Childhood maltreatment

童年虐待
  • 文章类型: Journal Article
    这项系统评价和荟萃分析旨在全面描述经历各种儿童虐待类型是否可以预测青少年中的各种物质使用/滥用类型,超出了以前关于类似主题的系统综述所涵盖的狭窄范围。六月进行了一次文献检索,2022使用PubMed,PsycInfo,和Embase。包括58项研究(总参与者n=170,749)。这些研究主要是根据物质类型的结果组织的,包括酒精(n=43),大麻(n=25),未指定物质(n=25),和其他特定物质(n=10)。结果按虐待类型进一步分层。对于特定的虐待和物质类型组合,大多数研究表明,儿童虐待是青少年药物使用/滥用的重要预测因素。在我们进行的10项荟萃分析中,发现大多数(9/10)的虐待和物质类型组合存在显著关联。例如,未指明的儿童虐待使青少年饮酒的可能性增加了约四倍,这是发现的最高相对风险。总之,这项研究表明,儿童虐待是青少年药物使用/滥用的预测因素。
    This systematic review and meta-analysis aimed to comprehensively describe whether experiencing a variety of childhood maltreatment types predicts a variety of substance use/misuse types among youth, beyond the narrow scope covered in previous systematic reviews on similar topics. A literature search was conducted in June, 2022 using PubMed, PsycInfo, and Embase. 58 studies (total participant n=170,749) were included. These studies were primarily organized by substance type outcomes including alcohol (n=43), cannabis (n=25), unspecified substances (n=25), and other specific substances (n=10). Results were further stratified by maltreatment type. For specific maltreatment and substance type combinations, the majority of studies indicated that childhood maltreatment was a significant predictor of substance use/misuse in youth. Of the 10 meta-analyses we conducted, significant associations were found for the majority (9/10) of maltreatment and substance type combinations. For instance, unspecified childhood maltreatment increased the probability of youth alcohol use by about four times, which was the highest relative risk found. In conclusion, this study shows that childhood maltreatment is a predictor of youth substance use/misuse.
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  • 文章类型: Journal Article
    背景:儿童虐待在全球范围内造成了巨大的心理健康负担。不同的儿童虐待措施是不等同的,可能会捕捉到有意义的差异。特别是,虐待的前瞻性和回顾性措施可识别不同的个体群体,并与精神病理学差异相关。然而,这些差异背后的原因尚未全面绘制。
    方法:在这篇综述中,我们借鉴了多学科研究,并提出了一个综合框架来解释虐待测量分歧。
    结果:我们确定了三个相互关联的域。首先,与测量和数据收集方法相关的方法论问题。第二,记忆在影响虐待回顾性报道中的作用。最后,个人可能不得不披露的动机,扣留,或者捏造关于虐待的信息。
    结论:对虐待测量分歧的更多理解可能指向概念化和评估虐待的新方法。此外,它可能有助于揭示虐待相关精神病理学的潜在机制和新干预措施的目标。
    BACKGROUND: Childhood maltreatment contributes to a large mental health burden worldwide. Different measures of childhood maltreatment are not equivalent and may capture meaningful differences. In particular, prospective and retrospective measures of maltreatment identify different groups of individuals and are differentially associated with psychopathology. However, the reasons behind these discrepancies have not yet been comprehensively mapped.
    METHODS: In this review, we draw on multi-disciplinary research and present an integrated framework to explain maltreatment measurement disagreement.
    RESULTS: We identified three interrelated domains. First, methodological issues related to measurement and data collection methods. Second, the role of memory in influencing retrospective reports of maltreatment. Finally, the motivations individuals may have to disclose, withhold, or fabricate information about maltreatment.
    CONCLUSIONS: A greater understanding of maltreatment measurement disagreement may point to new ways to conceptualise and assess maltreatment. Furthermore, it may help uncover mechanisms underlying maltreatment-related psychopathology and targets for novel interventions.
