Psychopathology

精神病理学
  • 文章类型: Journal Article
    精神病理学在家庭中运行,并影响个人及其家庭成员的功能。这项研究评估了精神病理学风险在三代人之间的代际传播,以及社会支持因素在多大程度上可以防止这种从父母到后代的传播。这项研究嵌入了R世代,从胎儿寿命开始的多种族人群队列。根据DSM-IV更新的《家庭告密者时间表标准》评估了祖父母的终生精神疾病。父母的精神病理学通过简短症状清单反复测量。后代精神病理学(10岁和14岁)用简短问题监测仪进行评估。使用问卷测量和计算机化的同伴提名评估来评估母婴社会因素。我们的结果表明,祖父母和产前和产后父母精神病理学向后代精神病理学的风险传播的估计累加相互作用效应为23%(95%CI19;27)。祖父母和父母精神病理学结合母婴社会支持因素的联合效应为13%(95%CI08;17)],表明社会支持因素减少了精神病理学从(大)父母(G1和G2)到后代(G3)的代际传播。精神病理学风险的传播可能会对几代人产生持久的发展影响。社会支持因素降低了对精神病理学风险影响的脆弱性,强调在高家庭风险的青少年中识别与良好心理健康相关的缓冲因素的重要性。
    Psychopathology runs in families and affects functioning of individuals and their family members. This study assessed the intergenerational transmission of psychopathology risk across three generations, and the extent to which social support factors may protect against this transmission from parents to their offspring. This study was embedded in Generation R, a multi-ethnic population-based cohort from fetal life onwards. Lifetime psychiatric disorders of grandparents were assessed with the Family Informant Schedule Criteria- updated for DSM-IV. Parental psychopathology was repeatedly measured by the Brief Symptom Inventory. Offspring psychopathology (ages 10 and 14) was assessed with the Brief Problem Monitor. Maternal and child social factors were assessed using questionnaire measures and a computerized peer nomination assessment. Our results show that the estimated additive interaction effect for the risk transmission of grandparental and pre- and postnatal parental psychopathology to offspring psychopathology was 23% (95% CI 19; 27). The joint effect of grandparental and parental psychopathology combined with maternal and child social support factors was 13% (95% CI 08; 17)], suggesting that social support factors diminished the intergenerational transmission of psychopathology from (grand)parents (G1 and G2) to offspring (G3). Transmission of psychopathology risk may have long-lasting developmental effects across generations. Social support factors reduced the vulnerability to the effects of psychopathology risk, underscoring the importance of the identification of buffering factors associated with good mental health in adolescents who are at high familial risk.
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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
    目的:精神合并症提示不同诊断的症状重叠;诊断网络方法对于研究精神病理学是有价值的。儿童创伤是精神疾病的常见诊断危险因素,但是,儿童创伤和精神病理学之间的复杂关系很少使用大型横断面诊断样本进行研究。
    方法:这项研究招募了869名诊断不同的患者,包括418例精神分裂症,215双相情感障碍,和236个重度抑郁症。参与者完成了精神病学访谈和自我报告问卷。我们构建了基于维度和项目级别的最小绝对收缩和选择算子(LASSO)网络,以探索童年创伤之间的关系,精神病理学,和疾病的持续时间。此外,我们构建了有向无环图(DAG),以初步阐明这些变量之间潜在的关联方向.对不同诊断组和性别分层组进行网络比较测试(NCT)。
    结果:经诊断的LASSO网络显示,不同类型的儿童创伤对不同的精神病理学维度产生不同的影响。情绪虐待与抑郁症状有关,身体虐待到兴奋症状,性虐待到积极和混乱的症状,情绪忽视抑郁症状和消极症状的动机和快乐(MAP)缺陷因子,和身体忽视MAP因素。DAG的发现通常与LASSO网络一致。NCT显示了可比的网络。
    结论:我们的研究结果表明,儿童创伤与不同诊断组的精神病理学发展显著相关。情感途径模型表明,对于有童年创伤史的人,需要早期识别和量身定制的干预措施。
    OBJECTIVE: Psychiatric comorbidities suggest that symptoms overlap across different diagnoses; the transdiagnostic network approach is valuable for studying psychopathology. Childhood trauma is a common transdiagnostic risk factor for psychiatric disorders, but the complex relationship between childhood trauma and psychopathology has seldom been investigated using a large cross-sectional transdiagnostic sample.
