Jainchill N, Hawke J, Yagelka J
Center for Therapeutic Community Research, National Development and Research Institutes, New York, New York 10048, USA.
Am J Drug Alcohol Abuse. 2000 Nov;26(4):553-67. doi: 10.1081/ada-100101895.
Substance abuse and severe mental illness are factors that have been linked to homelessness, and the rates of mental illness have been reported to be higher among homeless women than men. Only recently have investigators begun to examine the prevalence of abuse among the homeless population and its relationship to indicators of psychopathology. This study builds on the existing literature and examines the relationship among psychiatric disturbance, abusive experiences, and homelessness among adult men and women admitted to shelter-based therapeutic community (TC) drug treatment programs.
The sample presents with extensive psychopathology and a history of physical and sexual abuse. Gender differences indicate that, except for antisocial personality, females yield higher rates on measures of both psychiatric disturbance and abuse. The relationship between psychopathology and abuse also appears to be much stronger for females than for males. However, the relationship between abuse and adult homelessness appears to be similar for men and women. The gender differences in the relationship between histories of abuse and manifestations of psychiatric disturbance support a hypothesis that has been proposed elsewhere: Females internalize the trauma associated with abusive experience, while males externalize it. The findings suggest that, although there may be a need for gender-specific targeted interventions, treatment providers must also recognize that the impact of abuse seems to transcend gender within this population.
药物滥用和严重精神疾病是与无家可归相关的因素，据报道，无家可归女性中的精神疾病发病率高于男性。直到最近，研究人员才开始研究无家可归人群中的虐待流行情况及其与精神病理学指标的关系。本研究基于现有文献，考察了入住以庇护所为基础的治疗社区（TC）药物治疗项目的成年男女的精神障碍、虐待经历和无家可归之间的关系。
该样本存在广泛的精神病理学问题以及身体和性虐待史。性别差异表明，除了反社会人格外，女性在精神障碍和虐待测量指标上的发生率更高。精神病理学与虐待之间的关系在女性中似乎也比在男性中更为强烈。然而，虐待与成年无家可归之间的关系在男性和女性中似乎相似。虐待史与精神障碍表现之间关系的性别差异支持了在其他地方提出的一个假设：女性将与虐待经历相关的创伤内化，而男性则将其外化。研究结果表明，尽管可能需要有针对性别的干预措施，但治疗提供者也必须认识到，在这一人群中，虐待的影响似乎超越了性别。