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  • 文章类型: Journal Article
    虐待儿童是一个普遍的全球性问题,涉及父母或照顾者的任何形式的伤害或忽视,导致各种形式的身体或情感伤害,全球约有1.5亿受影响的儿童。本研究讨论了下丘脑-垂体-肾上腺轴功能障碍和皮质醇激素变化将儿童虐待与心理健康障碍联系起来的潜在机制。它还讨论了预防精神疾病和抵消这些疾病的生物学嵌入的支持性策略,强调需要采取综合干预措施,以解决虐待儿童对心理健康的长期影响。使用先前描述的已建立的方法选择文章。关键信息是从过去20年发表的科学论文中获得的,包括原始研究,系统评价,和荟萃分析。文章搜索使用顶级学术搜索引擎进行。虽然关于虐待儿童下丘脑-垂体-肾上腺轴对应激反应的研究仍在进行中,而且还没有定论,它对生理功能和精神病理学倾向的影响和意义是重要的。童年虐待会增加患精神疾病的风险,疾病的严重程度,和不良的治疗反应。儿童虐待表现为下丘脑-垂体-肾上腺轴功能中断,程度因因素而异,比如发病年龄,父母的反应,以及虐待的类型和特点。这些因素的复杂相互作用有助于虐待儿童下丘脑-垂体-肾上腺轴对应激反应的多样性,创造一系列生理功能和对精神病理学的脆弱性。
    Child maltreatment is a widespread global issue involving any form of harm or neglect by a parent or caregiver, leading to various forms of physical or emotional damage, with approximately 150 million affected children globally. This study discusses the potential mechanism of the hypothalamic-pituitary-adrenal axis dysfunction and cortisol hormone changes in linking child maltreatment to mental health disorders. It also discusses supportive strategies to prevent mental diseases and counteract the biological embedding of these conditions, emphasizing the need for comprehensive interventions to address the long-term impact of child maltreatment on mental health. Articles were selected using established methods previously described. Key information was obtained from scientific articles published during the past 20 years, including original studies, systematic reviews, and meta-analyses. Articles search was performed using top academic search engines. While research on hypothalamic-pituitary-adrenal axis response to stress in maltreated children is ongoing and far from conclusive, its impact and implications for physiological functioning and the predisposition to psychopathology are significant. Childhood maltreatment increases the risk of psychiatric illnesses, severity of diseases, and poor treatment responses. Childhood maltreatment manifests as disruptions to hypothalamic-pituitary-adrenal axis functioning, with the extent varying based on factors, such as the age of onset, parental responsiveness, and the type and characteristics of maltreatment. The complex interplay of these factors contributes to the diversity of hypothalamic-pituitary-adrenal axis responses to stress in maltreated children, creating a spectrum of physiological functioning and vulnerability to psychopathology.
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  • 文章类型: Systematic Review
    本系统综述旨在总结与儿童虐待(CM)相关的进食障碍(ED)的独特表型表达的证据。所谓的ED的虐待生态表型。遵循PRISMA标准。包括提供有关ED报告CM的个体特征数据的文章。对相关结果进行了提取和总结。进行了质量评估。共识别和筛选了1207条记录,包括1994年至2023年发表的97篇文章。研究结果揭示了报告CM的ED患者的独特生物学和临床特征,包括神经解剖学改变,改变应激反应,ghrelin水平,炎症标志物,和肠道菌群组成。临床上,CM与更严重的进食行为相关,精神病合并症较高,冲动,情绪失调,和危险的行为。此外,CM与较差的治疗结果相关,尤其是一般的精神病理学和精神合并症。这项审查强调了朝着病因知情的鼻图迈进的必要性,认识到CM不仅仅是一个风险因素,但也作为形成不同生态表型变异的ED的病原体。
    This systematic review aimed to summarize the evidence on the existence of a distinct phenotypic expression of Eating Disorders (EDs) associated with childhood maltreatment (CM), the so-called maltreated eco-phenotype of EDs. PRISMA standards were followed. Articles providing data about the characteristics of individuals with an ED reporting CM were included. Relevant results were extracted and summarized. A quality assessment was performed. A total of 1207 records were identified and screened, and 97 articles published between 1994 and 2023 were included. Findings revealed distinct biological and clinical features in patients with EDs reporting CM, including neuroanatomical changes, altered stress responses, ghrelin levels, inflammation markers, and gut microbiota composition. Clinically, CM correlated with severer eating behaviors, higher psychiatric comorbidity, impulsivity, emotional dysregulation, and risky behaviors. Additionally, CM was associated with poorer treatment outcomes, especially in general psychopathology and psychiatric comorbidities. This review highlighted the need to move towards an etiologically informed nosography, recognizing CM not merely as a risk factor, but also as an etiologic agent shaping different eco-phenotypic variants of EDs.
