【作者】 樊洁； 王向； 卢京洁； 朱熊兆；

【Author】 Jie Fan;Xiang Wang;Jingjie Lu;Xiongzhao Zhu;Medical Psychological Center,the Second Xiangya Hospital,Central South University;Medical Psychological Institute of Central South University;National Clinical Research Center for Mental Disorders;

【机构】 中南大学湘雅二医院医学心理中心； 中南大学医学心理研究所； 国家精神心理疾病临床医学研究中心；

【摘要】 目的:抑郁的症状表现存在异质性。大量研究提示,不同类型的童年创伤可能会导致独特的抑郁风险,与不同的抑郁症状表现有关。然而目前有关童年创伤类型与具体抑郁症状表现的关系仍不完全清楚,有待进一步研究。本研究基于逆境维度模型(Dimension Model of Adversity,DMA),将童年创伤区分为威胁和剥夺经历,在大学生被试中探索和区分剥夺和威胁经历对不同抑郁症状发展轨迹的影响。方法:本研究对湖南省某高校大一新生(N=3535)进行了为期2年、共4次的纵向追踪调查。采用童年创伤问卷(Childhood Trauma Questionnaire,CTQ)评估被试的童年创伤经历(第一次测量),并按照创伤类型,将其分为威胁和剥夺;分别采用贝克抑郁量表第二版(Beck Depression Inventory-II,BDI-II)、斯奈斯-汉密尔顿愉悦量表(Snaith-Hamilton Pleasure Scale,SHAPS)、压力知觉量表(Perceived Stress Scale,PSS)测量被试的抑郁情绪、快感缺失水平和感知压力水平(四次测量)。采用包含时间不变协变量(威胁和剥夺经历)和时间变化协变量(压力水平)的平行潜增长曲线模型检验不同类型童年创伤对抑郁情绪和快感缺失发展轨迹的影响,并进一步检验其关系是否存在性别差异。结果:童年创伤经历与抑郁情绪和快感缺失相关。威胁和剥夺经历均可预测抑郁情绪截距(β威胁=0.309,p<0.001;β剥夺=0.175,p<0.001)和斜率(β威胁=-0.139,p=0.068;β剥夺=-0.168,p<0.05);只有剥夺可以显著预测快感缺失截距(β=0.318,p<0.001)和斜率(β=-0.218,p<0.001)。不同类型童年创伤与抑郁症状的关系模式存在性别差异:女性受童年创伤的影响显著大于男性。结论:不同童年创伤经历对抑郁症状的预测作用不同:威胁和剥夺经历均可影响抑郁情绪的发展轨迹,但快感缺失只与剥夺经历有关。童年创伤对抑郁症状的影响会持续到成年早期,且女性受影响更大。更多还原

【Abstract】 Backgrounds:There is growing awareness that specific childhood trauma(CT) may confer to the unique risk of depression,but little is known about this.The present study seeks to provide insight into how CT subtypes(Threat and Deprivation) may impact distinct depressive symptoms over time based on the dimensional model of adversity(DMA) in college students.Methods:A total of 3535 college freshmen were recruited from a university in Hunan province with participating in a 2-year,four waves longitudinal tracking study.Childhood Trauma Questionnaire(CTQ) was used to assess CT experiences(wave 1),and was further divided to Threat and Deprivation experiences.Beck Depression Inventory(BDI-II) and Snaith-Hamilton Pleasure Scale(SHAPS) were used to assess depressed mood and anhedonia respectively(wave1-4).Perceived stress level was measured by Perceived stress scale(PSS)(wave 1-4).A parallel conditional parallel latent growth curve model(LGCM) was constructed to examine the impacts of different types of CT(threat and deprivation) on the development of depressed mood and anhedonia,and whether these relationships vary across gender.Results:Threat and deprivation differentially related to depressed mood and anhedonia.Both threat and deprivation predicted intercept(β=0.309,p<0.001;β=0.175,p<0.001,respectively)and slope(β=-0.139,p=0.068;β=-0.168,p<0.05,respectively) of depressed mood.Only deprivation predicted intercept(β=0.318,p<0.001) and slope(β=-0.218,p<0.001) of anhedonia.This pattern of relationships between CT and depressive symptoms varied across gender:females were significantly more affected by CT than males.Conclusion:These findings highlight specific pathways and symptomatic manifestations of the impacts of different CT subtypes on depression and are consistent with the hypothesis of DMA.Threat and deprivation predicted more severe depressed mood,whereas deprivation uniquely conferred to the risk of depression via elevated anhedonia.Meanwhile,the deleterious effects of CT would persist during early adulthood.Gender differences should not be ignored.更多还原