    METHODS: This study recruited 869 patients with different diagnoses, including 418 schizophrenia, 215 bipolar disorder, and 236 major depressive disorder. Participants completed psychiatric interviews and self-report questionnaires. We constructed dimension- and item-level Least Absolute Shrinkage and Selection Operator-based (LASSO) networks to explore the relationship between childhood trauma, psychopathology, and duration of illness. Moreover, we constructed directed acyclic graphs (DAGs) to tentatively clarify the potential directions of associations among these variables. Network Comparison Tests (NCTs) were conducted for different diagnostic groups and gender-stratified groups.
    RESULTS: The transdiagnostic LASSO networks showed that different types of childhood trauma exerted distinct impacts on various psychopathological dimensions. Emotional abuse was linked to depressive symptoms, physical abuse to excited symptoms, sexual abuse to positive and disorganized symptoms, emotional neglect to depressive symptoms and motivation and pleasure (MAP) deficits factor of negative symptoms, and physical neglect to MAP factor. The DAG findings generally concurred with the LASSO network. The NCT showed comparable networks.
    CONCLUSIONS: Our findings suggest that childhood trauma is significantly associated with the development of psychopathology across different diagnostic groups. The affective pathway model suggests that early identification and tailored interventions would be needed for people with a history of childhood trauma.
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  • 文章类型: Journal Article
    背景:护士越来越需要以更少的资源达到黄金护理标准。因此,有效地应对日常工作生活中遇到的压力至关重要。这项研究基于需求资源和个人效果(DRIVE)护士模型,并采用了以人为中心的方法,其目标有两个:1。确定护士为应对压力而采用的应对策略模式(以问题为中心;寻求建议;自责;一意孤行;逃避/回避);2.探索感知需求(努力)的潜在差异,资源(奖励,作业控制,社会支持),和精神病理学症状(焦虑,恐惧-焦虑,强迫症,躯体化,抑郁症,人际关系敏感,敌意,精神病,偏执的想法)根据出现的模式。
    方法:本横断面研究采用STROBE检查表进行报告。总的来说,265名护理专业人员完成了自我报告措施。采用非分层k均值聚类分析来得出应对模式。MANOVA被用来测试需求的差异,资源,和精神病理症状根据出现的模式。
    结果:确定了三种稳定且有意义的应对方式,并将其标记为主动/面向解决方案,失调/情绪集中,和被动/脱离。与属于主动/面向解决方案组的护士相比,属于失调/以情绪为中心组的护士出现了更高的风险(更高的努力/精神病理学痛苦;更低的资源)-其次是被动/脱离组。
    结论:培养护士对其潜在应对方式的认识,并支持积极的方法/情绪调节策略进行压力管理,应成为定义干预措施促进护士在医疗环境内/外健康的关键目标。
    BACKGROUND: Nurses are increasingly demanded to achieve gold-standards of care with fewer resources. Dealing effectively with stress experienced in their daily-work-life is thus crucial. This study is based on the Demands-Resources-and-Individual-Effects (DRIVE) Nurses Model and applied the person-centred approach with a twofold objective: 1. to identify patterns of coping strategies (Problem-Focused; Seek-Advice; Self-Blame; Wishful-Thinking; Escape/Avoidance) adopted by nurses to deal with perceived stress; 2. to explore potential differences in perceived Demands (Effort), Resources (Rewards, Job-Control, Social-Support), and Psychopathological Symptoms (Anxiety, Phobic-Anxiety, Obsessive-Compulsive, Somatization, Depression, Interpersonal-Sensitivity, Hostility, Psychoticism, Paranoid-Ideation) according to the emerged patterns.
    METHODS: This cross-sectional study was reported by using the STROBE Checklist. Overall, 265 nursing professionals completed self-report measures. Non-hierarchical k-means-cluster-analysis was employed to derive patterns of coping. MANOVAs were used to test differences in Demands, Resources, and Psychopathological Symptoms according to the emerged patterns.
