远近端人际压力与FKBP5基因对青少年自伤行为的联合影响：基于发展的视角

doi:10.3724/SP.J.1041.2023.01477

摘要/Abstract

摘要：

本研究采用为期2年的纵向追踪设计, 在436名青少年中考察远端童年期虐待与近端同伴侵害对青少年自伤的相对作用与影响模式, 以及FKBP5基因在其中发挥的调节作用。结果发现：(1)远近端人际压力均能显著预测青少年自伤行为, 但二者的相对作用在青春期不同阶段会发生变化; (2)在全样本中, 远近端人际压力均以“压力放大”模式影响自伤行为, 即高童年期虐待放大近期同伴侵害对自伤行为的预测作用; (3)纳入FKBP5基因后, 在AA纯合子青少年中仍符合“压力放大模型”, 但在AC和CC基因型青少年中, 影响模式则符合“压力敏感模型”, 即经历高童年期虐待的青少年对近期同伴侵害更加敏感, 在低同伴侵害下自伤得分相对较高。研究结果提示, 远近端人际压力对青少年自伤的特定影响模式因其遗传基因而有所差异。

关键词: 人际压力, 自伤行为, FKBP5基因, 压力放大模型, 压力敏感模型

Abstract:

Self-injury usually emerges in early adolescence and has a high incidence among adolescents worldwide. Self-injury not only damages body tissue but is also associated with depression, anxiety, personality disorders, substance abuse, and a higher-than-average risk of suicide. Given the high incidence of self-injury and the severity of its consequences, it is important to explore its predictors and specific mechanisms. Interpersonal theories of developmental psychopathology maintain that interpersonal stress is a critical risk factor for adolescent self-injury behavior. However, the ways the source and duration of exposure to that stress affect adolescent self-injury behavior are unclear. Adolescents also differ in their sensitivity to interpersonal stress. Stress-related genetic factors may play an important moderating role. The current study selected child abuse and recent peer victimization as distal and proximal interpersonal stress, respectively, and FKBP5 gene rs3800373 polymorphism as the genetic factor. The purpose of this study was to build upon the results of previous studies by exploring the relative and interactive effects of distal and proximal interpersonal stress on adolescent self-injury behavior.

The participants were 436 adolescents (12.84 ± 0.89 years, 49.8% males) recruited from four junior high schools in Guizhou Province. All were tracked from grade 7 to grade 9. At Time 1, adolescents reported child abuse via the Parent-Child Conflict Tactics Scale, reported peer victimization via the Multidimensional Peer Victimization Scale, and reported self-injury behavior via the Short Version of Self-Injury Behavior Scale. At Time 2, adolescents reported peer victimization and self-injury behavior, and saliva samples were collected. Genotyping with respect to the FKBP5 gene was performed with Agena MassArray software, and the corresponding typing results were analyzed using MassARRAY Typer software version 4.0.

Results showed that both distal and proximal interpersonal stress significantly predicted adolescent self-injury behavior, but the relative effect sizes differed in early and middle adolescence. Across the entire sample, distal and proximal interpersonal stress had an interactive effect on adolescent self-injury, and the interaction pattern was consistent with the stress amplification model. However, when the FKBP5 gene was considered, the interaction pattern was found to differ between adolescents in different genotype groups. Specifically, compared with AA homozygous adolescents who experienced less childhood abuse, those who experienced more child abuse were easily to be impacted by recent peer victimization and engage in NSSI. This was consistent with the stress amplification model. However, in adolescents with the AC/CC genotype who experienced more childhood abuse, mild recent peer victimization triggered adolescent self-injury. These participants showed lower self-injury thresholds and higher scores for self-injury than those who experienced less childhood abuse, which was consistent with a stress sensitization model. These relationships were stable in both early and middle adolescence.

These findings showed different patterns of interaction between interpersonal and intrapersonal factors on self-injury behavior in adolescents of different genotypes. Using an integrative, dynamic, and developmental framework, this study provides important insights into the relevant interpersonal theories. It is also valuable for the accurate identification of adolescents at high risk of self-injury and for both prevention and intervention.

