Hopper E K, Gonzalez L D
a The Trauma Center at Justice Resource Institute, Director, Project REACH , 1269 Beacon St. Brookline, MA , USA.
b Boston College, Consultant, Project REACH , 1269 Beacon St. Brookline, MA , USA.
Behav Med. 2018 Jul-Sep;44(3):177-188. doi: 10.1080/08964289.2018.1432551.
Human trafficking is a form of interpersonal trauma that has significant mental health impacts on survivors. This study examined psychological symptoms in 131 survivors of sex and labor trafficking, including people trafficked into or within the United States. High rates of depression (71%) and posttraumatic stress disorder (PTSD) (61%) were identified. Two thirds of survivors also met criteria for multiple categories of Complex PTSD (C-PTSD), including affect dysregulation and impulsivity; alterations in attention and consciousness; changes in interpersonal relationships; revictimization; somatic dysregulation; and alterations in self-perception. Although there were not significant differences in the prevalence rates of diagnoses of PTSD or depression between survivors of sex and labor trafficking, important group differences were identified. Compared to survivors of labor trafficking, sex trafficking survivors had higher prevalence rates of pre-trafficking childhood abuse and a higher incidence of physical and sexual violence during trafficking. They reported more severe post-trauma reactions than labor trafficking survivors, including more PTSD and C-PTSD symptoms. They were also more likely to meet criteria for comorbid PTSD and depression, while labor trafficking survivors were more likely than sex trafficking survivors to meet criteria for depression alone. An analysis of gender differences found that trafficking survivors who identified as transgender endorsed more PTSD and C-PTSD symptoms, than male or female survivors. Childhood abuse exposure was linked to PTSD and C-PTSD in trafficking survivors, and trafficking type was predictive of the number of trauma-related symptoms beyond the role of pre-trafficking child abuse. Implications for assessment and intervention with trafficking survivors are discussed.
人口贩卖是一种人际创伤形式，对幸存者的心理健康有重大影响。本研究调查了131名性交易和劳动力贩卖幸存者的心理症状，其中包括被贩卖到美国境内或在美国国内被贩卖的人。研究发现抑郁症（71%）和创伤后应激障碍（PTSD）（61%）的发生率很高。三分之二的幸存者还符合多种复杂创伤后应激障碍（C-PTSD）类别的标准，包括情绪失调和冲动；注意力和意识改变；人际关系变化；再次受害；躯体失调；以及自我认知改变。尽管性交易和劳动力贩卖幸存者在PTSD或抑郁症诊断患病率上没有显著差异，但仍发现了重要的群体差异。与劳动力贩卖幸存者相比，性交易幸存者在被贩卖前遭受童年虐待的患病率更高，在被贩卖期间遭受身体和性暴力的发生率也更高。他们报告的创伤后反应比劳动力贩卖幸存者更严重，包括更多的PTSD和C-PTSD症状。他们也更有可能符合PTSD和抑郁症共病的标准，而劳动力贩卖幸存者比性交易幸存者更有可能仅符合抑郁症的标准。一项性别差异分析发现，认定为跨性别者的贩卖幸存者比男性或女性幸存者认可更多的PTSD和C-PTSD症状。童年虐待经历与贩卖幸存者的PTSD和C-PTSD有关，而且贩卖类型可预测除被贩卖前儿童虐待作用之外与创伤相关症状的数量。文中讨论了对贩卖幸存者进行评估和干预的意义。
