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创伤对根据 DSM-IV 标准评估躯体形式障碍的自传体记忆的影响。

The Influence of Trauma on Autobiographical Memory in the Assessment of Somatoform Disorders According to DSM IV Criteria.

机构信息

Aplysia onlus, GIFT Institute of Integrative Medicine, p.za Cairoli 12, 56127, Pisa, Italy.

Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.

出版信息

Psychiatr Q. 2018 Dec;89(4):991-1005. doi: 10.1007/s11126-018-9597-0.

DOI:10.1007/s11126-018-9597-0
PMID:30136256
Abstract

Recalling an event impairs an individual's later ability to recall related knowledge. Impairment in this retrieval-induced forgetting (RIF) produces a dysfunction in autobiographical memory. This, like somatic symptoms, has been documented in trauma and sexual abuse survivors. To investigate the relationship between past trauma and somatoform disorders, and the role of memory recall dysfunction in this relationship, three sex-matched groups were constituted using DSM IV criteria: Somatoform (SD) (n. 22) other Psychiatric Disorders (PD) (n. 26) and Healthy Subjects (HS) (n. 35). Responses to Stressful Life Events Screening Questionnaire revised (SLESQ-R); Direct Forgetting paradigm (DF) for autobiographical memory; Deese-Roediger-McDermott (DRM) paradigm for false memory; Stanford Scale type A for Post-Hypnotic Amnesia (PHA); Stroop Colour Word test and a digit-span for cognitive assessment; and Somatosensory Amplification Scale (SSAS), Somatic Dissociation Questionnaire (SDQ-20), and Toronto Alexithymia Scale (TAS 20) for somatic discomfort were compared among groups. SSAS, SDQ-20 and TAS F1 were correlated with SLESQ-R scores; subjects with higher numbers of traumatic events (NSE) showed greater capacity to remember items-to-be-forgotten (DFF) and higher SDQ-20 scores. Although the SD group showed higher NSE, their autobiographical memory scores were no different to those of other DSM-IV groups. The somatic-trauma-autobiographical memory impairment relationship is identified by DSM V but not DSM IV criteria for somatoform disorder. Higher NSE appears to correlate with both the presence of somatic discomfort and impaired autobiographical memory, suggesting autonoetic consciousness dysfunction in subjects with past trauma and current somatic symptom disorders.

摘要

回忆事件会损害个体随后回忆相关知识的能力。这种在提取诱发遗忘(RIF)中的损伤会导致自传体记忆功能障碍。这种障碍类似于躯体症状,在创伤和性虐待幸存者中已有记录。为了研究过去创伤与躯体形式障碍之间的关系,以及记忆回忆功能障碍在这种关系中的作用,我们使用 DSM-IV 标准构建了三个性别匹配的组:躯体形式障碍(SD)组(n. 22)、其他精神障碍(PD)组(n. 26)和健康对照组(HS)组(n. 35)。使用修订后的应激性生活事件筛查问卷(SLESQ-R)评估各组的应激反应;使用自传体记忆直接遗忘范式(DF)评估直接遗忘;使用德西-罗迪格-麦克德莫特(DRM)范式评估虚假记忆;使用斯坦福催眠后遗忘量表(PHA)评估催眠后遗忘;使用 Stroop 色词测验和数字跨度测验评估认知功能;使用躯体感觉放大量表(SSAS)、躯体分离问卷(SDQ-20)和多伦多述情量表(TAS 20)评估躯体不适。比较各组的 SSAS、SDQ-20 和 TAS F1 与 SLESQ-R 评分的相关性;有更多创伤性事件(NSE)的受试者表现出更强的记住待遗忘项目的能力(DFF)和更高的 SDQ-20 评分。尽管 SD 组的 NSE 更高,但他们的自传体记忆评分与其他 DSM-IV 组没有差异。DSM V 标准识别了躯体-创伤-自传体记忆损伤的关系,但 DSM IV 标准不识别躯体形式障碍。较高的 NSE 似乎与躯体不适和自传体记忆损伤的存在都相关,这表明过去创伤和当前躯体症状障碍患者的自主意识功能障碍。

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本文引用的文献

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