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酒精成瘾者的依恋风格、童年期创伤、述情障碍和解离:依赖关系的结构方程模型

Attachment Style, Early Childhood Trauma, Alexithymia, and Dissociation Among Persons Addicted to Alcohol: Structural Equation Model of Dependencies.

作者信息

Zdankiewicz-Ścigała Elżbieta, Ścigała Dawid Konrad

机构信息

Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.

Institute of Psychology, Faculty of Applied Social Sciences, The Maria Grzegorzewska University, Warsaw, Poland.

出版信息

Front Psychol. 2020 Jan 24;10:2957. doi: 10.3389/fpsyg.2019.02957. eCollection 2019.

Abstract

AIM

Attachment theory is a broadly used paradigm for understanding human affective development. It is recognized that alexithymia is a key factor responsible for the non-adaptive strategies of regulating emotions in people addicted to alcohol. In addition, an important role is attributed to early childhood trauma and dissociation. The theoretical model was examined, in which connections between attachment styles, trauma, and alexithymia and dissociation were investigated in persons addicted to alcohol.

METHODS

The total number of study participants amounted to 268 persons, including 116 women (43% of all subjects) and 152 men (57% of all subjects) at the age of 18-73 ( = 39.19; = 13.45). In order to measure the analyzed variables, the following questionnaires were applied: Michigan alcoholism screening test (MAST), attachment styles questionnaire (ASQ), 20-item Toronto Alexithymia Scale (TAS-20), traumatic experiences checklist (TEC), and curious experiences survey (CES).

RESULTS

A comparative analysis between the group of alcohol addicts and non-addicts showed statistically significant differences related to attachment style, intensity of trauma, alexithymia, and dissociation. With structural equation models (i.e., AMOS and GLS), the adjustment of theoretical model to data was examined, which allowed the description of dependency paths. As a result of the conducted analysis of paths, it was found out that the model was accurately fitted to data, but only when an impact path related to a direct connection between an attachment style and an addiction was deleted. This impact is indirect, and from one side, it results from affective and cognitive deficits, i.e., alexithymia, and on the other side, from the intensity of traumatic experiences. No direct impact of dissociation on the development of an inclination to addiction was found, if contextual variables, i.e., alexithymia and trauma, are taken into account. The strongest direct relation was proven in the case of the anxious-ambivalent attachment style and alexithymia (β = 0.389; < 0.01) and avoidant attachment style and alexithymia (β = 0.497; < 0.01), which turned out a strong predictor fostering the development of alexithymia and the occurrence of traumas related to emotional negligence and mental violence and finally addiction.

CONCLUSION

Our studies revealed how important it is to investigate the role of individual variables in the context of developmental models. An extremely important element of the scientific achievement presented here is showing pillars of trauma, alexithymia, and dissociation in their cumulative impact on the development of emotional disorders resulting in addiction.

摘要

目的

依恋理论是理解人类情感发展的一种广泛应用的范式。人们认识到,述情障碍是酗酒者采用非适应性情绪调节策略的关键因素。此外,童年早期创伤和解离也被认为起着重要作用。本研究对一个理论模型进行了检验,该模型探讨了酗酒者的依恋风格、创伤、述情障碍和解离之间的联系。

方法

研究参与者总数为268人,其中116名女性(占所有受试者的43%)和152名男性(占所有受试者的57%),年龄在18 - 73岁之间(平均年龄 = 39.19岁;标准差 = 13.45岁)。为了测量分析变量,使用了以下问卷:密歇根酒精ism筛查测试(MAST)、依恋风格问卷(ASQ)、20项多伦多述情障碍量表(TAS - 20)、创伤经历清单(TEC)和好奇经历调查(CES)。

结果

酗酒者组和非酗酒者组之间的比较分析显示,在依恋风格、创伤强度、述情障碍和解离方面存在统计学上的显著差异。使用结构方程模型(即AMOS和GLS)检验了理论模型与数据的拟合度,从而能够描述相关路径。通过对路径的分析发现,该模型与数据拟合良好,但只有在删除与依恋风格和成瘾直接联系的影响路径时才成立。这种影响是间接的,一方面源于情感和认知缺陷,即述情障碍,另一方面源于创伤经历的强度。如果考虑情境变量,即述情障碍和创伤,未发现解离对成瘾倾向发展有直接影响。焦虑 - 矛盾依恋风格与述情障碍(β = 0.389;p < 0.01)以及回避型依恋风格与述情障碍(β = 0.497;p < 0.01)之间被证明存在最强的直接关系,这表明它们是促进述情障碍发展以及与情感忽视和心理暴力相关创伤发生并最终导致成瘾的有力预测因素。

结论

我们的研究揭示了在发展模型背景下研究个体变量作用的重要性。这里所展示的科学成果的一个极其重要的要素是表明了创伤、述情障碍和解离在其对导致成瘾的情绪障碍发展的累积影响中的支柱作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6499/6993624/d12d2a537468/fpsyg-10-02957-g001.jpg

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