Trait and State Impulsivity in Maltreated Children

有充分证据表明，儿童期虐待是各种负面公共卫生后果的潜在风险因素，包括焦虑和情绪障碍、非自杀和自杀性自我伤害、药物使用障碍和暴力行为。儿童期虐待与不良结果之间联系的一个潜在机制是冲动(即很少或根本没有预想、反思或考虑后果的行动)。冲动可以被视为一种稳定的个性方面(即特质)，通常通过问卷来测量，或者可以从一个人的行为(即状态)中观察到，通常通过执行计算机任务来观察。孩子有不同的方式可以表现出个性或状态冲动。例如，不加思考地行动，即脱口而出一个问题的答案，而没有考虑答案的准确性，这就是冲动的一种形式。另一个原因是无法等待自己渴望的东西，或者为了实现长期目标而抗拒诱惑，也就是说，孩子总是倾向于在完成家庭作业之前就开始看电视，而不是等到完成作业之后才开始看电视。另一种形式的冲动是当儿童在环境发生变化或信号后无法停止运动反应时，即儿童在路上骑自行车接近红绿灯，但在红灯变红时却没有设法停止。我们的项目将解决我们对虐待儿童冲动的理解中的四个主要差距。首先，我们不知道受虐待的儿童是否表现出所有形式的冲动，或者他们只是表现出特定形式的冲动。第二，虽然四种不同类型的虐待(性虐待、身体虐待、情感虐待和忽视)已被确认，并已知以不同方式影响儿童的大脑发育和认知能力，但我们不知道这些不同类型的虐待与冲动的不同方面有何关系。第三，我们知道儿童可能会或多或少地冲动，这取决于他们是处于积极的情绪(例如，高兴、兴奋)还是消极的情绪(例如，愤怒、沮丧)，但我们不知道不同的情绪如何影响已知存在情绪调节困难的虐待儿童的不同形式的状态冲动。最后，还不清楚冲动是否是儿童期虐待与情绪和行为问题随着时间的推移而出现的一种机制。如果我们想要帮助那些最脆弱的青少年，我们需要回答这些问题。更好地了解受虐待儿童的冲动将有助于临床实践，因为我们知道，减少冲动是对高危儿童进行关键干预的主要重点。因此，拟议的项目将要求受虐待儿童和未受虐待儿童完成问卷和计算机化任务，以衡量不同形式的特征和状态冲动，以确定哪些方面的特征和状态冲动的虐待儿童。儿童将首先在没有任何情绪诱导的情况下完成所有任务，然后我们将考察在积极和消极情绪诱导之后，他们在这些任务上的表现是如何受到影响的。最后，我们将使用来自美国青少年大脑认知发展(ABCD)研究的11,800名9-10岁儿童的公开前瞻性纵向数据来检验特质冲动是否可以解释虐待与三年后情绪和行为问题的出现之间的关联。我们还将寻求将该研究的临床意义转化为那些与儿童合作的人，以促进减少冲动的策略。考虑到我们与从事高危儿童工作的从业者(临床医生/教师)的密切合作，我们处于有利的地位。

There is good evidence that childhood maltreatment is a potent risk factor for a variety of negative public health outcomes, including anxiety and mood disorders, non-suicidal and suicidal self-injury, substance use disorders, and violent behaviour. One potential mechanism underlying the association between childhood maltreatment and poor outcomes is impulsivity (i.e., acting with little or no forethought, reflection, or consideration of the consequences). Impulsivity can be seen as a stable personality facet (i.e., trait), usually measured using questionnaires, or it can be observed in one's actions (i.e., state), usually through performance on computerized tasks. There are different ways a child can show trait or state impulsivity. For example, acting without thinking, i.e. blurting out an answer to a question without thinking long enough about the accuracy of the answer is one form of impulsivity. The inability to wait for things that you desire or resist temptation in favour of long-term goals is another one, i.e. a child who has the tendency to always start watching television prior to completing his home work rather than wait until after he has finished it. Another form of impulsivity can be seen when children cannot stop a motor response following a change or signal in their environment, i.e. a child riding his bike on the road and approaching a traffic light, but who does not manage to stop when the light turns red.Our project will address four major gaps in our understanding of impulsivity in maltreated children. First, we do not know if maltreated children show impulsivity in all its forms or if they are only characterized by specific forms of impulsivity. Second, although four different subtypes of maltreatment (sexual abuse, physical abuse, emotional maltreatment, and neglect) are recognised and are known to impact children's brain development and cognitive abilities in different ways, we do not know how these different subtypes of maltreatment are related to the various facets of impulsivity. Third, we know that children can be more or less impulsive depending on whether they are in a positive mood (e.g., happy, excited) or negative mood (e.g., angry, frustrated), but we do not know how different moods influence the different forms of state impulsivity in maltreated children who are known to have emotion regulation difficulties. Finally, it is unclear if impulsivity is one mechanism that links childhood maltreatment and the emergence of emotional and behavioural problems over time.We need to answer these questions if we want to help those youngsters who are most vulnerable. A better understanding of impulsivity in maltreated children will inform clinical practice because we know that reducing impulsivity is a major focus of key interventions for at-risk children. Thus, the proposed project will ask maltreated children and non-maltreated children to complete questionnaires and computerized tasks that measure different forms of trait and state impulsivity to identify what facets of trait and state impulsivity characterize maltreated children. Children will first complete all the tasks without any mood induction and subsequently we will examine how their performance on these tasks is influenced following positive and negative mood induction. Finally, we will use openly available prospective longitudinal data from > 11,800 children aged 9-10 years from the Adolescent Brain Cognitive Development (ABCD) Study in the U.S to test if trait impulsivity can explain the association between maltreatment and the emergence of emotional and behavioural problems 3 years on.We will also seek to translate the clinical implications of this research to those who work with children in order to promote strategies to reduce impulsivity. We are well placed to do this given our close collaborations with practitioners (clinicians/teachers) working with at-risk children.