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分离体验在儿童期创伤与幻听之间的中介作用。

Dissociative experiences as mediators between childhood trauma and auditory hallucinations.

机构信息

Virgen del Rocío Mental Health Rehabilitation Unit, Andalusian Health Services, Seville, Andalusia, Spain.

出版信息

J Trauma Stress. 2012 Jun;25(3):323-9. doi: 10.1002/jts.21693. Epub 2012 May 15.

Abstract

The purpose of this work was to study the relationship between reported traumatic experiences in childhood and positive psychotic symptoms. We hypothesized that dissociative experiences were potential mediators between childhood trauma and hallucinations, but not delusions. The sample comprised 71 patients diagnosed with psychoses. They were assessed with the Dissociative Experiences Scale (DES-II; Carlson & Putnam, 1993), a questionnaire on trauma (TQ; Davidson, Hughes, & Blazer, 1990), and the Positive and Negative Syndrome Scale (PANSS; Kay, Opler, & Lindenmayer, 1988) delusions and hallucinations items. The results showed that childhood trauma was positively associated with the dissociation scale scores (r = .40) and also the hallucination (r = .36) and delusions scale scores (r = .32). Furthermore, it was demonstrated that the dissociation variable was a potential mediator between childhood trauma and hallucinations, but not between childhood trauma and delusions. Of the 3 DES-II factors, only depersonalization showed a mediating relationship between childhood trauma and hallucinations. The main conclusion is that the impact of childhood trauma on hallucinations may not simply be direct, but mediated by dissociative experiences, especially depersonalization. Clinical implications are also briefly discussed.

摘要

本研究旨在探讨童年期创伤经历与阳性精神病症状之间的关系。我们假设,在童年创伤与幻觉之间,分离体验是潜在的中介因素,而不是妄想。该样本包括 71 名被诊断为精神病的患者。他们接受了分离体验量表(DES-II;Carlson & Putnam,1993)、创伤问卷(TQ;Davidson、Hughes 和 Blazer,1990)和阳性与阴性综合征量表(PANSS;Kay、Opler 和 Lindenmayer,1988)的妄想和幻觉项目评估。结果表明,童年创伤与分离量表评分呈正相关(r =.40),与幻觉(r =.36)和妄想量表评分(r =.32)也呈正相关。此外,研究还表明,分离变量是童年创伤与幻觉之间的潜在中介因素,但不是童年创伤与妄想之间的潜在中介因素。在 DES-II 的 3 个因素中,只有人格解体显示出与童年创伤和幻觉之间的中介关系。主要结论是,童年创伤对幻觉的影响可能不仅仅是直接的,而是通过分离体验,特别是人格解体来介导的。本文还简要讨论了临床意义。

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