Key words: interpersonal stress, self-injury behavior, FKBP5 gene, stress amplification model, stress sensitization model

中图分类号:

B844
B845

白荣, 高叶淼, 李金文, 刘霞. (2023). 远近端人际压力与FKBP5基因对青少年自伤行为的联合影响：基于发展的视角. 心理学报, 55(9), 1477-1488.

BAI Rong, GAO Yemiao, LI Jinwen, LIU Xia. (2023). Combined effects of distal and proximal interpersonal stress and FKBP5 gene on adolescent self-injury behavior: The developmental perspective. Acta Psychologica Sinica, 55(9), 1477-1488.

图/表 5

参考文献 60

[1]	Barzilay R., Moore T. M., Calkins M. E., Maliackel L., Jones J. D., Boyd R. C.,... Gur R. E. (2021). Deconstructing the role of the exposome in youth suicidal ideation: Trauma, neighborhood environment, developmental and gender effects. Neurobiology of Stress, 14, 100314. doi: 10.1016/j.ynstr.2021.100314 URL
[2]	Binder E. B. (2009). The role of FKBP5, a co-chaperone of the glucocorticoid receptor in the pathogenesis and therapy of affective and anxiety disorders. Psychoneuroendocrinology, 34(1), S186-S195.
[3]	Border R., & Keller M. C. (2017). Commentary: Fundamental problems with candidate gene-by-environment interaction studies -- reflections on Moore and Thoemmes (2016). Journal of Child Psychology and Psychiatry, 58(3), 328-330. doi: 10.1111/jcpp.2017.58.issue-3 URL
[4]	Bulik-Sullivan B. K., Daly M. J., Neale B. M., Loh P.-R., Finucane H. K., Ripke S., Yang J., Patterson N., & Price A. L. (2015). LD Score regression distinguishes confounding from polygenicity in genome-wide association studies. Nature Genetics, 47(3), 291-295. doi: 10.1038/ng.3211 pmid: 25642630
[5]	Dackis M. N., Rogosch F. A., Oshri A., & Cicchetti D. (2012). The role of limbic system irritability in linking history of childhood maltreatment and psychiatric outcomes in low-income, high-risk women: Moderation by FK506 binding protein 5 haplotype. Development and Psychopathology, 24(4), 1237-1252. doi: 10.1017/S0954579412000673 pmid: 23062294
[6]	Daskalakis N. P., Bagot R. C., Parker K. J., Vinkers C. H., & de Kloet E. R. (2013). The three-hit concept of vulnerability and resilience: Toward understanding adaptation to early- life adversity outcome. Psychoneuroendocrinology, 38(9), 1858-1873. doi: 10.1016/j.psyneuen.2013.06.008 pmid: 23838101
[7]	Davies P. T., Thompson M. J., Martin M. J., & Cummings E.M. (2021). The vestiges of childhood interparental conflict: Adolescent sensitization to recent interparental conflict. Child Development, 92(3), 1154-1172. doi: 10.1111/cdev.v92.3 URL
[8]	Derbidge C., & Beauchaine T. (2014). A developmental model of self-inflicted injury, borderline personality, and suicide risk. In M.Lewis, & K. Rudolph (Eds) Handbook of developmental psychopathology. Springer Boston, MA.
[9]	Gillies D., Christou M. A., Dixon A. C., Featherston O. J., Rapti I., Garcia-Anguita A., … Christou P. A. (2018). Prevalence and characteristics of self-harm in adolescents: Meta-analyses of community-based studies 1990-2015. Journal of the American Academy of Child & Adolescent Psychiatry, 57(10), 733-741. doi: 10.1016/j.jaac.2018.06.018 URL
[10]	Gratz K. L. (2001). Measurement of deliberate self-harm: Preliminary data on the deliberate self-harm inventory. Journal of Psychopathology and Behavioral Assessment, 23(4), 253-263. doi: 10.1023/A:1012779403943 URL
[11]	Guo H. Y., Chen L. H., Ye Z., Pan J., & Lin D. H. (2017). Characteristics of peer victimization and the bidirectional relationship between peer victimization and internalizing problems among rural-to-urban migrant children in China: A longitudinal study. Acta Psychologica Sinica, 49(3), 336-348. doi: 10.3724/SP.J.1041.2017.00336
	[郭海英, 陈丽华, 叶枝, 潘瑾, 林丹华. (2017). 流动儿童同伴侵害的特点及与内化问题的循环作用关系: 一项追踪研究. 心理学报, 49(3), 336-348.]
[12]	Halldorsdottir T., de Matos A. P. S., Awaloff Y., Arnarson E. Ö., Craighead W. E., & Binder E. B. (2017). FKBP5 moderation of the relationship between childhood trauma and maladaptive emotion regulation strategies in adolescents. Psychoneuroendocrinology, 84, 61-65. doi: S0306-4530(17)30161-0 pmid: 28654774
