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根据童年期虐待类型及施虐者与受虐者的关系来预测分离性障碍。

Predicting a dissociative disorder from type of childhood maltreatment and abuser-abused relational tie.

作者信息

Krüger Christa, Fletcher Lizelle

机构信息

a Department of Psychiatry , University of Pretoria; and Weskoppies Hospital , Pretoria , South Africa.

b Department of Statistics , University of Pretoria , Pretoria , South Africa.

出版信息

J Trauma Dissociation. 2017 May-Jun;18(3):356-372. doi: 10.1080/15299732.2017.1295420. Epub 2017 Feb 23.

Abstract

We investigate the types of childhood maltreatment and abuser-abused relational ties that best predict a dissociative disorder (DD). Psychiatric inpatients (n = 116; mean age = 35; F:M = 1.28:1) completed measures of dissociation and trauma. Abuse type and abuser-abused relational ties were recorded in the Traumatic Experiences Questionnaire. Multidisciplinary team clinical diagnosis or administration of the SCID-D-R to high dissociators confirmed DD diagnoses. Logit models described the relationships between abuser-abused relational tie and the diagnostic grouping of patients, DD present (n = 16) or DD absent (n = 100). Fisher's exact tests measured the relative contribution of specific abuse types. There was a positive relationship between abuse frequency and the presence of DD. DD patients experienced more abuse than patients without DDs. Two combinations of abuse type and relational tie predicted a DD: childhood emotional neglect by biological parents/siblings and later emotional abuse by intimate partners. These findings support the early childhood etiology of DDs and subsequent maladaptive cycles of adult abuse. Enquiries about childhood maltreatment should include a history of emotional neglect by biological parents/siblings. Adult emotional abuse by intimate partners should assist in screening for DDs.

摘要

我们调查了最能预测解离性障碍(DD)的儿童期虐待类型及施虐者与受虐者的关系。精神科住院患者(n = 116;平均年龄 = 35岁;女性与男性比例 = 1.28:1)完成了解离和创伤测量。创伤经历问卷记录了虐待类型及施虐者与受虐者的关系。多学科团队临床诊断或对高度解离者实施SCID-D-R以确认DD诊断。逻辑模型描述了施虐者与受虐者关系和患者诊断分组(存在DD,n = 16;不存在DD,n = 100)之间的关系。费舍尔精确检验测量了特定虐待类型的相对影响。虐待频率与DD的存在之间存在正相关。DD患者比无DD的患者经历了更多虐待。两种虐待类型与关系的组合可预测DD:亲生父母/兄弟姐妹在儿童期的情感忽视以及亲密伴侣随后的情感虐待。这些发现支持了DD的幼儿期病因及随后成人虐待的适应不良循环。关于儿童期虐待的询问应包括亲生父母/兄弟姐妹情感忽视的病史。亲密伴侣的成人情感虐待应有助于DD的筛查。

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