Waldinger Robert J, Schulz Marc S, Barsky Arthur J, Ahern David K
Department of Psychiatry, Brigham and Women's Hospitaland Harvard Medical School, Boston, MA 02215, USA.
Psychosom Med. 2006 Jan-Feb;68(1):129-35. doi: 10.1097/01.psy.0000195834.37094.a4.
This study tested whether insecure attachment mediates the link between childhood trauma and adult somatization.
A community sample of 101 couples completed self-report measures, including the Relationship Scales Questionnaire, the Childhood Trauma Questionnaire, the Somatic Symptom Inventory, the Beck Depression Inventory, and the Conflict Tactics Scale.
Childhood trauma was associated with higher levels of somatization and insecure attachment. Insecure attachment style was also associated with higher levels of somatization. Controlling for age, income, and recent intimate partner violence, analyses showed that fearful attachment fully mediated the link between childhood trauma and somatization for women. For men, there was no such mediation, but both childhood trauma and insecure attachment styles made independent contributions to predicting levels of somatization.
Findings are consistent with the hypothesis that, for women, childhood trauma influences adult levels of somatization by fostering insecure adult attachment. For men, findings suggest that trauma and attachment are both important independent predictors of adult somatization. Study results support the idea that childhood trauma shapes patients' styles of relating to others in times of need, and these styles, in turn, influence the somatization process and how patients respond to providers. Screening for attachment style may provide information that could allow health care providers to tailor treatment more effectively.
本研究旨在检验不安全依恋是否介导童年创伤与成人躯体化之间的联系。
101对夫妻组成的社区样本完成了自我报告测量,包括关系量表问卷、童年创伤问卷、躯体症状量表、贝克抑郁量表和冲突策略量表。
童年创伤与更高水平的躯体化及不安全依恋相关。不安全依恋风格也与更高水平的躯体化相关。在控制年龄、收入和近期亲密伴侣暴力后,分析表明,恐惧型依恋完全介导了女性童年创伤与躯体化之间的联系。对于男性,不存在这种中介作用,但童年创伤和不安全依恋风格均对预测躯体化水平有独立贡献。
研究结果与以下假设一致,即对于女性而言,童年创伤通过促进不安全的成人依恋影响成人躯体化水平。对于男性,研究结果表明创伤和依恋都是成人躯体化的重要独立预测因素。研究结果支持这样一种观点,即童年创伤塑造了患者在需要时与他人建立关系的方式,而这些方式反过来又会影响躯体化过程以及患者对医护人员的反应。筛查依恋风格可能会提供信息,使医疗保健提供者能够更有效地调整治疗方案。