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  • 文章类型: Systematic Review
    童年创伤会对心理功能的几个领域产生负面影响,包括自传记忆(AM)。有关儿童创伤对AM的影响的科学文献中出现了矛盾的结果。在这次审查中,我们探讨了童年创伤与AM之间的关系,将童年创伤归类为人际关系,非人际和整体(人际和非人际)。我们进行了系统的文献综述,遵循系统审查和荟萃分析的首选报告项目指南(PRISMA声明)。通过搜索PubMed,Scopus,和WebofScience数据库,我们确定了2014年至2023年进行的48项研究,这些研究包括:(a)用英语写的,(b)调查AM与儿童创伤之间的关系,(c)包括儿童样本,青少年,或经历过童年人际关系和/或非人际关系创伤的成年人。在48项符合条件的研究中,29指人际关系的创伤,12非人际性质的创伤,和7到整体创伤。关于童年创伤和AM之间的关系,24项研究发现童年人际创伤与AM之间存在负相关关系;在关于非人际创伤的文章中,10项研究没有发现相关关系;在关于整体创伤的研究中,4篇文章发现整体创伤与AM之间存在负相关。在我们的系统综述中探索的文献支持人际关系童年创伤与AM之间存在负相关的普遍性。无论精神疾病如何,这种关系都存在(例如,抑郁症,创伤后应激障碍,和人格障碍),而在后者面前,AM结果更加分散。未来的研究应该使用更准确的方法来识别和分类儿童创伤,以便更准确地确定其对AM的影响。
    Childhood trauma can have negative effects on several domains of mental functioning, including Autobiographical Memory (AM). Conflicting results emerge in the scientific literature regarding the effects of childhood trauma on AM. In this review, we explored the relationship between the childhood trauma and AM, classifying childhood trauma as interpersonal, non-interpersonal and overall (interpersonal and non-interpersonal). We carried out a systematic literature review, following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA statement). From searching the PubMed, Scopus, and Web of Science databases, we identified 48 studies conducted from 2014 to 2023, which were included when they: (a) were written in English, (b) investigated the relationship between AM and childhood trauma, (c) included a sample of children, adolescents, or adults who had experienced childhood interpersonal and/or non-interpersonal trauma. Of the 48 eligible studies, 29 referred to trauma of an interpersonal nature, 12 to trauma of a non-interpersonal nature, and 7 to overall trauma. Regarding the relationship between childhood trauma and AM, 24 studies found a negative relationship between childhood interpersonal trauma and AM; among the articles on non-interpersonal trauma, 10 studies found no relevant relationship; in the studies on overall trauma, 4 articles found negative relationship between overall trauma and AM. The literature explored in our systematic review supports the prevalence of a negative relationship between interpersonal childhood trauma and AM. This relationship is present regardless of psychiatric disorders (e.g., Depression, Post Traumatic Stress Disorder, and Personality Disorders), and in the presence of the latter, AM results even more fragmented. Future research should use more accurate methodologies in identifying and classifying childhood trauma in order to more precisely determine its effect on AM.
