Lysaker Paul H, Davis Louanne W, Gatton Michael J, Herman Steven M
Roudebush VA Medical Center, Indianapolis, IN 46202, USA.
J Clin Psychiatry. 2005 Oct;66(10):1279-84. doi: 10.4088/jcp.v66n1010.
Research suggests that persons with schizophrenia tend to experience significant levels of anxiety and that history of childhood sexual abuse may predispose some with schizophrenia to experience significant levels of persistent anxiety. It is unclear whether childhood sexual abuse is more closely linked to specific forms of anxiety including symptoms of post-traumatic stress disorder (PTSD).
Data were gathered from April 2004 through November 2004 on trauma history, PTSD symptoms, social anxiety, and state and trait anxiety from 45 men with a SCID-I-confirmed diagnosis of schizophrenia or schizoaffective disorder and 11 with a SCID-I-confirmed diagnosis of PTSD with no history of psychosis. Participants with schizophrenia spectrum disorders (schizophrenia group) were divided into those with and without history of childhood sexual abuse. Five participants in the schizophrenia group with a history of adult but not childhood sexual assault were excluded from analyses.
Analysis of variance comparing the childhood sexual abuse (N = 21) and non-abused (N = 19) schizophrenia groups and the PTSD group on all anxiety assessments revealed that the sexually abused schizophrenia group had significantly higher levels of dissociation, intrusive experiences, and state and trait anxiety than the non-abused schizophrenia group. The schizophrenia groups did not differ statistically on levels of anxious arousal, defensive avoidance, or social anxiety. When compared with participants with PTSD and no psychosis, the sexually abused schizophrenia group had significantly lower levels of state anxiety, anxious arousal, intrusive experiences, and fearful social avoidance but failed to differ statistically on other scores.
These results, if replicated, could lead to identification of those at risk for anxiety and PTSD and to targeted interventions.
研究表明,精神分裂症患者往往会经历显著程度的焦虑,童年期性虐待史可能使一些精神分裂症患者易出现显著程度的持续性焦虑。目前尚不清楚童年期性虐待是否与包括创伤后应激障碍(PTSD)症状在内的特定焦虑形式有更密切的联系。
于2004年4月至2004年11月收集了45名经SCID-I确诊为精神分裂症或分裂情感性障碍的男性以及11名经SCID-I确诊为PTSD且无精神病病史者的创伤史、PTSD症状、社交焦虑以及状态焦虑和特质焦虑的数据。患有精神分裂症谱系障碍的参与者(精神分裂症组)被分为有童年期性虐待史和无童年期性虐待史两组。精神分裂症组中有5名有成年期而非童年期性侵犯史的参与者被排除在分析之外。
对童年期性虐待组(N = 21)、未受虐待的精神分裂症组(N = 19)和PTSD组进行的所有焦虑评估的方差分析显示,遭受性虐待的精神分裂症组在解离、侵入性体验以及状态焦虑和特质焦虑方面的水平显著高于未受虐待的精神分裂症组。精神分裂症组在焦虑唤醒、防御性回避或社交焦虑水平上无统计学差异。与无精神病的PTSD参与者相比,遭受性虐待的精神分裂症组的状态焦虑、焦虑唤醒、侵入性体验和恐惧社交回避水平显著较低,但在其他分数上无统计学差异。
这些结果若能得到重复验证,可能有助于识别焦虑和PTSD的风险人群,并进行有针对性的干预。