Huntjens Rafaële J C, Wessel Ineke, Ostafin Brian D, Boelen Paul A, Behrens Friederike, van Minnen Agnes
Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands.
Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands.
Behav Res Ther. 2016 Dec;87:216-224. doi: 10.1016/j.brat.2016.10.002. Epub 2016 Oct 11.
This study examined the content of self-defining autobiographical memories in different identities in patients with Dissociative Identity Disorder (DID) and comparison groups of patients with PTSD, healthy controls, and DID simulators. Consistent with the DID trauma model, analyses of objective ratings showed that DID patients in trauma identities retrieved more negative and trauma-related self-defining memories than DID patients in avoidant identities. Inconsistent with the DID trauma model, DID patients' self-rated trauma-relatedness of self-defining memories and future life goals did not differ between trauma identities and trauma avoidant identities. That is, the DID patients did not seem to be "shut off" from their trauma while in their avoidant identity. Furthermore, DID patients in both identities reported a higher proportion of avoidance goals compared to PTSD patients, with the latter group scoring comparably to healthy controls. The simulators behaved according to the instructions to respond differently in each identity (i.e., to report memories and goals consistent with the identity tested). The discrepant task behavior by DID patients and simulators indicated that DID patients did not seem to intentionally produce the hypothesized differences in performance between identities. In conclusion, for patients with DID (i.e., in both identities) and patients with PTSD, trauma played a central role in the retrieval of self-defining memories and in the formulation of life goals.
本研究考察了分离性身份障碍（DID）患者不同身份下自我定义的自传体记忆的内容，并与创伤后应激障碍（PTSD）患者、健康对照组以及DID模拟者进行了比较。与DID创伤模型一致，客观评分分析表明，处于创伤身份的DID患者比处于回避身份的DID患者提取到更多负面的、与创伤相关的自我定义记忆。与DID创伤模型不一致的是，DID患者在自我定义记忆和未来生活目标中自我评定的与创伤的相关性在创伤身份和创伤回避身份之间并无差异。也就是说，DID患者在处于回避身份时似乎并未与他们的创伤“隔绝”。此外，与PTSD患者相比，两种身份下的DID患者报告的回避目标比例更高，而PTSD患者的得分与健康对照组相当。模拟者按照指令在每种身份下做出不同反应（即报告与所测试身份一致的记忆和目标）。DID患者和模拟者在任务行为上的差异表明，DID患者似乎并非故意制造身份之间在表现上的假定差异。总之，对于DID患者（即两种身份下）和PTSD患者而言，创伤在自我定义记忆的提取以及生活目标的形成中起着核心作用。
