Family environment is associated with HPA-axis activity in adolescents. The TRAILS study

The purpose of the present study was to investigate the developmental programming part of the theory of biological sensitivity to context using family environmental factors and hypothalamus-pituitary-adrenal (HPA) axis functioning. Specifically, we investigated whether perceived parenting (Rejection and Emotional Warmth) and socio-economic status (SES) predicted basal cortisol levels and the cortisol awakening response (CAR). In a population-based cohort of 1594 adolescents (mean age = 11.08, SD = 0.54) we assessed salivary cortisol, SES and perceived parenting. Perceived parental Emotional Warmth showed an inverse, linear association with basal cortisol levels. In addition, there was a curvilinear relationship between SES and both basal cortisol levels and the CAR. Our findings with regard to basal cortisol levels confirmed our hypothesis: lower basal HPA-axis activity in both high and low SES families compared to intermediate SES families.     

汶川地震男性救援者创伤后应激障碍危险因素研究

目的调查参加汶川地震中男性救援者创伤后应激障碍相关危险因素。方法采用分层随机抽样方法,对1590名男性救援者进行创伤后应激障碍检查问卷(PLC-C)测量,并将其分为PTSD组和非PTSD组,比较两组社会人口学资料、地震暴露初期个体心理特征问卷(SRQ)和灾后个体认知特征调查问卷(PTCI)测量结果,并利用Log istic回归分析筛选PTSD危险因素。结果 PTSD患者与其它男性救援者相比较在SRQ(10.75±3.75/3.29±3.31)和PTC I(104.72±29.13/55.94±20.16)上的得分明显较高(P0.001),其PTSD症状发生频率明显高于其它男性救援者(P0.001)。Logistic回归分析筛选出4个预测因素包括运送炸药(OR=2.76)、排除危房(OR=0.47)、PTCI(OR=0.97)和SRQ(OR=0.77)。结论汶川抗震救灾6个月后男性救援者的PTSD患病率与执行任务种类如运送炸药、排除危房以及第1个月地震暴露时的应激反应和对地震的认知评价方式明显相关。     

帕罗西汀治疗社交焦虑症疗效分析

目的：研究帕罗西汀治疗社交焦虑症（SAD）的疗效、副反应。对30例符合DSM－IV诊断标准的SAD患者在帕罗西汀治疗前、后进行Liebowitz社交焦虑量表（LSAS）、社交恐怖和焦虑问卷（SPIN）及治疗时出现的症状量表（TESS）评定。结果：帕罗西汀治疗SAD8周末LSAS减分率评定临床痊愈8例（26．7％）、显著进步17例（56．7％）、好转3例（10％）、无效2例（6．7％），显效率83．4％。结论：帕罗西汀治疗SAD有效，安全性高。     

Social information processing in middle childhood: Relations to infant-mother attachment

This longitudinal study was designed to examine the links between infant-mother attachment and social information processing in middle childhood. The Strange Situation was used to assess infant-mother attachment at 12 months and a revised and adapted Hebrew version of the Social Information Processing Interview (Dodge & Price, 1994) was used to measure social information processing in middle childhood (at 7.5 years). Findings revealed that with regard to both peer-group relationships and mother-child relationships, secure children demonstrated more competent social information processing than insecure-ambivalent children in one out of four social information processing stages. The major characteristic distinguishing secure from insecure-ambivalent children's social information processing was their level of expectations from others: secure children expected others to be emotionally and instrumentally available to them (but in the case of peers — only if their own behavior was socially acceptable), whereas ambivalent children did not expect others to be available to them in both peer-group and mother-child circumstances.     

儿童心理虐待与情绪行为问题:社会支持的中介效应

目的:探讨社会支持在儿童心理虐待与情绪行为问题之间的中介作用。方法:采用方便抽样的方法,对1605名中小学生采用儿童心理虐待量表、中小学生心理虐待自评量表、领悟社会支持量表以及长处和困难量表进行测量。结果:中介效应检验结果表明,儿童心理虐待对情绪行为问题既有直接效应又有间接效应,且以直接效应为主。结论:儿童心理虐待不仅直接影响个体的心理健康,同时还通过社会支持间接影响心理健康。     

Neurobiological effects of childhood abuse: implications for the pathophysiology of depression and anxiety

Summary Mood and anxiety disorders are highly prevalent psychiatric disorders, especially in women, and they are associated with significant morbidity and mortality. A considerable literature indicates that vulnerability to depression and anxiety disorders is markedly increased by childhood abuse, e.g., physical, sexual, and psychological abuse, as well as adulthood stressors, e.g., death of a spouse. Little is known about the developmental neurobiological mechanisms by which childhood abuse increases the susceptibility of women to the development of depression and anxiety disorders in adulthood. Recent research on the effects of adverse early life experiences on central nervous system (CNS) stress systems has provided a greater understanding of the link between childhood abuse and susceptibility to mood and anxiety disorders. Specifically, early life traumatic events, occurring during a period of neuronal plasticity, appear to permanently render neuroendocrine stress response systems supersensitive. These physiological maladaptations likely represent long-term risk factors for the development of psychopathology after exposure to additional stress. Received October 15, 2002; accepted November 17, 2002 Published online January 17, 2003 RID="*" ID="*"  Presented at the First World Congress on Women's Mental Health, Berlin, March, 2001; Symposium: Understanding the interaction of stress and gender in the prediction of major depression and treatment response. Acknowledgements This work is in part supported by NIMH grants MH-42088 and MH-38599. Correspondence: Charles B. Nemeroff, MD, PhD, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1639 Pierce Drive, WMB, Suite 4000, Atlanta, GA 30322, U.S.A.; e-mail: cnemero@emory.edu     

