Association of Childhood Adversity With Differential Susceptibility of Transdiagnostic Psychopathology to Environmental Stress in Adulthood
Association of Childhood Adversity With Differential Susceptibility of Transdiagnostic Psychopathology to Environmental Stress in Adulthood
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DOI：
10.1001/jamanetworkopen.2018.5354
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发表时间：
2018-11-01
影响因子：
13.8
通讯作者：
Anker, Justin J.
中科院分区：
文献类型：
--
作者：
Albott, C. Sophia;Forbes, Miriam K.;Anker, Justin J.
重要性多变量共病研究表明，童年逆境增加了常见精神障碍的发展风险。这种风险的解释是潜在的内化和外化transdiagnosis结构放大的环境压力。微分易感性模型表明，风险与环境的这种相互作用是双向的：在高压力环境中，高风险个体的结果会更差，但在低压力环境中的结果会更好。目的通过检查不良童年经历的历史如何调节生活压力和跨诊断精神病理学之间的关联来检验差异易感性模型。数据来自美国国家酒精及相关疾病流行病学调查（NESARC），这是一项针对成年人（≥ 18岁）的基于人群的观察性纵向调查。参与者在第一波（2001年至2002年）和第二波（2004年至2005年）完成了调查。从2017年3月3日到2018年10月8日，来自34458名参与者的回答被用于分析。主要结果和测量内化恐惧，内化痛苦的潜在变量。外化和一般精神病理学被创建来表示每个波中的精神病理学的连续水平。潜变量也被创建来表示在每个波的生活压力的连续水平。根据经历的童年逆境类型的数量（无[0种类型]、低[1 - 2种类型]和高[>= 3种类型]暴露）表征童年逆境的水平。分析研究了童年逆境水平和成年生活压力之间的相互作用如何与成人transdiagnosis psychopathology factors. RESULTS的变化相关，34 458名参与者包括在分析中（58.0%的女性和42.0%的男性;平均[SD]年龄。46.0第二波时49.0 [17.3]年），40.5%的儿童没有不良经历，34.6%的儿童有1 - 2次不良经历，24.9%的儿童有3次或以上不良经历。在第一波。61.5%的样本赞同至少1个压力性生活事件，27.2%符合至少1种精神障碍的标准;在第2波，这些数字分别为64.7%和29.7%。童年逆境调节成人生活压力的变化和所有transdiagnosis精神病理学因素的变化之间的关联。具体来说，较高水平的童年逆境有一个更强的成年生活压力和成人transdiagnosis精神病理学因素之间的关联。此外，童年逆境组之间发生显着差异的平均分数的所有transdiagnosis的精神病理学因素的增加和减少的生活stress.Conclusions和相关性的差异易感性提供了初步的证据，结果提供经验支持童年逆境作为一个差异易感性因素产生提高功能和功能失调的反应，后来的压力。
IMPORTANCE Multivariable comorbidity research indicates that childhood adversity increases the risk for the development of common mental disorders. This risk is explained by underlying internalizing and externalizing transdiagnostic constructs that are amplified by environmental stressors. The differential susceptibility model suggests that this interaction of risk and environment is bidirectional: at-risk individuals will have worse outcomes in high-stress environments but better outcomes in in low-stress environments.OBJECTIVE To test the differential susceptibility model by examining how a history of adverse childhood experiences moderates the association between life stress and transdiagnostic psychopathology.DESIGN, SETTING, AND PARTICIPANTS Data came from the US National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a population-based observational longitudinal survey administered to adults (>= 18 years of age). Participants completed the survey at wave 1 (from 2001 through 2002) and wave 2 (from 2004 through 2005). Responses from 34 458 participants were used for the analyses from March 3, 2017, through October 8, 2018.MAIN OUTCOMES AND MEASURES Latent variables for internalizing-fear, internalizing-distress. externalizing, and general psychopathology were created to represent continuous levels of psychopathology in each wave. Latent variables were also created to represent continuous levels of life stress at each wave. Level of childhood adversity was characterized based on the number of types of childhood adversity experienced (no [0 types], low [1-2 types], and high [ >= 3 types] exposure). Analyses examined how the interaction between level of childhood adversity and adult life stress was associated with change in adult transdiagnostic psychopathology factors.RESULTS Of the 34 458 participants included in the analysis (58.0% women and 42.0% men; mean [SD] age. 46.0 [17.4] years at wave land 49.0 [17.3] years at wave 2), 40.5% had no adverse childhood experiences, 34.6% had 1to 2, and 24.9% had 3 or more. At wave 1. 61.5% of the sample endorsed at least 1 stressful life event and 27.2% met criteria for at least 1 mental disorder; at wave 2, these figures were 64.7% and 29.7%, respectively. Childhood adversity moderated the association between changes in adult life stress and changes in all transdiagnostic psychopathology factors. Specifically, higher levels of childhood adversity had a stronger association between adult life stress and adult transdiagnostic psychopathology factors. Further, significant differences between childhood adversity groups occurred in the mean scores of all transdiagnostic psychopathology factors for both increases and decreases in life stress, providing preliminary evidence of differential susceptibility.CONCLUSIONS AND RELEVANCE Results provide empirical support for childhood adversity as a differential susceptibility factor engendering heightened functional and dysfunctional reactivity to later stress.