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重度精神障碍患者反复受害的轨迹。

Trajectories of recurring victimization among people with major mental disorders.

作者信息

Teasdale Brent, Daigle Leah E, Ballard Ellen

机构信息

Georgia State University, Atlanta, USA.

出版信息

J Interpers Violence. 2014 Apr;29(6):987-1005. doi: 10.1177/0886260513506054. Epub 2013 Nov 18.

Abstract

Relatively little is known about the violent victimization experiences of people with major mental disorders. Moreover, to date, no studies have examined recurring violent victimization experiences of people with major mental disorders. Using a risk heterogeneity framework commonly used in the study of recurring victimization, the current study examines the extent of recurring victimization among people with Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I mental disorders and trajectories of recurring violent victimization (n = 262), across four waves of data collected during a 1-year longitudinal study. Multilevel logistic regression analyses tested disorder, time, and time by disorder cross-level interactions predicting recurring victimization. Results suggest that recurring violent victimization is not uncommon among mentally disordered victims of violence, with 64% of victims experiencing a recurring victimization at a later point in time. However, trajectories of recurring violent victimization are not uniform across types of mental illness. Indeed, individuals diagnosed with a substance abuse disorder or major depression show significantly declining trajectories across the follow-up period whereas individuals diagnosed with a manic disorder or a schizophrenia spectrum disorder have flat trajectories of recurring violent victimization across the study period. Results of tests for cross-level interactions between disorder type and time demonstrate that individuals with a major depression or substance abuse/dependence diagnosis are significantly different from those with a schizophrenia spectrum diagnosis in their trajectories of recurring victimization.

摘要

人们对患有严重精神障碍者遭受暴力侵害的经历了解相对较少。此外,迄今为止,尚无研究考察过患有严重精神障碍者反复遭受暴力侵害的经历。本研究采用反复受害研究中常用的风险异质性框架,在一项为期1年的纵向研究收集的四波数据中,考察了患有《精神疾病诊断与统计手册》(DSM)轴I精神障碍者反复受害的程度以及反复遭受暴力侵害的轨迹(n = 262)。多层次逻辑回归分析检验了预测反复受害的障碍、时间以及障碍与时间的跨层次交互作用。结果表明,在遭受暴力侵害的精神障碍受害者中,反复遭受暴力侵害的情况并不罕见,64%的受害者在之后的某个时间点经历了反复受害。然而,反复遭受暴力侵害的轨迹在不同类型的精神疾病中并不一致。事实上,被诊断患有物质使用障碍或重度抑郁症的个体在随访期间的轨迹显著下降,而被诊断患有躁狂症或精神分裂症谱系障碍的个体在研究期间反复遭受暴力侵害的轨迹较为平稳。障碍类型与时间之间跨层次交互作用的检验结果表明,被诊断患有重度抑郁症或物质使用/依赖的个体在反复受害轨迹上与被诊断患有精神分裂症谱系障碍的个体存在显著差异。

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