[13]	Hatzopoulos K., Boyes M., & Hasking P. (2022). Relationships between dimensions of emotional experience, rumination, and nonsuicidal self-injury: An application of the emotional cascade model. Journal of Clinical Psychology, 78(4), 692-709. doi: 10.1002/jclp.v78.4 URL
[14]	He N., & Xiang Y. (2022). Child maltreatment and nonsuicidal self-injury among Chinese adolescents: The mediating effect of psychological resilience and loneliness. Children and Youth Services Review, 133, 106335. doi: 10.1016/j.childyouth.2021.106335 URL
[15]	Hessels C. J., Laceulle O. M., van Aken M. A. G., Resch F., & Kaess M. (2018). Differentiating BPD in adolescents with NSSI disorder: The role of adverse childhood experiences and current social relationships. Borderline Personality Disorder and Emotion Dysregulation, 5, 20. doi: 10.1186/s40479-018-0097-5 pmid: 30555704
[16]	Huang Y. C., Zhao Q. L., & Li C. N. (2021). How interpersonal factors impact the co-development of depression and non-suicidal self-injury in Chinese early adolescents. Acta Psychologica Sinica, 53(5), 515-526. doi: 10.3724/SP.J.1041.2021.00515
	[黄垣成, 赵清玲, 李彩娜. (2021). 青少年早期抑郁和自伤的联合发展轨迹:人际因素的作用. 心理学报, 53(5), 515-526.] doi: 10.3724/SP.J.1041.2021.00515
[17]	Kaess M., Hooley J. M., Klimes-Dougan B., Koenig J., Plener P. L., Reichl C.,... Cullen K. R. (2021). Advancing a temporal framework for understanding the biology of nonsuicidal self- injury: An expert review. Neuroscience and Biobehavioral Reviews, 130, 228-239. doi: 10.1016/j.neubiorev.2021.08.022 pmid: 34450182
[18]	Klonsky E. D., & Moyer A. (2008). Childhood sexual abuse and non-suicidal self-injury: Meta-analysis. The British Journal of Psychiatry, 192(3), 166-170. doi: 10.1192/bjp.bp.106.030650 URL
[19]	Klonsky E. D., Victor S. E., & Saffer B. Y. (2014). Nonsuicidal self-injury: What we know, and what we need to know. Canadian Journal of Psychiatry, 59(11), 565-568. doi: 10.1177/070674371405901101 URL
[20]	Kwon A., Kim S., Jeon H., Lee H. S., & Lee S.-H. (2021). Influence of FKBP5 variants and childhood trauma on brain volume in non-clinical individuals. Frontiers in Behavioral Neuroscience, 15, 663052. doi: 10.3389/fnbeh.2021.663052 URL
[21]	Laursen B., & Collins W. A. (2009). Parent-child relationships during adolescence. In R. M. Lerner & L. Steinberg (Eds.), Handbook of adolescent psychology (pp. 1-42). Wiley.
[22]	Lereya S. T., Copeland W. E., Costello E. J., & Wolke D. (2015). Adult mental health consequences of peer bullying and maltreatment in childhood: Two cohorts in two countries. Lancet Psychiatry, 2(6), 524-531. doi: 10.1016/S2215-0366(15)00165-0 pmid: 26360448
[23]	Liu S., You J., Ying J., Li X., & Shi Q. (2020). Emotion reactivity, nonsuicidal self-injury, and regulatory emotional self-efficacy: A moderated mediation model of suicide ideation. Journal of Affective Disorders, 266, 82-89. doi: S0165-0327(19)32012-9 pmid: 32056950
[24]	Lundh L., Karim J., & Quilisch E. (2007). Deliberate self-harm in 15-year-old adolescents: A pilot study with a modified version of the Deliberate Self-Harm Inventory. Scandinavian Journal of Psychology, 48(1), 33-41. doi: 10.1111/sjop.2007.48.issue-1 URL
[25]	Lyons D. M., & Parker K. J. (2007). Stress inoculation- induced indications of resilience in monkeys. Journal of Traumatic Stress, 20(4), 423-433. doi: 10.1002/jts.v20:4 URL
[26]	Madden A. R., Are F., Rea H., Thomassin K., & Shaffer A. (2018). Perceived negative peer relationships moderate the association between childhood emotional abuse and nonsuicidal self-injury. Journal of Child and Family Studies, 27(12), 3994-4000. doi: 10.1007/s10826-018-1230-1
[27]	Matosin N., Halldorsdottir T., & Binder E. B. (2018). Understanding the molecular mechanisms underpinning gene by environment interactions in psychiatric disorders: The FKBP5 model. Biological Psychiatry, 83(10), 821-830. doi: S0006-3223(18)30069-6 pmid: 29573791
[28]	Mo J., Wang C., Niu X., Jia X., Liu T., & Lin L. (2019). The relationship between impulsivity and self-injury in Chinese undergraduates: The chain mediating role of stressful life events and negative affect. Journal of Affective Disorders, 256, 259-266. doi: S0165-0327(18)31200-X pmid: 31200164
