Life event dimensions of loss, humiliation, entrapment, and danger in the prediction of onsets of major depression and generalized anxiety
Life event dimensions of loss, humiliation, entrapment, and danger in the prediction of onsets of major depression and generalized anxiety
复制标题
DOI：
10.1001/archpsyc.60.8.789
复制
发表时间：
2003-08-01
影响因子：
--
通讯作者：
Prescott, CA
中科院分区：
文献类型：
--
作者：
Kendler, KS;Hettema, JM;Prescott, CA
背景资料：虽然大量的证据表明，紧张的生活事件易患抑郁症和焦虑症发作，这些事件的基本特征是抑郁和焦虑仍然不确定。研究方法：高背景威胁压力的生活事件，在98 592人月从7322男性和女性成年双胞胎从人口为基础的登记确定评估，被盲目地评定的羞辱，诱捕，损失和危险的尺寸和它们的类别。发病的纯重性抑郁症（MD），纯广泛性焦虑综合征（GAS）（定义为广泛性焦虑障碍与2周的最小持续时间），和混合MD-GAS发作进行了检查使用logistic regression.Results：发病的纯MD和混合MD-GAS预测较高的评级损失和羞辱。纯GAS的发作由较高的损失和危险等级预测。高收视率的诱捕预测只有发作的混合事件。死亡和应答者启动的分离的损失类别预测纯MD，但不是纯GAS发作。羞辱（尤其是由他人引发的分离）和损失相结合的事件比纯粹的损失事件（包括死亡）更容易导致抑郁。没有性别差异被认为是在预测的疾病发作事件categorization.Conclusions：除了损失，羞辱事件，直接贬低个人的核心作用是密切相关的抑郁发作的风险。事件维度和类别，易患单纯MD与单纯GAS发作，可以区分与中度特异性。混合MD-GAS发作之前的事件维度主要是纯MD和纯GAS发作之前的事件维度的总和。
Background: Although substantial evidence suggests that stressful life events predispose to the onset of episodes of depression and anxiety, the essential features of these events that are depressogenic and anxiogenic remain uncertain..Methods: High contextual threat stressful life events, assessed in 98 592 person-months from 7322 male and female adult twins ascertained from a population-based registry, were blindly rated on the dimensions of humiliation, entrapment, loss, and danger and their categories. Onsets of pure major depression (MD), pure generalized anxiety syndrome (GAS) (defined as generalized anxiety disorder with a 2-week minimum duration), and mixed MD-GAS episodes were examined using logistic regression.Results: Onsets of pure MD and mixed MD-GAS were predicted by higher ratings of loss and humiliation. Onsets of pure GAS were predicted by higher ratings of loss and danger. High ratings of entrapment predicted only onsets of mixed episodes. The loss categories of death and respondent-initiated separation predicted pure MD but not pure GAS episodes. Events with a combination of humiliation (especially other-initiated separation) and loss were more depressogenic than pure loss events, including death. No sex differences were seen in the prediction of episodes of illness by event categories.Conclusions: In addition to loss, humiliating events that directly devalue an individual in a core role were strongly linked to risk for depressive episodes. Event dimensions and categories that predispose to pure MD vs; pure GAS episodes can be distinguished with moderate specificity. The event dimensions that preceded mixed MD-GAS episodes were largely the sum of those that preceded pure MD and pure GAS episodes.