不可預測性是一種童年期的逆境，會導致心理健康問題 Unpredictability is a childhood adversity that contributes to mental health problems ——《自然-心理健康》第4卷第8期，2026年8月—— <Nature / Mental Health>, Volume 4, Issue 8, August 2026 【摘要】儘管在群體層面，不良童年經歷（ACEs）會增加患精神疾病的風險，但現有的ACEs篩查工具在預測個體預後方面的效用有限，這表明它們可能未能涵蓋童年逆境中的關鍵要素。我們此前已確定，父母及家庭環境中的“不可預測性”是一種預示認知與心理健康狀況較差的不良童年經歷。然而，在現實環境中，這種不可預測性相對於既定ACEs的貢獻尚不明確。本研究利用加利福尼亞州現有的ACEs篩查體系，在覆蓋廣泛社會人口學群體的19家兒科診所引入了“童年不可預測性問卷（5項版）”（QUIC-5），並針對約3萬名兒童，比較了兩種篩查工具與精神健康診斷之間的關聯。結果顯示，ACEs和QUIC-5的評分均與抑鬱症、外化行為症狀、睡眠障礙、焦慮症及軀體症狀的發生概率相關。兩種篩查工具各具獨特的預測價值，且聯合使用往往能使關聯強度增加一倍。特別是在抑鬱症和睡眠障礙方面，QUIC-5能夠識別出ACEs篩查所遺漏的高危個體，從而提升了風險識別能力，並為後續干預措施的實施提供了支持。 [Abstract] Although adverse childhood experiences (ACEs) increase risk for mental illness at the population level, existing ACEs screens are less helpful in forecasting individual outcomes, suggesting they may not capture significant elements of childhood adversity. We have previously identified unpredictable parental and household experiences as an ACE that portends poorer cognitive and mental health. However, the contribution of unpredictability to established ACEs in real-world settings is unknown. Here, leveraging existing ACEs screening in California, we added the five-item Questionnaire on Unpredictability in Childhood (QUIC-5) in 19 pediatric clinics spanning broad sociodemographic constituencies and compared in ~30,000 children the link of each screen with mental health diagnoses. Scores on either the ACEs or QUIC-5 associated with probabilities of depression, externalizing symptoms, sleep disorders, anxiety and somatic symptoms. Each screen provided unique contributions and combining them often doubled the strength of associations. For depression and sleep disorders, the QUIC-5 identified vulnerable individuals missed by ACEs screen, improving risk detection and facilitating future interventions. 論文原文：Laura M. Glynn, Sabrina R. Liu, Charles Golden, et al. (2026). Unpredictability is a childhood adversity that contributes to mental health problems. Nature / Mental Health, Volume 4, Issue 8, Pages 1219–1226. August 2026. https://doi.org/10.1038/s44220-026-00681-x （翻譯兼責任編輯：MARY） （需要英文原文的朋友，請聯繫微信：millerdeng95或iacmsp）
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