发表评论-心理与性-万维博客-万维读者网（电脑版）

【摘要】尽管在群体层面，不良童年经历（ACEs）会增加患精神疾病的风险，但现有的ACEs筛查工具在预测个体预后方面的效用有限，这表明它们可能未能涵盖童年逆境中的关键要素。我们此前已确定，父母及家庭环境中的“不可预测性”是一种预示认知与心理健康状况较差的不良童年经历。然而，在现实环境中，这种不可预测性相对于既定ACEs的贡献尚不明确。本研究利用加利福尼亚州现有的ACEs筛查体系，在覆盖广泛社会人口学群体的19家儿科诊所引入了“童年不可预测性问卷（5项版）”（QUIC-5），并针对约3万名儿童，比较了两种筛查工具与精神健康诊断之间的关联。结果显示，ACEs和QUIC-5的评分均与抑郁症、外化行为症状、睡眠障碍、焦虑症及躯体症状的发生概率相关。两种筛查工具各具独特的预测价值，且联合使用往往能使关联强度增加一倍。特别是在抑郁症和睡眠障碍方面，QUIC-5能够识别出ACEs筛查所遗漏的高危个体，从而提升了风险识别能力，并为后续干预措施的实施提供了支持。

[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.

论文原文：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

（翻译兼责任编辑：MARY）

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