Carmen E, Rieker P P
Boston University School of Medicine; Massachusetts.
Psychiatr Clin North Am. 1989 Jun;12(2):431-43.
The psychosocial model of the victim-to-patient process explains how chronic abuse damages the self and sets into motion psychological processes that may evolve into various forms of mental illness. This model emphasizes the fragmented identity that derives from victims' attempts to accommodate to the judgments of others about the abuse, namely, it didn't happen; it happened, but it wasn't important and has no consequences; (s)he provoked it; and it wasn't abusive. Victims thus repress and deny the trauma and associated feelings in order to survive. The behavioral and psychological legacy of this adaptation forms the core of survivors' psychopathology and becomes an obstacle to treatment and recovery. The link between the damaged self and AIDS risk in adolescent runaway, homeless, and mentally ill survivor populations is underscored, along with recommendations for urgently needed clinical interventions.
受害者到患者过程的社会心理模型解释了长期虐待如何损害自我，并启动可能演变成各种精神疾病形式的心理过程。该模型强调了碎片化的身份认同，这种认同源于受害者试图迎合他人对虐待的判断，即：这没有发生；发生了，但不重要且没有后果；是她/他挑起的；以及这不是虐待。因此，受害者为了生存而压抑和否认创伤及相关感受。这种适应的行为和心理遗留构成了幸存者精神病理学的核心，并成为治疗和康复的障碍。强调了受损自我与青少年离家出走者、无家可归者以及患有精神疾病的幸存者群体中艾滋病风险之间的联系，并提出了对急需的临床干预措施的建议。
