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分离性遗忘的三个维度。

Three dimensions of dissociative amnesia.

机构信息

Psychotherapy Resources of Norfolk, Norfolk, VA, USA.

出版信息

J Trauma Dissociation. 2013;14(1):25-39. doi: 10.1080/15299732.2012.724762.

Abstract

Principal axis factor analysis with promax rotation extracted 3 factors from the 42 memory and amnesia items of the Multidimensional Inventory of Dissociation (MID) database (N = 2,569): Discovering Dissociated Actions, Lapses of Recent Memory and Skills, and Gaps in Remote Memory. The 3 factors' shared variance ranged from 36% to 64%. Construed as scales, the 3 factor scales had Cronbach's alpha coefficients of .96, .94, and .93, respectively. The scales correlated strongly with mean Dissociative Experiences Scale scores, mean MID scores, and total scores on the Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised (SCID-D-R). What is interesting is that the 3 amnesia factors exhibited a range of correlations with SCID-D-R Amnesia scores (.52, .63, and .70, respectively), suggesting that the SCID-D-R Amnesia score emphasizes gaps in remote memory over amnesias related to dissociative identity disorder. The 3 amnesia factor scales exhibited a clinically meaningful pattern of significant differences among dissociative identity disorder, dissociative disorder not otherwise specified-1, dissociative amnesia, depersonalization disorder, and nonclinical participants. The 3 amnesia factors may have greater clinical utility for frontline clinicians than (a) amnesia as discussed in the context of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, nosology of the dissociative disorders or (b) P. Janet's (1893/1977 ) 4-fold classification of dissociative amnesia. The author recommends systematic study of the phenomenological differences within specific dissociative symptoms and their differential relationship to specific dissociative disorders.

摘要

主轴因子分析采用 promax 旋转从多维分离量表(MID)数据库的 42 个记忆和遗忘项目中提取了 3 个因子(N=2569):发现分离动作、近期记忆和技能的遗忘以及远程记忆中的空白。这 3 个因子的共享方差范围为 36%-64%。作为量表构建,这 3 个因子量表的克朗巴赫α系数分别为.96、.94 和.93。这些量表与平均分离体验量表评分、平均 MID 评分以及 DSM-IV 修订版结构临床访谈分离障碍修订版(SCID-D-R)的总分强烈相关。有趣的是,这 3 个遗忘因子与 SCID-D-R 遗忘评分的相关性范围很广(分别为.52、.63 和.70),这表明 SCID-D-R 遗忘评分强调远程记忆中的空白,而不是与分离性身份障碍相关的遗忘。这 3 个遗忘因子量表在分离性身份障碍、未特指的分离性障碍-1、分离性遗忘症、人格解体障碍和非临床参与者之间表现出具有临床意义的显著差异模式。这 3 个遗忘因子可能比(a)DSM-5 分类中讨论的遗忘症(b)P. Janet(1893/1977)的 4 重分类的遗忘症对一线临床医生具有更大的临床效用。作者建议对特定分离症状的现象学差异及其与特定分离障碍的差异关系进行系统研究。

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