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  • 文章类型: Journal Article
    研究报告,注意缺陷/多动障碍(ADHD)儿童受到虐待的风险增加,以及儿童虐待(CM)患者的ADHD水平升高。然而,CM和ADHD之间因果关系的方向仍然不清楚-ADHD是否为CM创造了背景,CM会导致多动症吗,或两者兼有?
    本研究使用Bradford-Hill标准建立因果关系强度,系统地回顾并定性地综合了与此问题相关的研究证据,时间性,剂量反应和合理性。
    我们进行了系统评价,遵循PRISMA准则,前瞻性纵向研究检查CM和ADHD。然后,我们使用Bradford-Hill标准来评估CM和ADHD之间因果关系的证据质量。
    所有11项纳入的研究均表明CM与ADHD之间存在关联。七个包含了时间性的证据:五个表明CM在一生中先于ADHD;两个建议ADHD先于CM。四项研究表明剂量反应关系,其中较大的CM暴露与ADHD风险升高有关。研究提出了一系列合理的机制,包括CM通过生物编程引起多动症,与多动症通过父母压力引起CM相比。
    回顾的高质量前瞻性纵向研究证实了ADHD与CM之间的关联,但是关于因果关系的方向和支持这种关联的机制,提出了相互矛盾的证据。为了更好地理解CM和ADHD之间复杂的相互作用,将需要使用新的研究设计进行更多的研究,这些研究可以按CM类型划分效果,并考虑双向效果和其他复杂性。
    UNASSIGNED: Studies report an elevated risk of maltreatment in children with attention deficit/hyperactivity disorder (ADHD), and elevated levels of ADHD in people who suffered childhood maltreatment (CM). However, the direction(s) of causality between CM and ADHD remain unclear-does ADHD create a context for CM, does CM cause ADHD, or both?
    UNASSIGNED: This study systematically reviews and qualitatively synthesizes the research evidence relating to this question using Bradford-Hill criteria for establishing causality-strength, temporality, dose-response and plausibility.
    UNASSIGNED: We conducted a systematic review, following PRISMA guidelines, of prospective longitudinal studies examining both CM and ADHD. We then used Bradford-Hill criteria to assess the quality of evidence for a causal link between CM and ADHD.
    UNASSIGNED: All 11 included studies demonstrated an association between CM and ADHD. Seven included evidence for temporality: five suggesting that CM precedes ADHD in the lifespan; two suggesting ADHD precedes CM. Four studies demonstrated a dose response relationship in which greater CM exposure was associated with elevated risk of ADHD. Studies presented a range of plausible mechanisms, including CM causing ADHD through biological programming, versus ADHD causing CM through parental stress.
    UNASSIGNED: The high quality prospective longitudinal studies reviewed confirm the association between ADHD and CM, but present conflicting evidence about the direction of causality and mechanisms underpinning this association. To better understand the complex interplay between CM and ADHD, more studies using new research designs will be required that can partition effects by type of CM and account for bidirectional effects and other complexities.
