Plattner Belinda, Silvermann Melissa A, Redlich Allison D, Carrion Victor G, Feucht Martha, Friedrich Max H, Steiner Hans
Universitätsklinik für Neuropsychiatrie des Kindes- und Jugendalters, University Vienna, General Hospital Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria, EU.
J Nerv Ment Dis. 2003 Dec;191(12):781-8. doi: 10.1097/01.nmd.0000105372.88982.54.
Dissociation is postulated to occur as a function of particular types of child abuse or chronic abuse. Additionally, there is an ongoing controversy examining the perpetrator's relationship to the victim in the development of dissociation. In this study, reports of traumatic events experienced both in the family environment and in the community were used to examine the relationship between dissociative disorder as defined by DSM-IV (pathological dissociation), and dissociation as a defense mechanism. The first objective was to identify whether the site of the trauma or the quantity of trauma correlated more significantly with symptoms of dissociation. The second objective was to explore a potential correlation between topics that participants choose to disclose during a standardized Stress Inducing Speech Task (SIST), and symptoms of dissociation. The third objective was to examine the relationship between the age of occurrence, the duration of trauma, and symptoms of dissociation. Fifty-two delinquent juveniles completed measures (including the SCID-D, REM-71, CTQ, CTI, SIST) assessing traumatic experiences, psychopathological dissociation, and dissociation as defense mechanism. Blind raters scored the SIST for intrafamilial and extrafamilial trauma. The perpetrator's relationship to the victim, site of the trauma, quantity of the trauma, age of occurrence, and duration of the trauma were analyzed by descriptive statistics and Pearson partial correlations. Significant correlations were found between symptoms of pathological dissociation and intrafamilial trauma. Significant correlations were not found between extrafamilial trauma and pathological dissociation and dissociation as defense mechanism. All these correlations held constant the chronicity of traumas reported. The results obtained in this study through blind and independent assessment suggest that special trauma characteristics (i.e., childhood trauma perpetrated by a family member) rather than sheer cumulative effects of trauma may have greater implications for the development of pathological dissociation. The relationships to dissociation as a defense were much weaker.
分离被假定为特定类型的儿童虐待或长期虐待的一种表现。此外,在分离的发展过程中,关于施虐者与受害者关系的研究一直存在争议。在本研究中,通过家庭环境和社区中经历的创伤事件报告,来检验《精神疾病诊断与统计手册》第四版(DSM-IV)所定义的分离性障碍(病理性分离)与作为防御机制的分离之间的关系。第一个目标是确定创伤发生的地点或创伤的数量与分离症状的相关性更强。第二个目标是探讨参与者在标准化应激诱导言语任务(SIST)中选择披露的主题与分离症状之间的潜在相关性。第三个目标是研究创伤发生的年龄、创伤持续时间与分离症状之间的关系。52名违法青少年完成了评估创伤经历、精神病理分离和作为防御机制的分离的测量(包括分离性障碍结构性临床访谈量表[SCID-D]、修订版儿童创伤问卷[REM-71]、儿童创伤问卷[CTQ]、儿童创伤指数[CTI]、SIST)。盲评者对SIST中的家庭内和家庭外创伤进行评分。通过描述性统计和Pearson偏相关分析施虐者与受害者的关系、创伤发生地点、创伤数量、创伤发生年龄和创伤持续时间。发现病理性分离症状与家庭内创伤之间存在显著相关性。未发现家庭外创伤与病理性分离以及作为防御机制的分离之间存在显著相关性。所有这些相关性在报告的创伤慢性程度上保持不变。本研究通过盲法和独立评估获得的结果表明特殊的创伤特征(即家庭成员实施的儿童期创伤)而非单纯的创伤累积效应可能对病理性分离的发展有更大影响。与作为防御机制的分离之间的关系则弱得多。