婴儿期虐待与反社会人格障碍关系的美国长程纵向研究  

Prospectively longitudinal study of the relationship between infancy abuse and antisocial personality disorder

作　　者：石振宇 李志英[2] 赵旭东[3] LYONS.RUTHKarlen BUREAUJean-Francois 

机构地区：[1]上海交通大学医学院附属精神卫生中心,上海200030 [2]上海市长宁区精神卫生中心 [3]同济大学东方转化医学中心心身医学研究所 [4]美国麻省哈佛大学医学院精神医学系 [5]加拿大渥太华渥太华大学心理学院

出　　处：《中华行为医学与脑科学杂志》2012年第9期832-835,共4页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家科技支撑计划项目（2009BAP7805）;美国国立精神卫生研究所资助项目（R01MH35122.R01MH06030）

摘　　要：目的探讨婴儿期虐待与反社会人格障碍的关系。方法采用长程纵向研究方法，从婴儿期入组76例样本，到成年早期有效样本56例。婴儿期虐待信息通过官方儿童保护机构的客观记录获得，家访1h再确认。成年早期用DSM—IV半定式临床诊断访谈工具评估反社会人格障碍、物质滥用、和抑郁障碍。多重填补和分层回归分析纵向数据。结果33．9％的样本有1条以上反社会人格障碍症状，38．0％符合物质滥用诊断，32．4％有抑郁障碍。分析显示，男性反社会人格障碍发生率高于女性（F相似值=1．40，P=0．001）。婴儿期虐待对反社会人格障碍的预测有统计学意义（β=0．28，P=0．03）。剔除物质滥用和抑郁障碍的作用后，婴儿期虐待与反社会人格障碍的关联仍有统计学意义（β=0．19，P=0．04）。结论婴儿期虐待对人格产生长期影响，增加日后反社会人格障碍的发生，值得探索其中的生物学机制；对我国建立从婴儿期开始的虐待监控干预体系也有借鉴意义。Objective To investigate the relationship of antisocial personality disorder（ASPD） and infan- cy abuse. Methods With prospectively longitudinal research design,76 samples at infancy were initially recruited. Infancy abuse was measured by Child Protective Service records and reconfirmed by one hour family interview. 56 remained samples at young adulthood were measured for antisocial personality disorder, depression, and substance abuse by utilizing Structured Clinical Interview-Ⅰ/Ⅱ （SCID-Ⅰ/Ⅱ） of DSM-IV. Longitudinal data was analyzed by multiple imputation and hierarchal regression. Results 33.9% samples met at least one item of ASPD, 38.0% were diagnosed with substance abuse and 32.4% with depression. Gender was correlated with ASPD symptoms （F= 1.40, P=0. 001）. Infancy abuse significantly predicted ASPD （β=0.28, P=0.03）. Further analysis demonstrated that infancy abuse was associated with ASPD with controlling substance abuse and depression （ β = 0.19, P = 0.04）. Conclusion Infancy abuse, with fundamental long-term effects on personality, is a risk factor for the etiology of antisocial personality disorder. The underlying mechanism might involve biological alterna- tions. It is necessary to establish national early-life abuse monitoring and prevention system.

关 键 词：反社会人格障碍 婴儿期虐待 长程纵向研究 

分 类 号：B848[哲学宗教—心理学]