Cloitre M, Cohen L R, Edelman R E, Han H
Department of Psychiatry, New York Presbyterian Hospital-Cornell Medical Center, NY 10021, USA.
Women Health. 2001;34(3):1-17. doi: 10.1300/J013v34n03_01.
This study examined the relative contributions of Posttraumatic Stress Disorder (PTSD) symptoms and the extent of trauma exposure as factors contributing to the current health status of childhood abuse survivors. Sixty-seven women with a history of familial childhood abuse (sexual and/or physical) and twenty-nine women with no abuse history were assessed on two distinct aspects of health status: reported number of medical problems and perceptions of overall health. Women with abuse were found to have a greater number of medical problems and poorer perceived physical well-being than the no abuse comparison group. Regression analyses of the women with abuse histories revealed that trauma exposure was a stronger predictor than PTSD symptoms of medical problems. PTSD symptoms, however, were better predictors of the experience of physical well-being than trauma exposure. These results suggest that the nature of a traumatic exposure, especially when there is repeated, cumulative trauma may be more significant to medical problems than the psychological symptoms of PTSD. Perceived health, however, appears to be predominantly influenced by psychological factors, suggesting the importance of these variables in the quality of life of multiply traumatized women.
本研究考察了创伤后应激障碍(PTSD)症状以及创伤暴露程度作为影响童年期虐待幸存者当前健康状况因素的相对作用。对67名有童年期家庭虐待(性虐待和/或身体虐待)史的女性和29名无虐待史的女性在健康状况的两个不同方面进行了评估:报告的医疗问题数量和对整体健康的认知。结果发现,有虐待史的女性比无虐待史的对照组有更多的医疗问题,且自我感知的身体健康状况更差。对有虐待史女性的回归分析显示,对于医疗问题,创伤暴露比PTSD症状是更强的预测因素。然而,对于身体幸福感的体验,PTSD症状比创伤暴露是更好的预测因素。这些结果表明,创伤暴露的性质,尤其是当存在反复、累积性创伤时,对医疗问题的影响可能比PTSD的心理症状更为显著。然而,自我感知的健康状况似乎主要受心理因素影响,这表明这些变量在多次受创伤女性的生活质量中具有重要意义。