大学生的儿童期创伤史及孤独特质与执行功能失常的关系

摘要

目的:探讨大学生儿童期创伤史及孤独特质与执行功能失常的关系.方法:使用儿童期创伤问卷(CTQ)评估湖南两所高校2757例大学生的儿童期创伤情况,根据Bernstein等人定义中-重度虐待暴露的阈值定义有无儿童期创伤史,选出有、无创伤史的学生各63例和93例,使用孤独症谱系障碍问卷(AQ)、抑郁自评量表(SDS)和执行功能失常问卷(DEX)测量孤独特质、抑郁水平和执行功能失常.最后,将问卷得分上下27％作为高低分组的界限定义不同类型的创伤组和孤独特质组.结果:高、低情感虐待组,高、低躯体虐待组,高、低性虐待组,高、低情感忽视组,高、低躯体忽视组以及高、低孤独特质组之间的执行功能失常问卷得分差异均有统计学意义(均P＜0.05),且高变量组的执行功能失常问卷得分均高于低变量组.回归分析显示,儿童期创伤问卷的情感虐待、孤独症谱系障碍问卷得分、SDS得分对执行功能失常问卷得分均有正向预测作用(β =0.17 ～0.32,均P＜0.05).中介分析表明,SDS得分是情感虐待与DEX得分、孤独特质与DEX得分之间的中介变量,中介效应95％的可信区间分别是0.05 ～0.32和0.07 ～0.55.结论:儿童期创伤史与孤独特质正向预测执行功能失常,且抑郁在情感虐待与执行功能失常、孤独特质与执行功能失常之间起到中介作用.%Objective:To explore the relations among childhood trauma,autistic traits and dysexecutive functions in college students.Methods:Totally 2757 college students were assessed with the Childhood Trauma Questionnaire (CTQ).Sixty-three college students were randomly selected as the abused group according to the subscale cutoff point of CTQ Scale defined by Bernstein,and 93 students were randomly selected from students without history of childhood trauma as the control group.They were assessed with the Self-Rating Depression Scale (SDS),Autism Spectrum Quotient (AQ) and Dysexecutive Questionnaire (DEX) to measure depression,autistic traits and abnormality of executive functions,respectively.The individuals from the top and below 27％ of CTQ and AQ scores were defined as higher or lower-level different types of abused group and higher or lower-level autistic traits group,respectively.Results:The differences of DEX scores between higher or lower-level four types of CTQ (emotional abuse,physical abuse,sexual abuse,emotional neglect and physical neglect) and between higher or lower-level autistic traits group were significant (Ps ＜0.05).DEX scores in all higher-level groups were higher than all lower-level groups.Regression analysis showed that DEX score could be positively predicted by scores of emotional abuse,AQ and SDS (β =0.17-0.32,P ＜0.05).SDS score was a mediator between scores of emotional abuse and DEX,and between scores of autistic traits and DEX (95％ confidence interval were 0.05-0.32 and 0.07-0.55,respectively).Conclusion:Childhood trauma and autistic traits may positively predict dysexecutive function,and depression may play a mediating role between emotional abuse and dysexecutive function,and between autistic traits and dysexecutive function.