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心理障碍青少年的解离与童年创伤

Dissociation and childhood trauma in psychologically disturbed adolescents.

作者信息

Sanders B, Giolas M H

机构信息

Department of Psychology, University of Connecticut, Storrs 06269-1020.

出版信息

Am J Psychiatry. 1991 Jan;148(1):50-4. doi: 10.1176/ajp.148.3.A50.

Abstract

OBJECTIVE

To test the hypothesis that dissociation in adolescence is positively correlated with stress or abuse experienced earlier, the authors assessed dissociation in a heterogeneous group of disturbed adolescents and examined the relationship between the degree of dissociation and the degree of reported childhood stress, abuse, or trauma.

METHOD

The subjects were 47 adolescents, 13-17 years old, who were institutionalized for periods of 1-13 weeks in a private mental hospital; 35 were girls and 12 were boys. Participants completed the Dissociative Experiences Scale and a child abuse and trauma questionnaire. The hospital records of 40 of the 47 adolescents were also available.

RESULTS

Scores on the Dissociative Experiences Scale correlated significantly with self-reported physical abuse or punishment, sexual abuse, psychological abuse, neglect, and negative home atmosphere but not with abuse ratings made from hospital records.

CONCLUSIONS

Together with the authors' previous work showing a relation between childhood stress and later dissociation in normal college students, these findings support the view that dissociation represents a reaction to early negative experience and places multiple personality disorder at the extreme end of a continuum of dissociative sequelae of childhood trauma. Researchers should continue to try to identify psychiatric patients with prominent dissociative characteristics or symptoms and attempt to correlate this phenomenology with negative earlier experiences.

摘要

目的

为验证青少年期的分离症状与早年经历的压力或虐待呈正相关这一假设,作者对一组异质性的问题青少年进行了分离症状评估,并考察了分离程度与所报告的童年压力、虐待或创伤程度之间的关系。

方法

研究对象为47名13至17岁的青少年,他们在一家私立精神病院住院1至13周;其中35名是女孩,12名是男孩。参与者完成了分离体验量表和一份儿童期虐待与创伤问卷。47名青少年中有40人的医院记录也可供查阅。

结果

分离体验量表得分与自我报告的身体虐待或惩罚、性虐待、心理虐待、忽视及负面家庭氛围显著相关,但与根据医院记录得出的虐待评级无关。

结论

作者之前的研究表明童年压力与正常大学生后来出现的分离症状有关,结合这些发现,支持了以下观点:分离症状是对早期负面经历的一种反应,且多重人格障碍处于童年创伤所致分离后遗症连续谱的极端位置。研究人员应继续努力识别具有明显分离特征或症状的精神科患者,并尝试将这种现象学与早期负面经历联系起来。

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