Aakvaag Helene Flood, Thoresen Siri, Wentzel-Larsen Tore, Dyb Grete, Røysamb Espen, Olff Miranda
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.
J Affect Disord. 2016 Nov 1;204:16-23. doi: 10.1016/j.jad.2016.06.004. Epub 2016 Jun 11.
There is increasing interest in trauma-related shame and guilt. However, much remains unknown in terms of how these emotions relate to the type of event, gender and mental health. We investigated shame and guilt in men and women following various types of severe violence and their relation to mental health.
Telephone interviews were conducted with a Norwegian general population sample (n=4529; age=18-75; response rate=42.9%). Measures included child sexual abuse, child and adult rape, severe physical violence from/between parents, severe violence from a partner and non-partners, less severe violence and non-violent trauma, the new Shame and Guilt After Trauma Scale, and the Hopkins Symptom Checklist. Analyses included t-tests and linear regressions.
All types of severe violence were significantly associated with trauma-related shame and guilt (coefficients from 0.11 to 0.38, p-values <0.001). The number of violence types showed a graded relationship with both emotions. Women had significantly more shame and guilt than men did (p-values <0.001 for both emotions), which was partially explained by violence exposure. Both emotions were independently associated with mental health problems (p-values <0.001).
The study is cross-sectional. The shame and guilt measure requires further validation.
The more types of violence that were reported, the higher levels of shame and guilt were. Clinicians should be aware of shame and guilt after a variety of violent events, including non-sexual violence, in both men and women and should particularly be aware of whether individuals have multiple violent experiences.
人们对创伤相关的羞耻感和内疚感越来越感兴趣。然而，关于这些情绪如何与事件类型、性别及心理健康相关，仍有许多未知之处。我们调查了男性和女性在经历各类严重暴力事件后的羞耻感和内疚感及其与心理健康的关系。
对挪威普通人群样本（n = 4529；年龄 = 18 - 75岁；回复率 = 42.9%）进行电话访谈。测量内容包括儿童性虐待、儿童及成人强奸、来自父母/父母之间的严重身体暴力、来自伴侣及非伴侣的严重暴力、不太严重的暴力及非暴力创伤、新的创伤后羞耻与内疚量表以及霍普金斯症状清单。分析包括t检验和线性回归。
所有类型的严重暴力都与创伤相关的羞耻感和内疚感显著相关（系数从0.11至0.38，p值 < 0.001）。暴力类型的数量与这两种情绪呈分级关系。女性的羞耻感和内疚感显著多于男性（两种情绪的p值均 < 0.001），暴力暴露对此有部分解释作用。这两种情绪都与心理健康问题独立相关（p值 < 0.001）。
该研究为横断面研究。羞耻感和内疚感测量方法需要进一步验证。
报告的暴力类型越多，羞耻感和内疚感水平越高。临床医生应意识到男性和女性在经历包括非性暴力在内的各类暴力事件后的羞耻感和内疚感，尤其应注意个体是否有多次暴力经历。
