Dorahy Martin J, Middleton Warwick, Seager Lenaire, Williams Mary, Chambers Ron
a Department of Psychology , University of Canterbury , Christchurch , New Zealand.
b The Cannan Institute , Belmont Private Hospital , Brisbane , Australia.
J Trauma Dissociation. 2016;17(2):223-36. doi: 10.1080/15299732.2015.1077916. Epub 2015 Aug 14.
Only a select number of studies have examined different forms of child maltreatment in complex dissociative disorders (DDs) in comparison to other groups. Few of these have used child abuse-related chronic posttraumatic stress disorder (C-PTSD) and mixed psychiatric (MP) patients with maltreatment as comparison groups. This study examined child sexual, physical, and emotional abuse as well as physical and emotional neglect in DD (n = 39), C-PTSD (n = 13), and MP (n = 21) samples, all with abuse and neglect histories. The predictive capacity of these different forms of maltreatment across the 3 groups was assessed for pathological dissociation, shame, guilt, relationship esteem, relationship anxiety, relationship depression, and fear of relationships. All forms of maltreatment differentiated the DD from the MP group, and sexual abuse differentiated the DD sample from the C-PTSD group. Childhood sexual abuse was the only predictor of pathological dissociation. Emotional abuse predicted shame, guilt, relationship anxiety, and fear of relationships. Emotional neglect predicted relationship anxiety and relationship depression. Physical neglect was associated with less relationship anxiety. Different forms of abuse and neglect are associated with different symptom clusters in psychiatric patients with maltreatment histories.
与其他群体相比,只有少数研究考察了复杂解离障碍(DDs)中不同形式的儿童虐待情况。其中很少有研究将与儿童虐待相关的慢性创伤后应激障碍(C-PTSD)患者和有虐待经历的混合性精神障碍(MP)患者作为对照组。本研究考察了DD组(n = 39)、C-PTSD组(n = 13)和MP组(n = 21)样本中的儿童性虐待、身体虐待、情感虐待以及身体忽视和情感忽视情况,所有样本均有虐待和忽视史。评估了这三种不同形式的虐待在三组样本中对病理性解离、羞耻感、内疚感、关系自尊、关系焦虑、关系抑郁和关系恐惧的预测能力。所有形式的虐待都能将DD组与MP组区分开来,性虐待能将DD样本与C-PTSD组区分开来。童年期性虐待是病理性解离的唯一预测因素。情感虐待可预测羞耻感、内疚感、关系焦虑和关系恐惧。情感忽视可预测关系焦虑和关系抑郁。身体忽视与较少的关系焦虑有关。在有虐待史的精神科患者中,不同形式的虐待和忽视与不同的症状群相关。