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性侵犯后自责和创伤后应激障碍:一项纵向分析。

Self-Blame and PTSD Following Sexual Assault: A Longitudinal Analysis.

机构信息

VA Boston Healthcare System, MA, USA.

Boston University School of Medicine, MA, USA.

出版信息

J Interpers Violence. 2021 Mar;36(5-6):NP3153-NP3168. doi: 10.1177/0886260518770652. Epub 2018 Apr 21.

Abstract

Sexual assault is a prevalent trauma associated with high rates of posttraumatic stress disorder (PTSD). Social cognitive theories posit that behavioral self-blame (i.e., attributing the cause of the assault to personal peri-event behavior) contributes to the etiology and maintenance of PTSD symptoms. Yet the direction of the association between self-blame and PTSD symptoms in the acute aftermath of sexual assault is unknown. This study evaluated temporal pathways between behavioral self-blame and PTSD symptom severity in an epidemiological sample of sexual assault survivors ( = 126) assessed at four time points in the months immediately following the assault. Results of cross-lagged panel modeling revealed that reports of behavioral self-blame at the first assessment following sexual assault predicted PTSD symptom severity at Time 2. However, there was no association between behavioral self-blame at Time 2 and PTSD symptom severity at Time 3, nor was there an association between behavioral self-blame at Time 3 and PTSD symptom severity at Time 4. Instead, PTSD symptom severity predicted behavioral self-blame at Times 3 and 4. Findings suggest that behavioral self-blame following sexual assault may be particularly relevant to the onset of PTSD symptoms, while PTSD symptoms themselves appear to intensify subsequent perceptions of behavioral self-blame. Clinical implications and limitations are discussed.

摘要

性侵犯是一种普遍存在的创伤,与创伤后应激障碍(PTSD)的高发病率有关。社会认知理论假设,行为自责(即,将攻击的原因归因于个人事件前的行为)有助于 PTSD 症状的病因和维持。然而,在性侵犯后的急性发作期间,自责与 PTSD 症状之间的关联方向尚不清楚。本研究在性侵犯幸存者的流行病学样本中评估了行为自责与 PTSD 症状严重程度之间的时间路径(n = 126),在性侵犯后立即进行了四个时间点的评估。交叉滞后面板模型的结果显示,性侵犯后第一次评估时的行为自责报告预测了第二次评估时的 PTSD 症状严重程度。然而,第二次评估时的行为自责与第三次评估时的 PTSD 症状严重程度之间没有关联,第三次评估时的行为自责与第四次评估时的 PTSD 症状严重程度之间也没有关联。相反,PTSD 症状严重程度预测了第三次和第四次评估时的行为自责。研究结果表明,性侵犯后行为自责可能与 PTSD 症状的发作特别相关,而 PTSD 症状本身似乎会加剧随后对行为自责的感知。讨论了临床意义和局限性。

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