认知行为疗法与药物治疗社交焦虑障碍的疗效对照研究

目的探讨认知行为疗法联合药物治疗社交焦虑障碍的疗效。方法符合CCMD-3社交焦虑障碍诊断标准的36位病人,随机将其中的18例在常规药物治疗的基础上联用认知行为疗法做为研究组,另18例单纯接受常规药物治疗为对照组,均系统治疗12周,采用临床疗效评定,临床精神症状自评量表及自我评估报告评定两组治疗社交焦虑障碍的疗效。结果认知行为疗法联合药物治疗组的疗效优于单用常规药物治疗组。结论认知行为疗法联合药物治疗可以增强社交焦虑障碍的疗效。     

社交焦虑障碍与人格障碍的共病及父母养育方式的影响

目的:探讨社交焦虑障碍与轴Ⅱ人格障碍的共病情况及父母养育方式的影响.方法:采用人格障碍评估手册(PDA)和父母养育方式评价量表分别对50例社交焦虑障碍患者、40例强迫症患者和40例广泛性焦虑障碍患者进行测查.结果:社交焦虑障碍与回避型、强迫型人格障碍共病率较高,社交焦虑障碍组的回避型人格障碍得分和PDA总分明显高于强迫症组和广泛性焦虑症组.社交焦虑障碍患者父母情感温暖理解因子显著低于正常对照组,而父母惩罚严厉、拒绝否认因子显著高于正常对照组.结论:社交焦虑障碍与回避型人格障碍关系密切,父母不良的养育方式与社交焦虑障碍的形成有关.     

社交焦虑障碍患者的认知特征及其与父母教养方式的关系

目的探讨教养方式对社交焦虑症(SAD)病人的认知的影响,为临床干预提供指导。方法用惧怕否定评价量表(FNE)、社交苦恼与回避量表(SAD)和父母教养方式评价量表(EMBU)对40例SAD组和42例正常对照(NC)组进行评估。结果SAD患者的FNE分数和SAD分数(分别为114.2±14.1;22.4±4.9)显著高于NC组(分别为82.7±16.1;8.1±4.7)。SAD患者父母教养方式的情感温暖、理解因子分明显低于NC组,惩罚、拒绝和过度保护因子分明显高于NC组。结论SAD患者组FNE分与SAD分显著正相关,FEN分与EMBU的各因子分数显著相关。     

The Role of Childhood Maltreatment in The Relationship Between Social Anxiety and Dissociation: A Novel Link

ABSTRACT

Children that have been maltreated may experience manifold negative effects later in life. Two such sequelae are social anxiety and dissociation. Recent studies have noted their frequent co-occurrence, but no hypothesis has yet been offered explaining how they interact. College undergraduates (N = 198) completed the Child Trauma Questionnaire, Liebowitz Social Anxiety Scale, and Cambridge Depersonalization Scale. Social anxiety significantly predicted severity of dissociation, and self-reported childhood maltreatment (CM) significantly predicted both social anxiety and dissociation. Notably, emotional abuse was the only significant subtype of CM to predict social anxiety. Furthermore, CM moderated the relationship between social anxiety and dissociation, such that the presence of CM strengthened the predictive effect of social anxiety on dissociation. This study was the first to implicate CM as a mechanism in the social anxiety-dissociation relationship. This study was also the first to note a social anxiety-dissociation link in a non-clinical sample, thus demonstrating the existence of this relationship along a continuum of severity – not solely for those with extreme disturbances.     

The effects of glucocorticoids on the inhibition of emotional information: A dose-response study

There is evidence that cortisol influences cognitive and affective processes such as selective attention and memory for emotional events, yet the effects of glucocorticoids on attentional inhibition in humans remain unknown. Consequently, this double-blind study examined dose-dependent effects of exogenous glucocorticoids on the inhibition of emotional information. Sixty-three university students (14 male, 49 female) ingested either a placebo pill or hydrocortisone (10 mg or 40 mg), and completed a negative priming task assessing the inhibition of pictures depicting angry, sad, and happy faces. The 10 mg, but not the 40 mg hydrocortisone dose elicited increased inhibition for angry faces relative to placebo. Thus, moderate glucocorticoid elevations may have adaptive effects on emotional information processing, whereas high glucocorticoid elevations appear to attenuate this effect, consistent with the view that there are dose-dependent effects of glucocorticoids on cognition.     

聋童社交焦虑障碍沙盘游戏治疗的倒返设计研究

目的探讨采用沙盘游戏治疗1名聋童社交焦虑障碍的疗效。方法采用倒返设计，观察沙盘游戏治疗是否能改变被试与人交往的状况。结果治疗后，被试每天特定单位时间被观察到的与人接触的次数增加（P〈0．05），与人的交往方式改变，交往的质量提高．交往范围逐渐扩大，焦虑状况得以缓解。结论沙盘游戏治疗对聋童的社交焦虑障碍有效。