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      心理學Essay模板:Child Development Pathways for Developing Depression in Adulthood

      論文價格: 免費 時間:2022-01-14 09:14:59 來源:www.ourpropertyvalue.com 作者:留學作業網

      本文是心理學專業的留學生Essay范例,題目是“Child Development Pathways for Developing Depression in Adulthood兒童發展路徑與成年期抑郁癥的發展)”,童年時期建立的發展途徑被認為對個人一生的幸福有幫助。這篇文章的主要焦點將是評估證據,說明不安全的依戀風格,兒童逆境和創傷是在成年后發展抑郁的途徑。

       

      Developmental pathways established during childhood are considered to be instrumental for the wellbeing of the individual across the lifespan. The main focus of this essay will be evaluating evidence illustrating that insecure attachment style, child adversity and trauma are pathways for developing depression later in adulthood.

       心理學Essay范文

      Depression is a mood disorder characterised by: depressed mood, lack of interest in daily activities, disrupted diet, inability to concentrate, fatigue, extreme feelings of guilt and worthlessness (American Psychiatric Association, 2013).

      抑郁癥是一種情緒障礙,其特征是:情緒低落、對日?;顒尤狈εd趣、飲食紊亂、無法集中精力、疲勞、極度內疚和一無是處(美國精神病學協會,2013)。

       

      Suffering from depressive symptoms during childhood predicts a continuity of struggling with the same disorder in adulthood (Copeland et al.,2009). Childhood adversity and trauma are divided into four categories containing a total number of 12 types of adversities:

       

      interpersonal loss (parental divorce),

      parental maladjustment (family violence),

      maltreatment (abuse, neglect),

      and other childhood adversities (illness) (Kessler et al., 2010).

      Moreover, the attachment theory illustrates the development of an emotional connection between the infant and its primary caregiver as a means to regulate behaviour and emotion, especially during times of distress and the exploration period (Bowlby 1969).

       

      Child maltreatment is one of most prominent determinant for the development of psychiatric disorders in adolescence and adulthood (McLaughlin, 2015). According to the sensitization theory individuals who suffered from adversity and trauma during childhood are more prone to developing Depression later in life as a result of daily stressors (Bandoli, et al.,2017). Research examining the stress sensitization theory has focused primarily on modifications to the hypothalamic- pituitary-adrenal (HPA) axis as a result of trauma. However, differences in type of adversity suffered, duration and time of the incident have led to inconsistent results in concretely identifying how a certain adversity determines a particular malformation of the HPA axis (Nemeroff, 2004).

      兒童虐待是青少年和成年期精神障礙發展的最重要決定因素之一(McLaughlin, 2015)。根據敏化理論,童年時期遭受逆境和創傷的人更容易在日后的生活中由于日常壓力而發展成抑郁癥(Bandoli等人,2017)。檢查應激致敏理論的研究主要集中在由于創傷對下丘腦-垂體-腎上腺(HPA)軸的修改。然而,由于遭遇的逆境類型、持續時間和時間的不同,導致在具體確定某種逆境如何決定HPA軸的特定畸形方面的結果不一致(Nemeroff, 2004)。

       

      The HPA axis is part of the neuroendocrine stress response system which aims to ensure adaptation of the organism to its current circumstances, therefore, preserving health and stability (McEwen, 2004). Hyperactivity of the HPA axis has been found as one of the most significant brain changes in Major Depression (Heim, et al., 2008). Alterations to the HPA axis are associated with childhood adversity such as insecure attachment and abuse (Hammen et al., 2000). Heim et al., (2008) reviewed several studies concluding childhood adversities can cause a sensitization of the stress response system, which would lower the individualstolerance to stress thus explaining the link between trauma and Depression. Early childhood trauma is associated with a number of neuroanatomical and neuroendocrine changes (corticotropin- releasing factor (CRF) systems), which are similar to those described in animal studies. There are certain determinants that additionally increase the risk of depression such as being female and genetic factors.

      HPA軸是神經內分泌應激反應系統的一部分,其目的是確保機體適應當前環境,從而保持健康和穩定(McEwen, 2004)。HPA軸的過度活躍被發現是重度抑郁癥患者最重要的大腦變化之一(Heim, et al., 2008)。HPA軸的改變與兒童逆境相關,如不安全依戀和虐待(Hammen et al., 2000)。Heim等人(2008)回顧了幾項研究,得出童年逆境會導致應激反應系統敏感化的結論,這將降低個體對壓力的耐受性,從而解釋了創傷和抑郁癥之間的聯系。早期兒童創傷與許多神經解剖學和神經內分泌變化(促腎上腺皮質激素釋放因子(CRF)系統)有關,這些變化與動物研究中描述的相似。還有一些因素會增加患抑郁癥的風險,比如女性身份和遺傳因素。

       

      Hammen, et al., (2000) conducted a longitudinal study aimed to assess depressive episodes, caused by stressful file events in young women who were transitioning into adulthood. Women who have suffered from childhood adversities are more likely to suffer from depressive episodes when exposed to a lower threshold of stress than women without a traumatic background. The obtained results are consistent with the views expressed by the developmental psychopathology model, illustrating that childhood adversity and trauma is a pathway to depression (Cicchetti & Schneider-Rosen, 1986). Amirkhan and Marckwordt, (2017) comes in support of the previous study, as they uncovered that individuals who have suffered from childhood adversity are more likely to suffer from a greater level stress, caused by current life events as well as, avoid the stressful issues.

