Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Heidelberg University,Mannheim J5, D-68159,Germany.
Department of Psychology,School of Social Sciences, University of Mannheim,Mannheim,Germany.
Psychol Med. 2018 Nov;48(15):2467-2476. doi: 10.1017/S0033291718000740. Epub 2018 Apr 10.
Childhood abuse and neglect are associated with dissociative symptoms in adulthood. However, empirical studies show heterogeneous results depending on the type of childhood abuse or neglect and other maltreatment characteristics. In this meta-analysis, we systematically investigated the relationship between childhood interpersonal maltreatment and dissociation in 65 studies with 7352 abused or neglected individuals using the Dissociative Experience Scale (DES). We extracted DES-scores for abused and non-abused populations as well as information about type of abuse/neglect, age of onset, duration of abuse, and relationship to the perpetrator. Random-effects models were used for data synthesis, and meta-regression was used to predict DES-scores in abused populations from maltreatment characteristics. The results revealed higher dissociation in victims of childhood abuse and neglect compared with non-abused or neglected subsamples sharing relevant population features (MAbuse = 23.5, MNeglect = 18.8, MControl = 13.8) with highest scores for sexual and physical abuse. An earlier age of onset, a longer duration of abuse, and parental abuse significantly predicted higher dissociation scores. This meta-analysis underlines the importance of childhood abuse/neglect in the etiology of dissociation. The identified moderators may inform risk assessment and early intervention to prevent the development of dissociative symptoms.
童年期虐待和忽视与成年期的分离症状有关。然而，实证研究表明，具体取决于虐待或忽视的类型以及其他虐待特征，结果存在异质性。在这项荟萃分析中，我们使用分离体验量表（DES），系统地调查了 65 项研究中，65 项研究中 7352 名受虐待或忽视个体的童年人际虐待与分离之间的关系。我们提取了受虐待和未受虐待人群的 DES 评分，以及关于虐待/忽视类型、发病年龄、虐待持续时间和与施虐者的关系的信息。我们使用随机效应模型对数据进行综合，使用元回归来预测受虐待人群中从虐待特征预测 DES 评分。结果表明，与具有相关人口特征的未受虐待或未受忽视的子样本相比，童年期受虐待和忽视的受害者的分离程度更高（受虐者 MAbuse = 23.5，忽视者 MNeglect = 18.8，对照组 MControl = 13.8），性虐待和身体虐待的得分最高。发病年龄更早、虐待持续时间更长以及父母虐待显著预示着更高的分离评分。这项荟萃分析强调了童年期虐待/忽视在分离症病因学中的重要性。确定的调节因素可以为风险评估和早期干预提供信息，以预防分离症状的发展。