    RESULTS: Three stable and meaningful patterns of coping were identified and labelled as Active/Solution-Oriented, Dysregulated/Emotion-focused, and Passive/Disengaged. Nurses belonging to Dysregulated/Emotion-focused group emerged to be at higher risk (higher effort/psychopathological suffering; lower resources) - followed by Passive/Disengaged group - in comparison with nurses belonging to Active/Solution-Oriented group.
    CONCLUSIONS: Fostering nurses\' awareness of their latent coping patterns and supporting active approaches/emotional regulation strategies for stress management should represent a key goal when defining interventions promoting nurses\' health within/beyond the healthcare settings.
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  • 文章类型: Journal Article
    赌博障碍(GD)和其他精神障碍之间的共存现象很常见,但它与有问题的色情使用(PPU)的关联仍未被探索。本研究旨在调查社会人口统计学变量之间的关系,人格测量,精神病理学,情绪调节,以及使用结构方程模型(SEM)的冲动性和GD和PPU的共存。样本包括359名寻求GD治疗的成年人。有问题的色情消费量表(PPCS-6)的简短版本确定了GDPPU患者。精神病理学,冲动,情绪调节,还评估了人格。较高的冲动性水平在统计学上预测GD和PPU之间的共现。冲动性介导了年轻之间的关系,适应不良的人格特征,情绪失调和共同发生。精神病理学上的困扰与GDPPU的共同发生没有直接联系。冲动性与GD和PPU的共同出现非常重要。年龄更小,适应不良人格,和情绪失调有助于增加冲动水平和并发。研究结果强调了在理解和治疗同时发生的GD和PPU中解决冲动性的重要性。
    Co-occurrence between gambling disorder (GD) and other mental disorders is common, but its association with problematic pornography use (PPU) remains unexplored. This study aimed to investigate relationships between sociodemographic variables, personality measures, psychopathology, emotional regulation, and impulsivity and the co-occurrence of GD and PPU using structural equation modeling (SEM). The sample consisted of 359 adults seeking treatment for GD. The short version of the Problematic Pornography Consumption Scale (PPCS-6) identified patients with GD + PPU. Psychopathology, impulsivity, emotional regulation, and personality were also assessed. Higher impulsivity levels statistically predicted co-occurrence between GD and PPU. Impulsivity mediated the relationship between younger age, maladaptive personality features, and emotional dysregulation and co-occurrence. Psychopathological distress did not directly associate with GD + PPU co-occurrence. Impulsivity relates importantly to the co-occurrence of GD and PPU. Younger age, maladaptive personality, and emotional dysregulation contribute to increased impulsivity levels and co-occurrence. The findings highlight the importance of addressing impulsivity in understanding and treating co-occurring GD and PPU.
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  • 文章类型: Journal Article
    背景:面部表情是非语言交流的核心方面。面部情绪表现力降低是精神分裂症的常见阴性症状,然而,量化阴性症状可能在临床上具有挑战性,并且涉及评估者的主观性。我们使用计算机视觉来调查(i)面部表情的自动评估是否捕获负面以及正面和一般症状领域,和(ii)如果自动评估与首次发作精神病的初始抗精神病患者的治疗反应相关。
    方法:我们纳入了46例患者(平均年龄25.4(6.1);65.2%为男性)。使用阳性和阴性综合征量表(PANSS)在基线和氨磺必利单一疗法6周后评估精神病理学。录制了基线采访视频。十七个面部动作单元(AU),也就是说,激活肌肉,使用OpenFace2.0从面部动作编码系统中提取。计算每个患者的相关矩阵。在组级别使用谱聚类识别面部表情。使用多元线性回归研究了面部表情与精神病理学之间的关联。
    结果:确定了与面部不同位置相关的三个面部表情簇。第1组与基线时的阳性和一般症状相关,群集2与所有症状域相关联,显示出与负域的最强关联,第3类仅与一般症状相关。第1组与治疗后阳性和一般症状的临床评分改善显着相关,和集群2与所有领域的临床改善显着相关。
    结论:在PANSS访谈中使用自动计算机视觉面部表情不仅捕获了阴性症状,而且还捕获了精神病理学三个整体领域的组合。此外,基线时面部表情的自动评估与抗精神病药物初始治疗反应相关.这些发现强调了面部表情的临床相关性,并激发了对临床精神病学中计算机视觉的进一步研究。
    BACKGROUND: Facial expressions are a core aspect of non-verbal communication. Reduced emotional expressiveness of the face is a common negative symptom of schizophrenia, however, quantifying negative symptoms can be clinically challenging and involves a considerable element of rater subjectivity. We used computer vision to investigate if (i) automated assessment of facial expressions captures negative as well as positive and general symptom domains, and (ii) if automated assessments are associated with treatment response in initially antipsychotic-naïve patients with first-episode psychosis.
