Gerke Clarice K, Mazzeo Suzanne E, Kliewer Wendy
Department of Psychology, P.O. Box 842018, Virginia Commonwealth University, Richmond, VA 23284-2018, USA.
Child Abuse Negl. 2006 Oct;30(10):1161-72. doi: 10.1016/j.chiabu.2006.03.010. Epub 2006 Oct 5.
The goals of this study were to examine the role of dissociation and depression as possible mediators of the relationship between several forms of childhood trauma and bulimic symptomatology and to explore potential ethnic differences in these relationships.
Four hundred seventeen female undergraduates participated in this cross-sectional study. They completed measures of dissociative, depressive, and bulimic symptoms, and childhood trauma. Experiences of multiple forms of childhood trauma were measured, including physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect. However, only emotional abuse was correlated with bulimic symptoms at p<.01. Therefore, other forms of trauma were excluded from the analyses to control for Type I error.
Dissociation was not associated with emotional abuse after controlling for depression; therefore, tests of dissociation as a mediator were discontinued. Depression was significantly associated with emotional abuse after controlling for dissociation. Emotional abuse was significantly associated with bulimia. Finally, emotional abuse and depression together were significantly associated with bulimia after controlling for dissociation. However, emotional abuse became nonsignificant when entered with depression, indicating that depression mediated the relationship between emotional abuse and bulimic symptoms. There were no ethnic differences in this relationship.
It appears that among women who have experienced childhood emotional abuse, depression is more strongly associated with unhealthy eating behaviors than is dissociation. Results also suggest that emotional abuse is a form of childhood trauma particularly relevant to bulimia.
本研究的目的是检验解离和抑郁作为几种童年创伤形式与暴食症状之间关系的可能中介因素的作用，并探讨这些关系中潜在的种族差异。
417名本科女生参与了这项横断面研究。她们完成了解离、抑郁和暴食症状以及童年创伤的测量。测量了多种童年创伤经历，包括身体虐待、性虐待、情感虐待、身体忽视和情感忽视。然而，只有情感虐待与暴食症状在p<0.01水平上相关。因此，为控制I类错误，其他形式的创伤被排除在分析之外。
在控制抑郁后，解离与情感虐待无关；因此，作为中介因素的解离检验停止。在控制解离后，抑郁与情感虐待显著相关。情感虐待与暴食症显著相关。最后，在控制解离后，情感虐待和抑郁共同与暴食症显著相关。然而，当与抑郁一起纳入时，情感虐待变得不显著，表明抑郁介导了情感虐待与暴食症状之间的关系。在这种关系中没有种族差异。
在经历过童年情感虐待的女性中，抑郁似乎比解离与不健康饮食行为的关联更强。结果还表明，情感虐待是一种与暴食症特别相关的童年创伤形式。
