Macfie J, Cicchetti D, Toth S L
Mt. Hope Family Center, University of Rochester, NY, USA.
Child Abuse Negl. 2001 Sep;25(9):1253-67. doi: 10.1016/s0145-2134(01)00266-6.
Dissociation is linked to the experience of child maltreatment for adults and for school-aged children. The goals of the current paper were: First, to extend existing research and examine the link between child maltreatment and preschool-aged children; and second, to examine which subgroups of maltreated preschoolers are most likely to evidence dissociation.
A well-validated measure of dissociation in children, The Child Dissociative Checklist (CDC; Putnam, Helmers, & Trickett, 1993), was utilized in a sample of low SES maltreated and nonmaltreated preschoolers (N = 198). A measure of internalizing and externalizing symptoms was also utilized. The maltreated children were assessed for sexual abuse, physical abuse, neglect, and also for severity, chronicity, and multiple subtypes of maltreatment.
The sexually abused, physically abused, and neglected groups each demonstrated more dissociation than did the nonmaltreated group. Dissociation in the clinical (psychopathological) range was associated with physical abuse. Moreover, maltreatment severity, chronicity, multiple subtypes, and internalizing and externalizing symptomatology were each related to dissociation.
Child maltreatment is a factor in dissociation in preschool-aged children as it is in older children and in adults. Sexual abuse, physical abuse, neglect, severity, and chronicity are all implicated. Developmentally sensitive interventions that look beyond comorbidity with behavioral symptoms for dissociative preschool-aged children are needed.
分离现象与成人及学龄儿童遭受儿童期虐待的经历有关。本文的目标是:第一,扩展现有研究,考察儿童期虐待与学龄前儿童之间的联系;第二,考察受虐待学龄前儿童的哪些亚组最有可能表现出分离现象。
在一个由社会经济地位较低的受虐待和未受虐待学龄前儿童组成的样本(N = 198)中,使用了一种经过充分验证的儿童分离现象测量工具——儿童分离检查表(CDC;Putnam、Helmers和Trickett,1993)。还使用了一种内化和外化症状测量工具。对受虐待儿童进行了性虐待、身体虐待、忽视方面的评估,以及虐待的严重程度、持续性和多种亚型的评估。
性虐待组、身体虐待组和忽视组的分离现象均比未受虐待组更明显。临床(精神病理学)范围内的分离现象与身体虐待有关。此外,虐待的严重程度、持续性、多种亚型以及内化和外化症状均与分离现象有关。
儿童期虐待是学龄前儿童出现分离现象的一个因素,就像在大龄儿童和成人中一样。性虐待、身体虐待、忽视、严重程度和持续性都与之有关。需要开展对发育敏感的干预措施,这些措施不应只关注分离性学龄前儿童与行为症状的共病情况。