    METHODS: We included 46 patients (mean age 25.4 (6.1); 65.2% males). Psychopathology was assessed at baseline and after 6 weeks of monotherapy with amisulpride using the Positive and Negative Syndrome Scale (PANSS). Baseline interview videos were recorded. Seventeen facial action units (AUs), that is, activation of muscles, from the Facial Action Coding System were extracted using OpenFace 2.0. A correlation matrix was calculated for each patient. Facial expressions were identified using spectral clustering at group-level. Associations between facial expressions and psychopathology were investigated using multiple linear regression.
    RESULTS: Three clusters of facial expressions were identified related to different locations of the face. Cluster 1 was associated with positive and general symptoms at baseline, Cluster 2 was associated with all symptom domains, showing the strongest association with the negative domain, and Cluster 3 was only associated with general symptoms. Cluster 1 was significantly associated with the clinically rated improvement in positive and general symptoms after treatment, and Cluster 2 was significantly associated with clinical improvement in all domains.
    CONCLUSIONS: Using automated computer vision of facial expressions during PANSS interviews did not only capture negative symptoms but also combinations of the three overall domains of psychopathology. Moreover, automated assessments of facial expressions at baseline were associated with initial antipsychotic treatment response. The findings underscore the clinical relevance of facial expressions and motivate further investigations of computer vision in clinical psychiatry.
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  • 文章类型: Journal Article
    目的:先前关于酒精使用障碍(AUD)的神经影像学研究发现,大脑的显著性功能连接发生了改变,默认模式,和中央执行(CEN)网络(即三重网络模型),尽管它们与AUD严重程度和大量饮酒的具体关联尚不清楚。这项研究利用静息状态功能磁共振成像来检查这些网络中的功能连通性和酒精滥用的措施。
    方法:76名成年重度饮酒者在视觉固定过程中完成了7分钟的静息状态功能MRI扫描。线性回归模型测试了三个目标网络中的连通性是否与过去12个月的AUD症状和过去30天内大量饮酒天数相关。探索性分析检查了连通性簇与冲动性和心理病理学措施之间的相关性。
    结果:CEN网络内的功能连接(左右外侧前额叶皮层[LPFC]种子与13和15簇共同激活,分别)与AUD症状显着相关(右LPFC:β=.337,p-FDR=.016;左LPFC:β=.291,p-FDR=.028),但与大量饮酒(p-FDR>.749)无关。事后测试显示,与CEN网络共同激活的六个簇与AUD症状-右额中回有关,右顶叶下回,左颞中回,还有左右小脑.默认模式和显著性网络都与酒精变量没有显着关联。左侧LPFC的连通性与货币延迟贴现相关(r=.25,p=.03)。
    结论:这些发现支持CEN网络内的连通性与AUD严重性之间的先前关联,为三重网络模型与AUD的相关性提供额外的特异性。
    OBJECTIVE: Previous neuroimaging research in alcohol use disorder (AUD) has found altered functional connectivity in the brain\'s salience, default mode, and central executive (CEN) networks (i.e. the triple network model), though their specific associations with AUD severity and heavy drinking remains unclear. This study utilized resting-state fMRI to examine functional connectivity in these networks and measures of alcohol misuse.
    METHODS: Seventy-six adult heavy drinkers completed a 7-min resting-state functional MRI scan during visual fixation. Linear regression models tested if connectivity in the three target networks was associated with past 12-month AUD symptoms and number of heavy drinking days in the past 30 days. Exploratory analyses examined correlations between connectivity clusters and impulsivity and psychopathology measures.