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  • 文章类型: Systematic Review
    静息状态功能连接(rsFC)有可能揭示童年虐待和忽视与负面精神病结果的关系。然而,儿童虐待对大脑静息状态功能组织的影响尚未进行全面审查。我们系统地搜索了遭受虐待的儿童和青年的rsFC研究。19项研究(共n=3079)符合我们的纳入标准。观察到两个一致的发现。儿童虐待与前岛和背侧前扣带皮质之间的连通性降低有关,杏仁核与突出部分关键结构的连接广泛增强,默认模式,和前额叶调控网络。其他显示连通性改变的大脑区域包括腹前扣带皮质,背外侧前额叶皮质,和海马体。这些与虐待暴露相关的功能连接改变的模式与症状无关,然而,与在有明显临床疾病的个体中看到的那些相当。总结性发现表明,与虐待经历相关的rsFC改变与认知和社会功能不良有关,并且是未来症状的预后。总之,虐待与情绪反应性rsFC改变有关,regulation,学习,和显着性检测大脑回路。这表明与适应不良发育结果有关的推定机制的重新校准模式。
    Resting-state functional connectivity (rsFC) has the potential to shed light on how childhood abuse and neglect relates to negative psychiatric outcomes. However, a comprehensive review of the impact of childhood maltreatment on the brain\'s resting state functional organization has not yet been undertaken. We systematically searched rsFC studies in children and youth exposed to maltreatment. Nineteen studies (total n = 3079) met our inclusion criteria. Two consistent findings were observed. Childhood maltreatment was linked to reduced connectivity between the anterior insula and dorsal anterior cingulate cortex, and with widespread heightened amygdala connectivity with key structures in the salience, default mode, and prefrontal regulatory networks. Other brain regions showing altered connectivity included the ventral anterior cingulate cortex, dorsolateral prefrontal cortex, and hippocampus. These patterns of altered functional connectivity associated with maltreatment exposure were independent of symptoms, yet comparable to those seen in individuals with overt clinical disorder. Summative findings indicate that rsFC alterations associated with maltreatment experience are related to poor cognitive and social functioning and are prognostic of future symptoms. In conclusion, maltreatment is associated with altered rsFC in emotional reactivity, regulation, learning, and salience detection brain circuits. This indicates patterns of recalibration of putative mechanisms implicated in maladaptive developmental outcomes.
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  • 文章类型: Review
    儿童时期的创伤暴露是精神疾病的非特异性危险因素,包括饮食失调(ED),在生命历程中。此外,记录了应激性生活事件与ED的发作/维持之间的关联。因此,下丘脑-垂体-肾上腺(HPA)轴,即内源性应激反应系统的主要组成部分,已被认为与ED的病理生理学有关。在这篇叙述性综述中,将说明有关早期创伤暴露对HPA轴活性的影响及其在ED病理生理学中的推定作用的最新知识。研究结果证实了儿童期创伤暴露对HPA轴活动有长期失调的影响,这可能有助于整个生命周期中与早期创伤相关的ED发展风险的生物学背景。此外,文献数据支持在具有特定临床和神经内分泌特征的ED中存在“治疗不良的生态表型”,这可能对这类患者的治疗计划具有重要意义。
    Exposure to trauma during childhood is a non-specific risk factor for psychiatric disorders, including eating disorders (EDs), over the life course. Moreover, an association between stressful life events and the onset/maintenance of EDs has been documented. Therefore, the hypothalamus-pituitary-adrenal (HPA) axis, namely the main component of the endogenous stress response system, has been proposed to be implicated in the pathophysiology of EDs. In this narrative review the current knowledge concerning the effects of early trauma exposure on the HPA axis activity and their putative role in the pathophysiology of EDs will be illustrated. Research findings corroborate the idea that childhood trauma exposure has long-lasting dysregulating effects on the activity of the HPA axis, which may contribute to the biological background of the early trauma-related risk for the development of EDs across the life span. Moreover, literature data support the existence of a \"maltreated ecophenotype\" in EDs characterized by specific clinic and neuroendocrine features, which may have important implications in treatment programming for such a type of patients.
