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童年期虐待创伤:物质使用障碍治疗患者与心理健康治疗患者的比较

Childhood maltreatment trauma: a comparison between patients in treatment for substance use disorders and patients in mental health treatment.

作者信息

Rasmussen Ingvild S, Arefjord Kjersti, Winje Dagfinn, Dovran Anders

机构信息

Outpatient Department, Karmøy District Psychiatric Center, Kopervik, Norway.

Faculty of Psychology, Department of Clinical Psychology, University of Bergen, Bergen, Norway.

出版信息

Eur J Psychotraumatol. 2018 Jul 17;9(1):1492835. doi: 10.1080/20008198.2018.1492835. eCollection 2018.

Abstract

While previous research has found strong associations between childhood maltreatment trauma and substance use disorders (SUDs), the role of possible moderating effects of gender and mediating effects of psychopathology and SUD is unclear. The objective of this study was to investigate differences in self-reported childhood maltreatment trauma, general psychological distress, and post-traumatic stress symptoms between 112 patients in treatment for substance use disorders (SUD group) and 112 matched controls with mild to moderate mental health disorders (comparison group). Childhood maltreatment trauma was measured by the Childhood Trauma Questionnaire - Short Form (CTQ-SF). General psychological distress was measured by the Symptom Checklist-90 - Revised (SCL-90-R), and post-traumatic stress symptoms were measured by the Impact of Event Scale - Revised (IES-R). The SUD group reported more severe childhood maltreatment trauma than the comparison group. Females in the SUD group reported more severe and various forms of trauma compared to males. The SUD group reported higher mean scores on the SCL-90-R, but the proportions of people with caseness scores on the IES-R and the SCL-90-R were similar in the two samples. The SUD group reported more avoidance symptoms than the comparison group. This study adds further evidence to the repeatedly found strong associations between childhood maltreatment trauma and SUD, implying that the prevention of childhood maltreatment trauma may reduce the occurrence of SUD. Furthermore, patients with SUD should be screened for childhood maltreatment trauma, and the results should be applied in trauma-informed as well as trauma-focused interventions aimed to help this population. The association appears to be particularly strong for female substance users.

摘要

虽然先前的研究发现童年期虐待创伤与物质使用障碍(SUDs)之间存在密切关联,但性别可能的调节作用以及精神病理学和SUD的中介作用尚不清楚。本研究的目的是调查112名接受物质使用障碍治疗的患者(SUD组)和112名匹配的轻度至中度精神健康障碍对照组(比较组)在自我报告的童年期虐待创伤、一般心理困扰和创伤后应激症状方面的差异。童年期虐待创伤通过儿童创伤问卷简表(CTQ-SF)进行测量。一般心理困扰通过症状自评量表90修订版(SCL-90-R)进行测量,创伤后应激症状通过事件影响量表修订版(IES-R)进行测量。SUD组报告的童年期虐待创伤比比较组更严重。SUD组中的女性比男性报告了更严重和更多样化的创伤形式。SUD组在SCL-90-R上的平均得分更高,但两个样本中IES-R和SCL-90-R上达到病例分数的人群比例相似。SUD组报告的回避症状比比较组更多。本研究进一步证明了反复发现的童年期虐待创伤与SUD之间的密切关联,这意味着预防童年期虐待创伤可能会减少SUD的发生。此外,应对SUD患者进行童年期虐待创伤筛查,结果应应用于以创伤为导向以及专注于创伤的干预措施,以帮助这一人群。这种关联在女性物质使用者中似乎尤为强烈。

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