      Hammen等人(2000)進行了一項縱向研究,旨在評估由壓力檔案事件引起的年輕女性成年期抑郁發作。與沒有創傷背景的女性相比,童年經歷過逆境的女性在受到較低的壓力閾值時更有可能出現抑郁發作。所獲得的結果與發展精神病理學模型所表達的觀點一致,說明童年逆境和創傷是通向抑郁的途徑(Cicchetti & Schneider-Rosen, 1986)。AmirkhanMarckwordt,(2017)支持之前的研究,因為他們發現,遭受童年不幸的人更有可能遭受更大程度的壓力,由當前生活事件造成,以及避免壓力問題。 心理學Essay怎么寫

      Bandoli et al., (2017) uncovered that childhood maltreatment increases the risk of developing Depression in a sample consisting of new US army soldiers. The said effect may occur because, in addition to childhood trauma, military personnel also experience great levels of stress, resulting in an interaction that is detrimental to their psychological wellbeing and mental health. The results of the study align with the stress sensitization theory as they depict the influences of childhood adversity on stress sensitivity. Soldiers who have suffered from maltreatment are at greater risk of suffering from Major Depression, when compared to soldiers who benefited from a healthy upbringing.

       

      Furthermore, attachment is divided into 3 categories:

       

      secure,

      disorganised,

      and insecure (anxious or avoidant.)

      Insecure attachment patterns are the product of inconsistent caregiving, lack of attention towards the child, neglect and rejection (Dagan et al.,2018). The interaction between the infant and the caregiver shapes into a representational model of self and others (McLaughlin et al., 2013). From an attachment theory point of view, psychopathology (Depression) illustrates maladaptive modifications from the heathy developmental pathway, in order to adapt to the current environment in the short term, at the expense of normal adaptation in the long term (Carson and Sroufe, 1995). Bowlby (1973) considered attachment a dynamic theory of development, suggesting that attachment styles are not stable (dependent on past events), therefore they may change over time as a result of new experiences and relationships as well as, have the power to influence and give a negative meaning to the said experiences (Sroufe et al., 2005).

      不安全的依戀模式是不一致的照顧、對孩子缺乏關注、忽視和拒絕的產物(Dagan et al.,2018)。嬰兒和照顧者之間的互動形成了自我和他人的表征模型(McLaughlin et al., 2013)。從依戀理論的角度來看,精神病理學(抑郁癥)從健康的發展路徑出發,以犧牲長期的正常適應為代價,在短期內適應當前的環境(Carson and Sroufe, 1995)。鮑比(1973)認為附件動態理論的發展,認為依戀風格是不穩定的(依賴于過去的事件),因此它們可能隨時間變化的結果以及新的經驗和關系,有能力影響和給一個消極意義的經歷(Sroufe et al ., 2005)。

       

      Attachment as a pathway to Depression can best assessed for both avoidant and anxious attachments. Duggal et al., (2001) conducted a longitudinal study which uncovered that both anxious and avoidant attachments are moderately related to depression. Perhaps, the reason for this is that infants presenting anxious attachment are becoming hyper-vigilant in order to ensure that they will attract the attention of the caregiver, whose responsiveness towards the needs of the child is usually inconsistent. Sroufe et al (2005) proposed two explanatory routes of depression from an attachment perspective: avoidant attachment, leads to feelings of rejection and hopelessness caused by the emotional unavailability of the caregiver, as well as a disconnection of interpersonal relationships. While anxious attachment causes feelings of hopelessness and anxiety, due to inconsistent caregiving, which generates a hypervigilant child, as the caregiver is deemed unreliable.

       

      Dagan et al., (2018) conducted a meta-analysis analysing a number of studies examining attachment as a pathway to depression. The study uncovered that insecurely attached individuals regardless of the sub-type are more likely to suffer from depression as opposed to those who are securely attached. One of the major limitation of the study is represented by the fact that both clinical and non-clinical samples were assessed, therefore, the obtained results do not illustrate a pure depiction of attachment as a pathway to clinically diagnosed Major Depression, but rather to long term prevalence of depressive symptoms. In addition, it is difficulty to infer causality due to the fact that, although insecure attachment representation may predict depression, it is also possible that some individuals develop insecure attachment styles because they suffer from depressive symptoms.

