-垂体-肾上腺应激反应的失调和储备能力的理论进行审查，以整合我们的复杂关系的研究结果。
ObjectiveWe examined the association between retrospective reports of adverse childhood experiences (ACEs) and painful medical conditions. We also examined the mediating and moderating roles of mood and anxiety disorders in the ACEs–painful medical conditions relationship.MethodTen‐year longitudinal data were obtained from the National Comorbidity Surveys (NCS‐1, NCS‐2;N= 5001). The NCS‐1 obtained reports of ACEs, current health conditions, current pain severity, and mood and anxiety disorders. The NCS‐2 assessed for painful medical conditions (e.g., arthritis/rheumatism, chronic back/neck problems, severe headaches, other chronic pain).ResultsSpecific ACEs (e.g., verbal and sexual abuse, parental psychopathology, and early parental loss) were associated with the painful medical conditions. Baseline measures of depression, bipolar disorder, and posttraumatic stress disorder were also associated with the number of painful medical conditions. Anxiety and mood disorders were found to partially mediate the ACEs–painful medical conditions relationship. We determined through mediation analyses that ACEs were linked to an increase in anxiety and mood disorders, which, in turn, were associated with an increase in the number of painful medical conditions. We determined through moderation analyses that ACEs had an effect on increasing the painful medical conditions at both high and low levels of anxiety and mood disorders; though, surprisingly, the effect was greater among participants at lower levels of mood and anxiety disorders.ConclusionThere are pernicious effects of ACEs across mental and physical domains. Dysregulation of the hypothalamic‐pituitary‐adrenal stress response and the theory of reserve capacity are reviewed to integrate our findings of the complex relationships.