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童年期复杂创伤,成年期的一种精神疾病诊断:解读一种双刃剑现象。

Complex trauma in childhood, a psychiatric diagnosis in adulthood: Making meaning of a double-edged phenomenon.

作者信息

McCormack Lynne, Thomson Sherilyn

机构信息

School of Psychology, Faculty of Science and IT, University of Newcastle.

出版信息

Psychol Trauma. 2017 Mar;9(2):156-165. doi: 10.1037/tra0000193. Epub 2016 Oct 6.

DOI:10.1037/tra0000193
PMID:27710004
Abstract

OBJECTIVE

No known research explores the double-edged phenomenon of childhood trauma/adult mental health consumer. Therefore, whether receiving a psychiatric diagnosis in light of childhood trauma supports or impedes psychological wellbeing in adult life, is unknown.

METHOD

Interpretative phenomenological analysis (IPA) provided the methodological framework. Data were collected through the use of semistructured interviews. Analysis sought thematic representation from subjective interpretations of the experienced phenomenon: childhood trauma survivor/mental health consumer.

RESULTS

Data revealed 1 superordinate theme, Childhood Betrayal, Identity, and Worthiness, that overarched 5 subordinate themes a) legacies, (b) the label, (c) putting the jigsaw together, (d) stigma, and (e) better than good enough self. Legacies of doubt that perpetuated "not good enough" delayed the development of an adult identity of worthiness in these participants. Importantly, the right diagnosis separated self as worthy-adult from self as traumatized child and facilitated positive change for breaking harmful cycles, self-valuing, and increased empathy, wisdom, and patience.

CONCLUSIONS

Findings inform future research and therapeutic practice in regards to adult help seeking behaviors in light of childhood trauma, often postponed through fear of stigma associated with mental health diagnoses and services. Similarly, findings suggest that ameliorating wellbeing may be dependent on a therapeutic relationship in which accuracy or right fit of diagnosis provides a conduit for the client to disengage from self-blame, unworthiness, and "not good enough." (PsycINFO Database Record

摘要

目的

尚无已知研究探讨童年创伤/成年心理健康消费者这一双刃现象。因此,鉴于童年创伤接受精神科诊断对成年生活中的心理健康是有支持作用还是有阻碍作用尚不清楚。

方法

解释现象学分析(IPA)提供了方法框架。数据通过半结构化访谈收集。分析从童年创伤幸存者/心理健康消费者对所经历现象的主观解释中寻求主题呈现。

结果

数据揭示了1个上位主题,即童年背叛、身份认同和价值感,该上位主题涵盖了5个下位主题:(a)遗留问题,(b)标签,(c)拼凑拼图,(d)耻辱感,以及(e)比足够好更好的自我。持续存在的“不够好”的怀疑遗留问题延迟了这些参与者形成有价值的成年身份认同。重要的是,正确的诊断将作为有价值成年人的自我与作为受创伤儿童的自我区分开来,并促进了积极的改变,以打破有害循环、自我珍视以及增强同理心、智慧和耐心。

结论

研究结果为未来关于成年期因童年创伤而寻求帮助行为的研究和治疗实践提供了参考,这类行为往往因担心与心理健康诊断和服务相关的耻辱感而被推迟。同样,研究结果表明,改善幸福感可能依赖于一种治疗关系,在这种关系中,诊断的准确性或恰当性为来访者摆脱自责、无价值感和“不够好”提供了途径。(《心理学文摘数据库记录》

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