青少年童年虐待、焦虑抑郁症状、认知功能的结构方程模型分析

Structural equation model analysis of childhood abuse,anxiety and depression symptoms and cognitive function in normal adolescents

目的研究青少年的童年虐待史对其神经认知功能和社会认知功能的影响,并探索焦虑、抑郁症状在上述关联中的中介作用。方法本研究入组480名年龄12~18岁的健康青少年,所有受试者完成童年期虐待问卷、9项患者健康问卷、7项广泛性焦虑障碍量表和中文版成套认知测试评估。建立结构方程模型,得出效应量。结果童年虐待史对神经认知功能(r=-0.405,P<0.001)和社会认知功能(r=-0.228,P<0.001)两者均有直接影响;童年虐待史与焦虑/抑郁症状间亦有直接影响(r=0.392,P<0.001)。焦虑/抑郁症状在童年虐待史和神经认知功能(中介效应量15.8%)之间以及童年虐待史和社会认知功能(中介效应量25.4%)之间的关联中均起到部分中介作用。结论童年虐待史会直接影响社会认知和神经认知功能,也会通过焦虑/抑郁症状这一中介因素而间接影响社会认知、神经认知功能,但焦虑抑郁症状不是唯一的中介因素。

Objective To investigate the effects of childhood abuse on neurocognitive and social cognitive functions of adolescents,and to explore the mediating role of anxiety and depression symptoms in the above associations.Methods In this study,480 healthy adolescents aged 12 to 18 years were enrolled.All subjects completed the Childhood Abuse Questionnaire,the 9-item Patient Health Questionnaire,the 7-item Generalized Anxiety Disorder Scale and the Chinese version of the MATRICS cognitive test kit.The structural equation model was established and the effect size was obtained.Results Childhood abuse had direct effects on both neurocognitive function(r=-0.405,P<0.001)and social cognitive function(r=-0.228,P<0.001).There was also a direct correlation between childhood abuse and anxiety/depression symptoms(r=0.392,P<0.001).Anxiety/depression symptoms were partially mediating the association between history of childhood abuse and neurocognitive function(mediating effect size 15.8%)and between history of childhood abuse and social cognitive function(mediating effect size 25.4%).Conclusion Childhood abuse history directly affects social cognition and neurocognitive function;Social cognition and neurocognitive function are also indirectly affected through anxiety/depression symptoms,but anxiety/depression symptoms are not the only mediating factor.