[29]	Monroe S. M., & Harkness K. L. (2005). Life Stress, the “Kindling” hypothesis, and the recurrence of depression: Considerations from a life stress perspective. Psychological Review, 112(2), 417-445. doi: 10.1037/0033-295X.112.2.417 pmid: 15783292
[30]	Morris M. C., Ciesla J. A., & Garber J. (2010). A prospective study of stress autonomy versus stress sensitization in adolescents at varied risk for depression. Journal of Abnormal Psychology, 119(2), 341-354. doi: 10.1037/a0019036 pmid: 20455607
[31]	Mynard H., & Joseph S. (2000). Development of the multidimensional peer-victimization scale. Aggressive Behavior, 26(2), 169-178. doi: 10.1002/(ISSN)1098-2337 URL
[32]	Nederhof E. (2012). The mismatch hypothesis of psychiatric disease. Physiology & Behavior, 106(5), 689-690. doi: 10.1016/j.physbeh.2012.02.014 URL
[33]	Nock M. K. (2010). Self-injury. Annual Review of Clinical Psychology, 6, 339-363. doi: 10.1146/annurev.clinpsy.121208.131258 pmid: 20192787
[34]	Nock M. K., & Prinstein M. J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology, 72(5), 885-890. doi: 10.1037/0022-006X.72.5.885 pmid: 15482046
[35]	Normann C., & Buttenschøn H. N. (2020). Gene-environment interactions between HPA-axis genes and childhood maltreatment in depression: A systematic review. Acta Neuropsychiatrica, 32(3), 1-30. doi: 10.1017/neu.2019.17 URL
[36]	Parker J. G., Rubin K. H., Erath S. A., Wojslawowicz J. C., & Buskirk A. A. (2006). Peer relationships, child development, and adjustment:A developmental psychopathology perspective. In D. Cicchetti & D. J. Cohen. (Eds.), Developmental psychopathology: Theory and method (Vol. 1, 2nd ed., pp. 419-493). Hoboken, NJ: John Wiley
[37]	Plener P. L., Kaess K., Schmahl C., Pollak S., Fegert J. M., Brown R. C. (2018). Nonsuicidal self-injury in adolescents. Deutsches Rzteblatt International, 115(3), 23-30.
[38]	Richter A., Al-Bayati M., Paraskevopoulou F., Krämer B., Pruessner J. C., Binder E. B., & Gruber O. (2021). Interaction of FKBP5 variant rs3800373 and city living alters the neural stress response in the anterior cingulate cortex. Stress: The International Journal on the Biology of Stress, 24(4), 421-429. doi: 10.1080/10253890.2020.1855420 URL
[39]	Rudolph K. D., Flynn M., & Abaied J. L. (2008). A developmental perspective on interpersonal theories of youth depression. In J. R. Z. Abela & B. L. Hankin (Eds.), Handbook of depression in children and adolescents (pp. 79-102). New York, NY: Guilford.
[40]	Rudolph K. D., Lansford J. E., & Rodkin P. C. (2016). Interpersonal Theories of Developmental Psychopathology. In D. Cicchetti (Eds.), Developmental psychopathology (pp. 1-69). John Wiley & Sons, Inc.
[41]	Rutter M. (2014). Nature-nurture integration. In M. Lewis & K. D. Rudolph (Eds.), Handbook of developmental psychopathology (3rd ed., pp. 45-65). New York, NY: Plenum.
[42]	Ruttle P. L., Armstrong J. M., Klein M. H., & Essex M. J. (2014). Adolescent internalizing symptoms and negative life events: The sensitizing effects of earlier life stress and cortisol. Development and Psychopathology, 26(4 Pt 2), 1411-1422. doi: 10.1017/S0954579414001114 pmid: 25422970
[43]	Sheng X. X., Li J. Y., Niu H., & Wang M. F. (2019). Parental harsh discipline and adolescents’ externalizing problem behaviors: The moderating role of puberty timing. Chinese journal of Clinical Psychology, 27(6), 1199-1204+1209.
	[生笑笑, 李静雅, 牛骅, 王美芳. (2019). 父母严厉管教与青少年外化问题行为的关系:青春发育时相与性别的调节作用. 中国临床心理学杂志, 27(6), 1199-1204+1209.]
[44]	Shih J. H., Eberhart N. K., Hammen C. L., & Brennan P. A. (2006). Differential exposure and reactivity to interpersonal stress predict sex differences in adolescent depression. Journal of Clinical Child & Adolescent Psychology, 35(1), 103-115.
[45]	Slavich G. M., Monroe S. M., & Gotlib I. H. (2011). Early parental loss and depression history: Associations with recent life stress in major depressive disorder. Journal of Psychiatric Research, 45(9), 1146-1152. doi: 10.1016/j.jpsychires.2011.03.004 pmid: 21470621
[46]	Starr L. R., Hammen C., Conway C. C., Raposa E., & Brennan P. A. (2014). Sensitizing effect of early adversity on depressive reactions to later proximal stress: Moderation by polymorphisms in serotonin transporter and corticotropin releasing hormone receptor genes in a 20-year longitudinal study. Development and Psychopathology, 26(4pt2), 1241-1254. doi: 10.1017/S0954579414000996 URL