    RESULTS: Functional connectivity within the CEN network (right and left lateral prefrontal cortex [LPFC] seeds co-activating with 13 and 15 clusters, respectively) was significantly associated with AUD symptoms (right LPFC: β = .337, p-FDR = .016; left LPFC: β = .291, p-FDR = .028) but not heavy drinking (p-FDR > .749). Post-hoc tests revealed six clusters co-activating with the CEN network were associated with AUD symptoms-right middle frontal gyrus, right inferior parietal gyrus, left middle temporal gyrus, and left and right cerebellum. Neither the default mode nor the salience network was significantly associated with alcohol variables. Connectivity in the left LPFC was correlated with monetary delay discounting (r = .25, p = .03).
    CONCLUSIONS: These findings support previous associations between connectivity within the CEN network and AUD severity, providing additional specificity to the relevance of the triple network model to AUD.
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  • 文章类型: Journal Article
    背景:抑郁症是全球因疾病致残的主要原因之一。以前的研究已经证明了抑郁症诊断的显著异质性,有必要开发新的诊断方法。网络分析是将症状视为精神疾病本身的组成部分的观点。目的是使用CES-D和ZDS抑郁量表确定抑郁症状的结构。
    方法:使用CES-D和ZDS量表对194例患者进行二次分析的横断面研究。从数据库中构建相关矩阵和正则化偏相关网络。估计了中心性度量,并进行了网络稳定性分析。
    结果:在CES-D量表上,最核心的项目是“悲伤”;而在ZDS量表上,最核心的项目是“悲伤”和“生活”。在CES-D尺度上,“享受”和“快乐”之间的联系是最强烈的。在ZDS尺度上,最强的连接是项目之间的“活”与“有用”。项目“早晨”是ZDS上连接最少的项目。
    结论:CES-D量表最主要的症状是悲伤,而从ZDS量表来看,是悲伤和快感。
    BACKGROUND: Depression represents one of the leading causes of disability due to illness worldwide. Previous studies have demonstrated the significant heterogeneity of the diagnosis of depression, making it necessary to develop new diagnostic approaches. Network analysis is a perspective that considers symptoms as constituents of the psychiatric disorder itself. The objective was to determine the structure of depressive symptoms using the CES-D and ZDS depression scales.
    METHODS: Cross-sectional study of secondary analysis of 194 patients using the CES-D and ZDS scales. Correlation matrices and regularised partial correlation networks were constructed from the database. Centrality measures were estimated, and a network stability analysis was performed.
    RESULTS: On the CES-D scale, the most central item was \"Sad\"; while on the ZDS scale, the most central items were \"Sad\" and \"Live\". On the CES-D scale, the connection between \"Enjoy\" and \"Happy\" was the strongest. On the ZDS scale, the strongest connection was between the items \"Live\" with \"Useful\". The item \"Morning\" was the least connected on the ZDS.
    CONCLUSIONS: The most central symptom from the CES-D scale was sadness, while from the ZDS scale, was sadness and anhedonia.
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  • 文章类型: Journal Article
    缺乏精神病学中的生物标志物需要对精神障碍的精神病理学进行有效和可靠的评估,桥梁研究和临床护理,可以捕捉临床医生和患者的观点。在这里,我们建议,一本小说,brief,评估和可视化不同精神疾病症状严重程度的诊断工具。诊断性整体印象-精神病理学量表(TGI-P)基于临床整体印象-严重程度量表(CGI-S),最初设计用于衡量全球疾病严重程度。TGI-P涵盖10个诊断症状域,与CGI-S相似,从1(正常)到7(极端)的李克特评分为7分。这十个领域包括阳性症状,阴性症状,躁狂症状,抑郁症状,成瘾症状,认知症状,焦虑症状,睡眠症状,敌对症状,和自我伤害症状。结果直观地呈现,从而简化了对症状的监测,并促进与患者和护理人员的讨论。作为开发过程的一部分,对来自3个国家的36名精神科医生进行了TGI-P调查.重要的是,超过80%的人对工具的概念“非常积极”或“积极”,他们中的大多数(70%)表示愿意在日常实践中使用它。随着未来涵盖不良事件的TGI量表,TGI-P的进一步心理测量开发和测试正在进行中。功能和满意度。
    Lacking biomarkers in psychiatry calls for a valid and reliable assessment of psychopathology across mental disorders that is easy to use, bridges research and clinical care, and that can capture clinician and patient perspectives. Herein we propose, a novel, brief, transdiagnostic tool to assess and visualize symptom severity in different psychiatric disorders. The Transdiagnostic Global Impression - Psychopathology scale (TGI-P) is based on the Clinical Global Impression - Severity scale (CGI-S), which was originally designed to measure global illness severity in one score. The TGI-P covers 10 transdiagnostic symptom domains and similar to the CGI-S, it is rated on a 7-point Likert-scale from 1 (normal) to 7 (extreme). These ten domains include positive symptoms, negative symptoms, manic symptoms, depressive symptoms, addiction symptoms, cognitive symptoms, anxiety symptoms, sleep symptoms, hostility symptoms, and self-harm symptoms. The results are visually presented, thus simplifying the monitoring of symptoms, and facilitating discussion with patients and caregivers. As part of the development process, the TGI-P was surveyed among 36 psychiatrists from 3 countries. Importantly, over 80 % of them was \"very positive\" or \"positive\" about the concept of the tool, and most of them (70 %) reported willingness to use it in their everyday practice. Further psychometric development and testing of the TGI-P is underway alongside future TGI scales covering adverse events, functioning and satisfaction.
