早期虐待与复杂重度抑郁症的感知生活负担：临床应用早期虐待与关爱经历问卷

IF 3.4 2区心理学 Q1 FAMILY STUDIES

Child Abuse & Neglect Pub Date : 2025-09-13 DOI:10.1016/j.chiabu.2025.107682

Pablo Martínez , Dante Diez de Medina , M. Victoria Chacón , Cristián Cáceres , Eduardo Sánchez , Marietta Alegría , Sergio Gloger

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引用次数: 0

摘要

严重虐待经历（EME）与复杂和严重的抑郁症有关，但结果的可变性表明了暴露之外的机制。目的探讨感知生活负担（PLB，由EME引起的持续困难）在EME与复杂和严重抑郁症之间的联系机制。参与者和背景271名患有重度抑郁症的成年人首次门诊心理健康咨询的横断面样本。方法采用早期虐待与关爱经历（EMCE）问卷，对儿童的seme、PLB和早期关爱经历（ECE）进行评估。复杂和重度抑郁症定义为PHQ-9≥20加上≥1个临床复杂性标记（早发、复发、精神病性特征、自杀倾向或家族史）。逻辑回归、中介和调节分析检验了EME、PLB、适应性应对和复杂和严重抑郁之间的关联，并对ECE进行了调整。采用层次分析法对PLB的增量预测值进行检验。结果splb与复杂重度抑郁相关（OR 1.69 [95% CI 1.23-2.32]）。PLB部分介导EME-complex和重度抑郁相关（间接效应23.4% [95% CI 14.5 - 83.5%]）。适应性应对调节了EME-PLB的关联（交互作用比为0.96 [95% CI 0.92-0.99]），在较高的适应性应对中减弱了PLB，但没有显著调节复杂和严重抑郁的关联。添加PLB可改善契合度，并且PLB仍然与复杂和严重的抑郁症独立相关。结论splb反映了EME的主观负担，提高了对EME和ECE之外的复杂和严重抑郁的预测，并受到适应性应对的调节。研究结果支持将PLB纳入创伤知情评估。

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Perceived life burdens of early maltreatment and complex and severe depression: Using the early maltreatment & caring experiences questionnaire in clinical practice

Background

Early maltreatment experiences (EME) are linked to complex and severe depression, but outcome variability suggests mechanisms beyond exposure.

Objective

To examine perceived life burdens (PLB; enduring difficulties attributed to EME) as a mechanism linking EME to complex and severe depression.

Participants and setting

Cross-sectional sample of 271 adults with major depression disorder at their first outpatient mental health consultation.

Methods

EME, PLB, and early caring experiences (ECE) were assessed with the Early Maltreatment & Caring Experiences (EMCE) questionnaire. Complex and severe depression was defined as PHQ-9 ≥ 20 plus ≥1 clinical complexity marker (early onset, recurrence, psychotic features, suicidality, or family history). Logistic regression, mediation, and moderation analyses examined associations among EME, PLB, adaptive coping, and complex and severe depression, adjusting for ECE. Incremental predictive value of PLB was tested with hierarchical.

Results

PLB was associated with complex and severe depression (OR 1.69 [95 % CI 1.23–2.32). PLB partially mediated the EME–complex and severe depression association (indirect effect 23.4 % [95 % CI 14.5–83.5 %]). Adaptive coping moderated the EME–PLB association (interaction OR 0.96 [95 % CI 0.92–0.99]), attenuating PLB at higher adaptive coping, but did not significantly moderate associations with complex and severe depression. Adding PLB improved fit, and PLB remained independently associated with complex and severe depression.

Conclusions

PLB reflects the subjective burden of EME, improves prediction of complex and severe depression beyond EME and ECE, and is moderated by adaptive coping. Findings support incorporating PLB into trauma-informed assessment.

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来源期刊

Child Abuse & Neglect Multiple-

CiteScore

7.40

自引率

10.40%

发文量

397

期刊介绍： Official Publication of the International Society for Prevention of Child Abuse and Neglect. Child Abuse & Neglect The International Journal, provides an international, multidisciplinary forum on all aspects of child abuse and neglect, with special emphasis on prevention and treatment; the scope extends further to all those aspects of life which either favor or hinder child development. While contributions will primarily be from the fields of psychology, psychiatry, social work, medicine, nursing, law enforcement, legislature, education, and anthropology, the Journal encourages the concerned lay individual and child-oriented advocate organizations to contribute.