[47]	Straus M. A., Hamby S. L., Finkelhor D., Moore D. W., & Runyan D. (1998). Identification of child maltreatment with the parent-child conflict tactics scales: Development and psychometric data for a national sample of American parents. Child Abuse & Neglect, 22(4), 249-270. doi: 10.1016/S0145-2134(97)00174-9 URL
[48]	Taylor S. E. (2010). Mechanisms linking early life stress to adult health outcomes. Proceedings of the National Academy of Sciences of the United States of America, 107(19), 8507-8512. doi: 10.1073/pnas.1003890107 pmid: 20442329
[49]	Tian X. J., Cao Y. M., & Zhang W. X. (2020). The influence of maternal negative parenting, peer victimization and FKBP5 gene on adolescent depressive symptoms. Acta Psychologica Sinica, 52(12), 1407-1420. doi: 10.3724/SP.J.1041.2020.01407 URL
	[田相娟, 曹衍淼, 张文新. (2020). 母亲消极教养、同伴侵害与FKBP5基因对青少年抑郁的影响. 心理学报, 52(12), 1407-1420.] doi: 10.3724/SP.J.1041.2020.01407
[50]	Touma C., Gassen N. C., Herrmann L., Cheung-Flynn J., Büll D. R., Ionescu I. A.,... Rein T. (2011). FK506 binding protein 5 shapes stress responsiveness: Modulation of neuroendocrine reactivity and coping behavior. Biological Psychiatry, 70(10), 928-936. doi: 10.1016/j.biopsych.2011.07.023 pmid: 21907973
[51]	Vergara G. A., Stewart J. G., Cosby E. A., Lincoln S. H., & Auerbach R. P. (2019). Non-suicidal self-injury and suicide in depressed adolescents: Impact of peer victimization and bullying. Journal of Affective Disorders, 245, 744-749. doi: S0165-0327(18)31992-X pmid: 30448758
[52]	Victor S. E., Hipwell A. E., Stepp S. D., & Scott L. N. (2019). Parent and peer relationships as longitudinal predictors of adolescent non-suicidal self-injury onset. Child and Adolescent Psychiatry and Mental Health, 13(1), 1-13. doi: 10.1186/s13034-018-0261-0
[53]	Wadman R., Vostanis P., Sayal K., Majumder P., Harroe C., Clarke D., Armstrong M., & Townsend E. (2018). An interpretative phenomenological analysis of young people’s self-harm in the context of interpersonal stressors and supports: Parents, peers, and clinical services. Social Science and Medicine, 212, 120-128. doi: 10.1016/j.socscimed.2018.07.021 URL
[54]	Wang Q., & Liu X. (2022). Child abuse and non-suicidal self-injury among Chinese migrant adolescents: The moderating roles of beliefs about adversity and family socioeconomic status. Journal of Interpersonal Violence, 38(3-4), 3165-3190. doi: 10.1177/08862605221104537 URL
[55]	Weiss R. B., Stange J. P., Boland E. M., Black S. K., LaBelle D. R., Abramson L. Y., & Alloy L. B. (2015). Kindling of life stress in bipolar disorder: Comparison of sensitization and autonomy models. Journal of Abnormal Psychology, 124(1), 4-16. doi: 10.1037/abn0000014 pmid: 25688428
[56]	White M. G., Bogdan R., Fisher P. M., Muñoz K. E., Williamson D. E., & Hariri A. R. (2012). FKBP5 and emotional neglect interact to predict individual differences in amygdala reactivity. Genes, Brain and Behavior, 11(7), 869-878.
[57]	World Health Organization. (2014). Health for the world’s adolescents: A second chance in the second decade. executive summary. Retrieved Aug 17, 2022, from https://www.who.int/publications/i/item/WHO-FWC-MCA-14.05
[58]	Zannas A. S., & Binder E. B. (2014). Gene-environment interactions at the FKBP5 locus: Sensitive periods, mechanisms and pleiotropism. Genes, Brain and Behavior, 13(1), 25-37.
[59]	Zhang W., Cao Y., Wang M., Ji L., Chen L., & Deater- Deckard K. (2015). The dopamine D2 receptor polymorphism (DRD2 TaqIA) interacts with maternal parenting in predicting early adolescent depressive symptoms: Evidence of differential susceptibility and age differences. Journal of Youth and Adolescence, 44(7), 1428-1440. doi: 10.1007/s10964-015-0297-x pmid: 25941120
[60]	Zhao L., Zhou D., Ma L., Hu J., Chen R., He X., … Kuang L. (2023). Changes in emotion-related EEG components and brain lateralization response to negative emotions in adolescents with nonsuicidal self-injury: An ERP study. Behavioural Brain Research, 445(8), 114324.

