Childhood maltreatment, 9/11 exposure, and latent dimensions of psychopathology: A test of stress sensitization.
Childhood maltreatment, 9/11 exposure, and latent dimensions of psychopathology: A test of stress sensitization.
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DOI：
10.1016/j.jpsychires.2015.05.005
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发表时间：
2015-09
影响因子：
4.8
通讯作者：
Hasin D
中科院分区：
文献类型：
--
作者：
Meyers JL;Lowe SR;Eaton NR;Krueger R;Grant BF;Hasin D
2001年9月11日，美国发生恐怖袭击事件（9/11）。关于9/11和精神病学结果的研究集中在个体疾病上，而不是更广泛的精神病理学的内化（INT）和外化（EXT）领域，因此不知道直接和间接的9/11暴露是否对这些领域产生了不同的影响，而不是个体疾病。此外，这种影响是否因童年早期的虐待（即压力敏感化）而加剧，也不得而知。来自美国全国样本的18，713名参与者在9/11之前没有精神疾病史，使用结构化面对面访谈进行评估。对一个在9/11之前没有精神病史的样本进行的结构方程模型表明，间接暴露于9/11（即媒体，朋友/家人）与EXT（酒精，尼古丁和大麻依赖，以及反社会人格障碍）和INT（重度抑郁症、广泛性焦虑和创伤后应激障碍（PTSD））精神病理学维度（EXT：β = 0.10，p < 0.001; INT：β = 0.11，p < 0.001），而直接暴露仅与INT维度相关（β = 0.11，p < 0.001）。对于经历过童年虐待的个体，与9/11相关的EXT和INT维度的风险加剧（相互作用：分别为β = 0.06，p < 0.01; β = 0.07，p < 0.001）。这些发现表明，9/11事件影响了美国普通人群中广泛的精神病理学领域的潜在倾向，而不是特定的疾病，除了PTSD，其具有超出INT的独立影响（如修正指数的显著（p < 0.05）改善所示）。研究结果还表明，儿童期虐待增加了与成人创伤暴露相关的风险，为压力敏感化的概念提供了进一步的证据。
On September 11, 2001, a terrorist attack occurred in the U.S. (9/11). Research on 9/11 and psychiatric outcomes has focused on individual disorders rather than the broader internalizing (INT) and externalizing (EXT) domains of psychopathology, leaving unknown whether direct and indirect 9/11 exposure differentially impacted these domains rather than individual disorders. Further, whether such effects were exacerbated by earlier childhood maltreatment (i.e. stress sensitization) is unknown. 18,713 participants from a U.S. national sample with no history of psychiatric disorders prior to 9/11 were assessed using a structured in-person interview. Structural equation modeling conducted in a sample who endorsed no psychiatric history prior to 9/11, indicated that indirect exposure to 9/11 (i.e. media, friends/family) was related to both EXT (alcohol, nicotine, and cannabis dependence, and antisocial personality disorder) and INT (major depression, generalized anxiety, and post-traumatic stress disorder (PTSD)) dimensions of psychopathology (EXT: β = 0.10, p < 0.001; INT: β = 0.11, p < 0.001) whereas direct exposure was associated with the INT dimension only (β = 0.11, p < 0.001). For individuals who had experienced childhood maltreatment, the risk for EXT and INT dimensions associated with 9/11 was exacerbated (Interactions: β = 0.06, p < 0.01; β = 0.07, p < 0.001, respectively). These findings indicate that 9/11 impacted latent liability to broad domains of psychopathology in the US general population rather than specific disorders with the exception of PTSD, which had independent effects beyond INT (as indicated by a significant (p < 0.05) improvement in modification indices). Findings also indicated that childhood maltreatment increases the risk associated with adult trauma exposure, providing further evidence for the concept of stress sensitization.