Boyette Lindy-Lou, van Dam Daniëlla, Meijer Carin, Velthorst Eva, Cahn Wiepke, de Haan Lieuwe, Kahn René, de Haan Lieuwe, van Os Jim, Wiersma Durk, Bruggeman Richard, Cahn Wiepke, Meijer Carin, Myin-Germeys Inez
Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands;
Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands;
Schizophr Bull. 2014 Nov;40(6):1356-65. doi: 10.1093/schbul/sbu057. Epub 2014 Apr 25.
Patients with psychotic disorders who experienced childhood trauma show more social dysfunction than patients without traumatic experiences. However, this may not hold for all patients with traumatic experiences. Little is known about the potential compensating role of Five-Factor Model personality traits within this group, despite their strong predictive value for social functioning and well-being in the general population.
Our sample consisted of 195 patients with psychotic disorders (74% diagnosed with schizophrenia) and 132 controls. Cluster analyses were conducted to identify and validate distinct personality profiles. General linear model analyses were conducted to examine whether patients with different profiles differed in social functioning and quality of life (QoL), while controlling for possible confounders. Mediation models were tested to assess potential causal links.
In general, patients with higher levels of self-reported traumatic experiences (PT+) showed lower QoL and more social withdrawal compared with patients with lower traumatic experiences (PT-). Two clusters reflecting personality profiles were identified. PT+ with the first profile (lower neuroticism and higher extraversion, openness, agreeableness, and conscientiousness) presented higher levels of QoL and better social functioning in several areas, including less withdrawal, compared with both PT+ and PT- with the second profile. PT+ and PT- with the first personality profile did not differ in QoL and social functioning. Mediation analyses suggested that personality traits mediate the relation between traumatic experiences and QoL and social withdrawal.
Our findings indicate that personality may "buffer" the impact of childhood traumatic experiences on functional outcome in patients with psychotic disorders.
经历过童年创伤的精神障碍患者比没有创伤经历的患者表现出更多的社会功能障碍。然而,这可能并不适用于所有有创伤经历的患者。尽管五因素模型人格特质对一般人群的社会功能和幸福感具有很强的预测价值,但对于该群体中这些特质的潜在补偿作用知之甚少。
我们的样本包括195名精神障碍患者(74%被诊断为精神分裂症)和132名对照者。进行聚类分析以识别和验证不同的人格特征。进行一般线性模型分析,以检查不同特征的患者在社会功能和生活质量(QoL)方面是否存在差异,同时控制可能的混杂因素。测试中介模型以评估潜在的因果联系。
总体而言,自我报告创伤经历水平较高的患者(PT+)与创伤经历水平较低的患者(PT-)相比,生活质量较低,社交退缩更明显。识别出反映人格特征的两个聚类。与具有第二种特征的PT+和PT-相比,具有第一种特征(较低的神经质和较高的外向性、开放性、宜人性和尽责性)的PT+在几个方面表现出更高的生活质量和更好的社会功能,包括更少的退缩。具有第一种人格特征的PT+和PT-在生活质量和社会功能方面没有差异。中介分析表明,人格特质介导了创伤经历与生活质量和社交退缩之间的关系。
我们的研究结果表明,人格可能“缓冲”童年创伤经历对精神障碍患者功能结局的影响。