变量	1	2	3	4	5	6	7	8	9
1. 性别	1
2. 年龄	-0.10^*	1
3. SES	-0.06	-0.19^***	1
4. FKBP5基因	0.02	-0.06	-0.02	1
5. T1童年期虐待	-0.05	0.04	-0.01	-0.02	1
6. T1同伴侵害	-0.03	0.04	-0.07	-0.04	0.39^***	1
7. T2同伴侵害	-0.01	-0.01	-0.06	-0.04	0.17^**	0.29^***	1
8. T1自伤行为	-0.05	0.03	0.04	-0.08	0.34^***	0.33^***	0.27^***	1
9. T2自伤行为	0.05	0.01	0.02	-0.01	0.19^***	0.17^***	0.38^***	0.22^***	1
M	—	12.84	-0.01	—	1.28	1.64	1.62	1.20	1.24
SD	—	0.89	0.75	—	1.98	0.40	0.48	0.41	0.39

变量	1	2	3	4	5	6	7	8	9
1. 性别	1
2. 年龄	-0.10^*	1
3. SES	-0.06	-0.19^***	1
4. FKBP5基因	0.02	-0.06	-0.02	1
5. T1童年期虐待	-0.05	0.04	-0.01	-0.02	1
6. T1同伴侵害	-0.03	0.04	-0.07	-0.04	0.39^***	1
7. T2同伴侵害	-0.01	-0.01	-0.06	-0.04	0.17^**	0.29^***	1
8. T1自伤行为	-0.05	0.03	0.04	-0.08	0.34^***	0.33^***	0.27^***	1
9. T2自伤行为	0.05	0.01	0.02	-0.01	0.19^***	0.17^***	0.38^***	0.22^***	1
M	—	12.84	-0.01	—	1.28	1.64	1.62	1.20	1.24
SD	—	0.89	0.75	—	1.98	0.40	0.48	0.41	0.39

