Van Buren Brian R, Weierich Mariann R
a Hunter College , The City University of New York , New York , New York , USA.
b The Graduate Center , The City University of New York , New York , New York , USA.
J Child Sex Abus. 2015;24(8):959-74. doi: 10.1080/10538712.2015.1082003.
Tonic immobility is a set of involuntary motor responses elicited under conditions of extreme fear and perceived inescapability, and it is one type of peritraumatic distress reported by survivors of child sexual abuse. Experiencing tonic immobility during child sexual abuse is associated with increased risk for developing symptoms of post-traumatic stress disorder, although less is known about relations between tonic immobility and other established risk factors for post-traumatic stress disorder. We investigated posttraumatic cognitions as a potential mediator of the relations between peritraumatic fear, perceptions of inescapability, tonic immobility, and post-traumatic stress disorder symptoms. Specifically, we tested posttraumatic negative beliefs about the self, the world, and self-blame as pathways that might increase risk for post-traumatic stress disorder symptoms in child sexual abuse survivors who had experienced tonic immobility. Forty-six women with a history of unwanted childhood sexual contact completed questionnaires measuring peritraumatic tonic immobility, posttraumatic cognitions, and current posttraumatic stress symptoms. Negative beliefs about the self independently mediated the relation between peritraumatic perceptions of inescapability and post-traumatic stress disorder symptoms, but the data did not support similar path model for the physical symptoms of tonic immobility and post-traumatic stress disorder. We discuss ways in which treatment of survivors and future research on CSA can benefit from attention to the impact of peritraumatic distress on posttraumatic beliefs.
紧张性不动是在极度恐惧和感到无法逃避的情况下引发的一系列非自主运动反应，它是儿童性虐待幸存者报告的一种创伤周围困扰类型。在儿童性虐待期间经历紧张性不动与创伤后应激障碍症状发展风险增加有关，尽管对于紧张性不动与创伤后应激障碍其他既定风险因素之间的关系了解较少。我们调查了创伤后认知作为创伤周围恐惧、不可逃避感、紧张性不动和创伤后应激障碍症状之间关系的潜在中介。具体而言，我们测试了关于自我、世界和自责的创伤后消极信念，这些信念可能是经历过紧张性不动的儿童性虐待幸存者创伤后应激障碍症状风险增加的途径。46名有童年期非自愿性接触史的女性完成了测量创伤周围紧张性不动、创伤后认知和当前创伤后应激症状的问卷。关于自我的消极信念独立中介了创伤周围不可逃避感与创伤后应激障碍症状之间的关系，但数据不支持紧张性不动的身体症状与创伤后应激障碍之间类似的路径模型。我们讨论了关注创伤周围困扰对创伤后信念的影响如何能使幸存者的治疗和未来关于儿童性虐待的研究受益。
