The pathoplasticity of dysphoric episodes: differential impact of stressful life events on the pattern of depressive symptom inter-correlations.
The pathoplasticity of dysphoric episodes: differential impact of stressful life events on the pattern of depressive symptom inter-correlations.
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DOI：
10.1017/s003329171100211x
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发表时间：
2012-05
影响因子：
6.9
通讯作者：
Kendler, K. S.
中科院分区：
文献类型：
--
作者：
Cramer, A. O. J.;Borsboom, D.;Aggen, S. H.;Kendler, K. S.
先前的研究表明，压力性生活事件（SLEs）会影响个体抑郁症状的模式。但是，我们不知道这些差异是如何产生的。关于精神障碍的性质，有两种理论对这些差异的来源有不同的预测：（1）SLE通过潜在的急性倾向性发展为焦虑发作（DE;共同原因假设）间接影响抑郁症状及其之间的相关性;（2）SLE直接影响抑郁症状及其之间的相关性（网络假设）。本研究探讨了这两个理论的预测。我们将2096名白人双胞胎（49.9%为女性）的人群样本分为四组，他们在过去一年中报告了至少两种聚集的抑郁症状，根据他们报告的SLE引起的症状。对于这些群体，我们计算了14个分解的抑郁症状之间的四项相关性，随后，测试是否产生的相关模式是显着不同的，如果这些差异可以解释为潜在的差异，在一个单一的急性倾向发展DE。四组SLE患者抑郁症状的相关模式有显著差异。这些差异是显著的，并且不能通过发生DE的急性倾向的潜在差异来解释。我们的研究结果是不兼容的共同原因的观点，但与网络假说的预测是一致的。我们详细阐述了网络视角的概念转变对我们的诊断和哲学方法的概念构成精神疾病的影响。
Previous research has shown that stressful life events (SLEs) influence the pattern of individual depressive symptoms. However, we do not know how these differences arise. Two theories about the nature of psychiatric disorders have different predictions about the source of these differences : (1) SLEs influence depressive symptoms and correlations between them indirectly, via an underlying acute liability to develop a dysphoric episode (DE; common cause hypothesis); and (2) SLEs influence depressive symptoms and correlations between them directly (network hypothesis). The present study investigates the predictions of these two theories. We divided a population-based sample of 2096 Caucasian twins (49.9% female) who reported at least two aggregated depressive symptoms in the last year into four groups, based on the SLE they reported causing their symptoms. For these groups, we calculated tetrachoric correlations between the 14 disaggregated depressive symptoms and, subsequently, tested whether the resulting correlation patterns were significantly different and if those differences could be explained by underlying differences in a single acute liability to develop a DE. The four SLE groups had markedly different correlation patterns between the depressive symptoms. These differences were significant and could not be explained by underlying differences in the acute liability to develop a DE. Our results are not compatible with the common cause perspective but are consistent with the predictions of the network hypothesis. We elaborate on the implications of a conceptual shift to the network perspective for our diagnostic and philosophical approach to the concept of what constitutes a psychiatric disorder.