      Dagan等人(2018)進行了一項薈萃分析,分析了一些研究依戀作為抑郁的途徑。研究發現,與安全型依戀的人相比,不安全型依戀的人無論屬于哪種亞型,都更容易患抑郁癥。該研究的一個主要局限性在于,臨床和非臨床樣本都進行了評估,因此,所獲得的結果并沒有說明依戀作為臨床診斷重度抑郁癥的途徑的純描述,而是反映了抑郁癥癥狀的長期流行。此外,雖然不安全依戀表征可以預測抑郁,但也有可能一些個體因為患有抑郁癥狀而發展出不安全依戀風格,因此很難推斷其因果關系。

       

      Despite the fact that attachment pattern during infancy was adaptive to the respective situation, it is particularly likely to become precarious across the lifespan, as it will be applied to other relationships. Studies have identified that insecurely attached individuals are more attentive to negative affective information in comparison to securely attached people (Maier et al.,2005). Moreover, it may determine insecurely attached individuals to misinterpret the behaviour of others, deeming it as hostile, unreliable or rejecting (Dykas & Cassidy, 2011). Consequently, insecure attachment is likely to cause difficulties in forming, preserving as well as, emotionally investing in interpersonal relationships (Pietromaco & Beck,2015). As such, insecurely attached individuals are suffering from interpersonal stress, which has been shown to be a significant predictor of Depression.

       

      Tsachi et al., (2018) found that avoidant attachment had higher levels epigenetic markers such as OXTR and NR3C1. These results illustrate that in the case of avoidant attachment, the OXTR factor causes an inability to regulate stress through positive social relationships, therefore illustrating a maladaptation to the gene environment interactions. Respectively, the NR3C1 factor indicates towards dysfunctions of the HPA axis, which results in a reduced regulation of stress and emotions. There were no significant results between these two epigenetic markers and anxious attachment. Causality between these results cannot be inferred as the study was cross-sectional.

      Tsachi et al.,(2018)發現回避依戀具有更高水平的表觀遺傳標記,如OXTRNR3C1。這些結果表明,在回避依戀的情況下,OXTR因子無法通過積極的社會關系調節壓力,因此說明了對基因環境交互作用的不適應。NR3C1因子分別表明HPA軸功能失調,導致壓力和情緒調節的減少。這兩種表觀遺傳標記與焦慮依附之間沒有顯著性差異。這些結果之間的因果關系不能推斷,因為這項研究是橫斷面的。

       

      Lastly, Kessler et al., (2010) concluded that childhood adversity and trauma has a strong influence on the development of any kind of mental health issues across the life-span, regardless of the country of origin. Attachment represents the first interpersonal relationship humans build therefore, being particularly important for a healthy growth from a psychological point of view. In addition, insecure attachment can be considered a type of childhood maltreatment. Consequently, there is some overlap between the two developmental pathways as both are highly related to stress, thus, leading to alterations of the HPA axis (Hammen, et al.,2000;? Tsachi et al., 2018). The evidence regarding their influence on development of depression in adulthood is not sufficient when it comes to the processes by which they lead to depression and there is a clear need for further investigations.

       

      Perhaps, more longitudinal studies are needed for assessing these processes in order to systematically investigate attachment and maltreatment as pathways for depression through observation, as well as, having the possibility to establish causation. The majority of studies have focused on self-report retrospective measures which are somewhat unreliable and biased. Despite this a number of studies have found that both insecure attachment and childhood adversity lead to suffering from depressive symptoms from childhood but mostly in adulthood. Major depression affects 2.8% of children under 13 yearsold, but these statistics increase to 5.6% for adolescents, reaching 16.2% in adulthood (McLaughlin et al., 2013) therefore it can be considered a significant mental health problem. Given the results of a great number of studies, there is sufficient evidence to conclude that childhood attachment and adversities are pathways to developing depression in adulthood, even though the precise mechanisms by which they happen are yet to be determined.

      也許,還需要更多的縱向研究來評估這些過程,以便通過觀察系統地調查依戀和虐待作為抑郁的路徑,并有可能建立因果關系。大多數研究都集中于自我報告的回顧性測量,這在某種程度上是不可靠和有偏見的。盡管如此,一些研究發現,不安全的依戀和童年時期的逆境都導致了童年時期的抑郁癥狀,但主要是在成年時期。13歲以下兒童中有2.8%患有重度抑郁癥,但青少年的這一數據增加到5.6%,成年時達到16.2% (McLaughlin et al., 2013),因此可以認為重度抑郁癥是一種重要的心理健康問題。鑒于大量研究的結果,有足夠的證據可以得出這樣的結論:童年的依戀和逆境是形成成年抑郁癥的途徑,盡管它們發生的確切機制尚未確定。

       

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