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  • 文章类型: Journal Article
    背景:儿童期不良经历(ACE)与青春期焦虑的发展有关。根据最近的研究,COVID-19大流行代表了一种与青少年焦虑相关的新型ACE。本研究调查了ACEs之间的关系,COVID-19和青少年焦虑。
    方法:使用社区样本进行了一项横断面研究,该样本来自东部阿提卡的五所高中的248名12至15岁(平均=13.50岁)的男孩和女孩。共使用四份问卷:(1)人口统计问卷,(2)儿童状态特质焦虑量表-STAIC,(3)不良童年经历量表,和(4)COVID-19影响量表。
    结果:结果表明,青春期ACEs总数与焦虑(特质和状态)之间存在中度关联(特质焦虑:ρ=0.37,p<0.001;状态焦虑:ρ=0.29,p<0.001)。女孩在特质焦虑(U=4353,p<0.001;平均差=5.5)和状态焦虑(U=5822.5,p=0.014;平均差=2)方面的得分均显着高于男孩。ACEs的数量与COVID-19的影响显著相关(β=0.025,p<0.001)。
    结论:这项研究强调了ACEs与青少年焦虑增加之间的显著联系,COVID-19大流行进一步加剧了这种情况。调查结果表明,女孩比男孩受到的影响更大。这些结果强调需要有针对性的心理健康干预措施,以加强应对机制,减轻压力,解决青少年的焦虑问题,特别是在大流行等全球危机期间。制定此类计划对于支持面临多种压力的年轻人的心理健康至关重要。
    BACKGROUND: Adverse Childhood Experiences (ACEs) are linked to the development of anxiety in adolescence. According to recent studies, the COVID-19 pandemic represents a novel ACE that is associated with anxiety among adolescents. This study investigates the relationship between ACEs, COVID-19, and anxiety in adolescents.
    METHODS: A cross-sectional study was conducted using a community sample of 248 boys and girls ages 12 to 15 years (mean = 13.50 years) from five high schools in Eastern Attica. A total of four questionnaires were used: (1) Demographic Questionnaire, (2) State-Trait Anxiety Inventory for Children-STAIC, (3) Adverse Childhood Experiences Scale, and (4) COVID-19 Impact Scale.
    RESULTS: The results demonstrated a moderate association between the total number of ACEs and anxiety (trait and state) in adolescence (trait anxiety: ρ = 0.37, p < 0.001; state anxiety: ρ = 0.29, p < 0.001). Girls scored significantly higher than boys on both trait anxiety (U = 4353, p < 0.001; mean difference = 5.5) and state anxiety (U = 5822.5, p = 0.014; mean difference = 2). The number of ACEs was found to be significantly related to the impact of COVID-19 (β = 0.025, p < 0.001).
    CONCLUSIONS: This study highlights the significant link between ACEs and increased anxiety in adolescents, which is further exacerbated by the COVID-19 pandemic. The findings indicate that girls are more affected than boys. These results emphasize the need for targeted mental health interventions to enhance coping mechanisms, reduce stress, and address anxiety in adolescents, particularly during global crises like the pandemic. Developing such programs is essential for supporting the mental well-being of youth facing multiple stressors.
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