The long shadow of childhood trauma for depression in midlife: examining daily psychological stress processes as a persistent risk pathway.
The long shadow of childhood trauma for depression in midlife: examining daily psychological stress processes as a persistent risk pathway.
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中年抑郁症的童年创伤的漫长阴影：将日常心理压力过程视为持续的风险途径。
DOI：
10.1017/s0033291721000921
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发表时间：
2021-03-26
影响因子：
6.9
通讯作者：
Epel ES
中科院分区：
文献类型：
--
作者：
Mayer SE;Surachman A;Prather AA;Puterman E;Delucchi KL;Irwin MR;Danese A;Almeida DM;Epel ES
童年创伤会增加成年抑郁症的风险。缓冲效应需要了解潜在的持续风险路径。这项研究探讨了日常心理压力过程--个体如何解释和情感地回应日常小事--是否介导了童年创伤对成年抑郁症状的影响。中年女性（N = 183）在基线时报告了童年创伤，并在基线、9个月和18个月时完成了7天的威胁评估和负面夜间情绪的每日日记。在1.5年的时间里测量了抑郁症状。调解采用多层次结构方程模型。报告的儿童期创伤预测在1.5年的时间内更大的抑郁症状（估计值= 0.27，SE = 0.07，95% CI 0.15至0.38，p <0.001）。日常威胁评估和负面情绪介导了报告的儿童期创伤对抑郁症状的影响（估计值= 0.34，SE = 0.08，95%CI 0.22至0.46，p <0.001）。每日威胁评估解释了一半以上的影响（估计值= 0.19，SE = 0.07，95% CI 0.08至0.30，p = 0.004）。对报告至少有中度童年创伤的个人进行的事后分析表明，较低的威胁评估可以缓冲抑郁症状。在报告没有/低严重性儿童创伤的个人中发现了类似的模式。报告的童年创伤史是一种潜在的脆弱性，夸大了对日常事件的威胁评估，引发了更大的负面夜间影响--这些过程具有重要的心理健康后果，并可能提供可塑性的干预目标。
Childhood trauma increases the risk of adult depression. Buffering effects requires an understanding of the underlying persistent risk pathways. This study examined whether daily psychological stress processes – how an individual interprets and affectively responds to minor everyday events – mediate the effect of childhood trauma on adult depressive symptoms. Middle-aged women (N = 183) reported childhood trauma at baseline and completed daily diaries of threat appraisals and negative evening affect for 7 days at baseline, 9 and 18 months. Depressive symptoms were measured across the 1.5-year period. Mediation was examined using multi-level structural equation modeling. Reported childhood trauma predicted greater depressive symptoms over the 1.5-year time period (estimate = 0.27, SE = .07, 95% CI 0.15 to 0.38, p < .001). Daily threat appraisals and negative affect mediated the effect of reported childhood trauma on depressive symptoms (estimate = 0.34, SE = 0.08, 95% CI 0.22 to 0.46, p < .001). Daily threat appraisals explained more than half of this effect (estimate = 0.19, SE = 0.07, 95% CI 0.08 to 0.30, p = .004). Post hoc analyses in individuals who reported at least moderate severity of childhood trauma showed that lower threat appraisals buffered depressive symptoms. A similar pattern was found in individuals who reported no/low severity of childhood trauma. A reported history of childhood trauma acts as a latent vulnerability, exaggerating threat appraisals of everyday events, which trigger greater negative evening affect – processes that have important mental health consequences and may provide malleable intervention targets.