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社交焦虑障碍、童年创伤经历和解离之间是否存在复杂的关系?

Is there a complex relation between social anxiety disorder, childhood traumatic experiences and dissociation?

作者信息

Belli Hasan, Akbudak Mahir, Ural Cenk, Solmaz Mustafa, Dogan Zuhal, Konkan Ramazan

机构信息

a Department of Psychiatry , Bagcilar Education and Research Hospital , Bagcılar , İstanbul , Turkey.

出版信息

Nord J Psychiatry. 2017 Jan;71(1):55-60. doi: 10.1080/08039488.2016.1218050. Epub 2016 Aug 26.

Abstract

BACKGROUND

A possible relationship has been suggested between social anxiety and dissociation. Traumatic experiences, especially childhood abuse, play an important role in the aetiology of dissociation.

AIM

This study assesses childhood trauma history, dissociative symptoms, and dissociative disorder comorbidity in patients with social anxiety disorder (SAD).

METHOD

The 94 psychotropic drug-naive patients participating in the study had to meet DSM-IV criteria for SAD. Participants were assessed using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), the Dissociation Questionnaire (DIS-Q), the Liebowitz Social Anxiety Scale (LSAS), and the Childhood Trauma Questionnaire (CTQ). Patients were divided into two groups using the DIS-Q, and the two groups were compared.

RESULTS

The evaluation found evidence of at least one dissociative disorder in 31.91% of participating patients. The most prevalent disorders were dissociative disorder not otherwise specified (DDNOS), dissociative amnesia, and depersonalization disorders. Average scores on LSAS and fear and avoidance sub-scale averages were significantly higher among the high DIS-Q group (p < .05). In a logistic regression taking average LSAS scores as the dependent variable, the five independent variables DIS-Q, CTQ-53 total score, emotional abuse, sexual abuse, and emotional neglect were associated with average LSAS scores among patients with SAD (p < .05).

CONCLUSIONS

It is concluded that, on detecting SAD symptoms during hospitalization, the clinician should not neglect underlying dissociative processes and traumatic experiences among these patients.

摘要

背景

社交焦虑与分离之间可能存在关联。创伤经历,尤其是童年期受虐,在分离的病因学中起重要作用。

目的

本研究评估社交焦虑障碍(SAD)患者的童年创伤史、分离症状及分离障碍共病情况。

方法

参与研究的94名未服用过精神药物的患者须符合DSM-IV的SAD标准。使用《精神疾病诊断与统计手册第四版》分离障碍结构化临床访谈量表(SCID-D)、分离问卷(DIS-Q)、莱博维茨社交焦虑量表(LSAS)和儿童创伤问卷(CTQ)对参与者进行评估。使用DIS-Q将患者分为两组并进行比较。

结果

评估发现31.91%的参与患者存在至少一种分离障碍。最常见的障碍是未另行说明的分离障碍(DDNOS)、分离性遗忘症和人格解体障碍。高DIS-Q组的LSAS平均得分以及恐惧和回避子量表平均得分显著更高(p < 0.05)。在以LSAS平均得分作为因变量的逻辑回归分析中,五个自变量DIS-Q、CTQ-53总分、情感虐待、性虐待和情感忽视与SAD患者的LSAS平均得分相关(p < 0.05)。

结论

得出的结论是,在住院期间检测到SAD症状时,临床医生不应忽视这些患者潜在的分离过程和创伤经历。

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