Walker E A, Katon W J, Neraas K, Jemelka R P, Massoth D
Department of Psychiatry and Behavioral Sciences, University of Washington 98195.
Am J Psychiatry. 1992 Apr;149(4):534-7. doi: 10.1176/ajp.149.4.534.
The authors' goal was to determine if women with chronic pelvic pain are significantly more likely to use dissociation as a coping mechanism than women without pain.
The subjects were recruited from women who attended a university women's clinic during a 1-month period. Twenty-two women who reported that they had at any time in their lives experienced pelvic pain nearly every day for a period of at least 6 months were included in the study, along with 21 randomly selected women without a history of chronic pelvic pain. The 43 women were given structured sexual assault interviews and completed psychological self-report measures.
The women with chronic pain were significantly more likely to use dissociation as a coping mechanism, to show current psychological distress, to see themselves as medically disabled, to experience vocational and social decrements in function, and to amplify physical symptoms. They were also significantly more likely to have experienced severe childhood sexual abuse. In the total study group, women with a childhood history of sexual abuse had significantly higher scores on measures of psychological distress, somatization, and dissociation and viewed their physical health and functioning as more impaired.
The authors discuss a model for the development of somatization, dissociation, and pain symptoms in victims of early sexual abuse.
作者的目标是确定患有慢性盆腔疼痛的女性是否比无疼痛的女性更有可能将解离作为一种应对机制。
研究对象从在一个月内就诊于大学女性诊所的女性中招募。22名报告在其生命中的任何时候曾几乎每天经历盆腔疼痛至少6个月的女性被纳入研究,还有21名随机挑选的无慢性盆腔疼痛病史的女性。这43名女性接受了结构化的性侵犯访谈并完成了心理自我报告测量。
患有慢性疼痛的女性更有可能将解离作为一种应对机制,表现出当前的心理困扰,将自己视为医学上的残疾,经历职业和社会功能下降,以及放大身体症状。她们也更有可能经历过严重的童年性虐待。在整个研究组中,有童年性虐待史的女性在心理困扰、躯体化和解离测量上的得分显著更高,并认为她们的身体健康和功能受损更严重。
作者讨论了早期性虐待受害者中躯体化、解离和疼痛症状发展的模型。