Saleptsi Evangelia, Bichescu Dana, Rockstroh Brigitte, Neuner Frank, Schauer Margarete, Studer Karl, Hoffmann Klaus, Elbert Thomas
Department of Psychology, University of Konstanz, Fach D-25, 78457 Konstanz, Germany.
BMC Psychiatry. 2004 Nov 26;4:40. doi: 10.1186/1471-244X-4-40.
A high frequency of childhood abuse has often been reported in adult psychiatric patients. The present survey explores the relationship between psychiatric diagnoses and positive and negative life events during childhood and adulthood in psychiatric samples.
A total of 192 patients with diagnoses of alcohol-related disorders (n = 45), schizophrenic disorders (n = 52), affective disorders (n = 54), and personality disorders (n = 41) completed a 42-item self-rating scale (Traumatic Antecedents Questionnaire, TAQ). The TAQ assesses personal positive experiences (competence and safety) and negative experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas, and alcohol and drugs abuse) during four developmental periods, beginning from early childhood to adulthood. Patients were recruited from four Psychiatric hospitals in Germany, Switzerland, and Romania; 63 subjects without any history of mental illness served as controls.
The amount of positive experiences did not differ significantly among groups, except for safety scores that were lower in patients with personality disorders as compared to the other groups. On the other side, negative experiences appeared more frequently in patients than in controls. Emotional neglect and abuse were reported in patients more frequently than physical and sexual abuse, with negative experiences encountered more often in late childhood and adolescence than in early childhood. The patients with alcohol-related and personality disorders reported more negative events than the ones with schizophrenic and affective disorders.
The present findings add evidence to the relationship between retrospectively reported childhood experiences and psychiatric diagnoses, and emphasize the fact that a) emotional neglect and abuse are the most prominent negative experiences, b) adolescence is a more 'sensitive' period for negative experiences as compared to early childhood, and c) a high amount of reported emotional and physical abuse occurs in patients with alcohol-related and personality disorders respectively.
成年精神科患者中经常有童年期受虐频率较高的报道。本调查探讨了精神科样本中精神疾病诊断与童年及成年期正负性生活事件之间的关系。
共有192例被诊断为酒精相关障碍（n = 45）、精神分裂症（n = 52）、情感障碍（n = 54）和人格障碍（n = 41）的患者完成了一份42项自评量表（创伤性前因问卷，TAQ）。TAQ评估从幼儿期到成年期四个发育阶段的个人积极经历（能力和安全感）和消极经历（忽视、分离、秘密、情感、身体和性虐待、目睹创伤、其他创伤以及酒精和药物滥用）。患者从德国、瑞士和罗马尼亚的四家精神病院招募；63名无精神疾病史的受试者作为对照。
除人格障碍患者的安全感得分低于其他组外，各组间积极经历的数量无显著差异。另一方面，患者中消极经历出现的频率高于对照组。报告患者中情感忽视和虐待比身体和性虐待更常见，消极经历在童年晚期和青春期比幼儿期更常遇到。酒精相关障碍和人格障碍患者报告的负面事件比精神分裂症和情感障碍患者更多。
本研究结果为回顾性报告的童年经历与精神疾病诊断之间的关系提供了证据，并强调了以下事实：a）情感忽视和虐待是最突出的负面经历；b）与幼儿期相比，青春期是负面经历更“敏感”的时期；c）酒精相关障碍和人格障碍患者分别报告了大量的情感和身体虐待。