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  • 文章类型: Journal Article
    父母与婴儿的关系对于社会情感发展至关重要,并且受到围产期物质使用的不利影响。本系统综述认为,这些风险对母婴关系的潜在机制集中在3个主要过程上:(1)母亲的童年虐待经历;(2)依恋方式和随之而来的人际关系内部工作模式;(3)围产期物质使用。Further,审查考虑了hyperkatifeia的作用,或对物质使用障碍患者不使用物质时发生的负面影响过敏,并推动成瘾的负面强化。作者对与这些结构及其对母婴关系和后代结局的影响相关的文章(发表于2000-2022年)进行了系统的回顾。包括解决这些结构之间关系的原始临床研究文章,不包括案例研究,reviews,非人类动物研究,干预研究,女性参与者少于30%的研究,临床指南,仅限于产科结果的研究,机械/生物学研究,以及排除解释的方法论问题的研究。总共筛选了1844篇文章,377人被选中进行全文审查,数据来自157篇文章。结果显示,母亲与儿童虐待经历之间存在着密切的关系,不太优化的内部工作模型,围产期物质使用的风险增加,而且重要的是,所有这些预测因子与hyperkatifeia相互作用,对母婴关系产生显著影响,而有关后代结局的数据较少.这些数据有力地支持了未来研究的必要性,以解决产妇儿童虐待经历的累加影响,次优的内部工作模型,和围产期物质的使用,Hyperkatifeia作为潜在的主持人,以及它们对母婴社会情感结果的相互作用。
    The parent-infant relationship is critical for socioemotional development and is adversely impacted by perinatal substance use. This systematic review posits that the mechanisms underlying these risks to mother-infant relationships center on 3 primary processes: (1) mothers\' childhood maltreatment experiences; (2) attachment styles and consequent internal working models of interpersonal relationships; and (3) perinatal substance use. Further, the review considers the role of hyperkatifeia, or hypersensitivity to negative affect which occurs when people with substance use disorders are not using substances, and which drives the negative reinforcement in addiction. The authors performed a systematic review of articles (published 2000-2022) related to these constructs and their impact on mother-infant relationships and offspring outcomes, including original clinical research articles addressing relationships between these constructs, and excluding case studies, reviews, non-human animal studies, intervention studies, studies with fewer than 30% female-sex participants, clinical guidelines, studies limited to obstetric outcomes, mechanistic/biological studies, and studies with methodological issues precluding interpretation. Overall 1844 articles were screened, 377 were selected for full text review, and data were extracted from 157 articles. Results revealed strong relationships between mothers\' childhood maltreatment experiences, less optimal internal working models, and increased risk for perinatal substance use, and importantly, all of these predictors interacted with hyperkatifeia and exerted a marked impact on mother-infant relationships with less data available on offspring outcomes. These data strongly support the need for future studies addressing the additive impact of maternal childhood maltreatment experiences, suboptimal internal working models, and perinatal substance use, with hyperkatifeia as a potential moderator, and their interacting effects on mother-infant socioemotional outcomes.
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  • 文章类型: Meta-Analysis
    在过去的十年里,关于童年虐待(CM)与感恩之间关系的研究一直在积累,但是缺乏系统的,对现有文献进行定量评价。本系统综述旨在通过进行三级荟萃分析来填补这一空白。在五个英文和三个中文数据库中进行全面搜索后,我们从16项研究中检索了33项效应大小,总样本为13,818名参与者.结果表明,CM(跨形式汇总)与感恩呈负相关且中度相关(r=-.311,95%CI[-0.382,-0.235],p<.001)。童年忽视(即,身体和情感上的忽视)对感恩的影响比情感虐待更大,而儿童身体虐待和性虐待的影响微不足道。此外,在样本较年轻的研究中,平均效应大小较大.然而,效果没有随CM测量的函数而变化,方法的严谨,样本是否只包括大学生,出版物类型,或样品的区域。最后,我们强调了现有研究的局限性,提出了未来研究的议程,并讨论了实际意义。
    During the past decade, research on the association between childhood maltreatment (CM) and gratitude has been accumulating, but there is a lack of systematic, quantitative evaluation of existing literature. The present systematic review aims to fill this gap by conducting a three-level meta-analysis. After a comprehensive search in five English and three Chinese databases, we retrieved 33 effect sizes from 16 studies with a total sample of 13,818 participants. The results showed that CM (aggregated across forms) was negatively and moderately linked to gratitude (r = -.311, 95% CI [-0.382, -0.235], p < .001). Childhood neglect (i.e., physical and emotional neglect) exhibited more substantial effects on gratitude than emotional abuse, while the effects of childhood physical and sexual abuse were insignificant. In addition, the mean effect sizes were larger in studies with younger samples. However, the effect did not vary as functions of CM measurement, methodological rigor, whether the sample included college students only, publication type, or region of the sample. Last, we highlighted the limitations of existing research, proposed agendas for future studies, and discussed practical implications.
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