Stress Responsivity and the Structure of Common Mental Disorders: Transdiagnostic Internalizing and Externalizing Dimensions Are Associated With Contrasting Stress Appraisal Biases
Stress Responsivity and the Structure of Common Mental Disorders: Transdiagnostic Internalizing and Externalizing Dimensions Are Associated With Contrasting Stress Appraisal Biases
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DOI：
10.1037/abn0000163
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发表时间：
2016-11-01
影响因子：
4.6
通讯作者：
Hammen, Constance
中科院分区：
文献类型：
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作者：
Conway, Christopher C.;Starr, Lisa R.;Hammen, Constance
有偏见的压力评估与许多-也许是大多数-精神病理学形式的起源和时间进程密切相关。我们假设异常的压力评估与潜在的内化和外化特征直接相关，而内化和外化特征反过来又易患多种疾病。815名青少年的高风险社区样本进行了半结构化访谈，以评估临床疾病和自然主义的压力在15岁和20岁。参与者和盲评团队分别评估了过去一年中发生的与急性压力源相关的威胁，以及评估偏差指数（即，主观和团队评定的威胁之间的差异）。一个2因素（内化和外化）的潜变量模型提供了一个很好的适合诊断相关性。调整因素之间的协变后，青少年的威胁高估前瞻性地预测较高的立场内化，而威胁低估前瞻性地预测海拔高度外化。横断面分析在成年早期复制了这种模式。评估是不相关的任何诊断的剩余部分的潜变量模型，这表明transdiagnosis尺寸介导的压力评估偏差和障碍实体之间的连接。我们讨论了提高新兴研究的压力反应的效率的影响，并推测这些发现，如果复制，可能会指导改进心理治疗与压力有关的疾病。
Biased stress appraisals critically relate to the origins and temporal course of many-perhaps most-forms of psychopathology. We hypothesized that aberrant stress appraisals are linked directly to latent internalizing and externalizing traits that, in turn, predispose to multiple disorders. A high-risk community sample of 815 adolescents underwent semistructured interviews to assess clinical disorders and naturalistic stressors at ages 15 and 20. Participants and blind rating teams separately evaluated the threat associated with acute stressors occurring in the past year, and an appraisal bias index (i.e., discrepancy between subjective and team-rated threat) was generated. A 2-factor (Internalizing and Externalizing) latent variable model provided an excellent fit to the diagnostic correlations. After adjusting for the covariation between the factors, adolescents' threat overestimation prospectively predicted higher standing on Internalizing, whereas threat underestimation prospectively predicted elevations on Externalizing. Cross-sectional analyses replicated this pattern in early adulthood. Appraisals were not related to the residual portions of any diagnosis in the latent variable model, suggesting that the transdiagnostic dimensions mediated the connections between stress appraisal bias and disorder entities. We discuss implications for enhancing the efficiency of emerging research on the stress response and speculate how these findings, if replicated, might guide refinements to psychological treatments for stress-linked disorders.