变量	β	t	p	95% CI	ΔR²
第一层：T1童年期虐待	0.30^***	4.19	<0.001	[0.06, 0.18]	0.16^***
T1同伴侵害	0.18^**	2.68	0.008	[0.02, 0.13]
FKBP5基因	0.01	0.14	0.886	[-0.06, 0.07]
第二层：T1童年期虐待×T1同伴侵害	0.31^***	4.33	<0.001	[0.04, 0.10]	0.04^***
T1童年期虐待×FKBP5基因	-0.03	-0.40	0.687	[-0.10, 0.07]
T1同伴侵害×FKBP5基因	-0.01	-0.02	0.987	[-0.07, 0.07]
第三层：T1童年期虐待×T1同伴侵害×FKBP5基因	-0.45^***	-6.08	<0.001	[-0.19, -0.10]	0.06^***

变量	β	t	p	95% CI	ΔR²
第一层：T1童年期虐待	0.30^***	4.19	<0.001	[0.06, 0.18]	0.16^***
T1同伴侵害	0.18^**	2.68	0.008	[0.02, 0.13]
FKBP5基因	0.01	0.14	0.886	[-0.06, 0.07]
第二层：T1童年期虐待×T1同伴侵害	0.31^***	4.33	<0.001	[0.04, 0.10]	0.04^***
T1童年期虐待×FKBP5基因	-0.03	-0.40	0.687	[-0.10, 0.07]
T1同伴侵害×FKBP5基因	-0.01	-0.02	0.987	[-0.07, 0.07]
第三层：T1童年期虐待×T1同伴侵害×FKBP5基因	-0.45^***	-6.08	<0.001	[-0.19, -0.10]	0.06^***

变量	β	t	p	95% CI	ΔR²
第一层：T1自伤行为	0.04	0.73	0.464	[-0.06, 0.13]	0.05^***
第二层：T1童年期虐待	0.18^**	2.83	0.005	[0.02, 0.12]	0.12^***
T2同伴侵害	0.40^***	6.39	< 0.001	[0.11, 0.20]
FKBP5基因	0.04	0.94	0.347	[-0.04, 0.10]
第三层：T1童年期虐待×T2同伴侵害	0.24^***	3.79	< 0.001	[0.04, 0.13]	0.02^*
T1童年期虐待×FKBP5基因	-0.10	-1.62	0.105	[-0.13, 0.01]
T2同伴侵害×FKBP5基因	-0.05	-0.87	0.387	[-0.10, 0.04]
第四层：T1童年期虐待×T2同伴侵害×FKBP5基因	-0.27^***	-4.17	< 0.001	[-0.19, -0.07]	0.03^***