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COVID-19 相关恐惧和压力在经历过儿童虐待的个体中的表现:复杂创伤后应激障碍的中介作用。

COVID-19-related fear and stress among individuals who experienced child abuse: The mediating effect of complex posttraumatic stress disorder.

机构信息

Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.

Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.

出版信息

Child Abuse Negl. 2020 Dec;110(Pt 2):104694. doi: 10.1016/j.chiabu.2020.104694. Epub 2020 Aug 17.

Abstract

BACKGROUND

The COVID-19 pandemic exposes individuals not only to health-related risks, but also to psychosocial fear and acute stress. Previous studies reveal that individuals who experienced child abuse (CA), especially those who suffer from complex posttraumatic stress disorder (CPTSD), are at a higher risk of reacting with fear and stress when faced with stressful life-events.

OBJECTIVE

To test whether exposure to CA is implicated in a higher risk of COVID-19-related fear and acute stress, and whether CPTSD intervenes in such processes.

PARTICIPANTS AND SETTINGS

A convenience sample of 837 adults participated in the study during the first peak of COVID-19 in Israel.

METHODS

Participants completed self-report questionnaires, assessing child physical, sexual and emotional abuse, CPTSD (ITQ), COVID-19-related acute stress disorder (COVID-19 ASD; ASDS) and fear of COVID-19.

RESULTS

Bivariate analyses showed that participants who experienced CA were higher than participants who did not experience CA in COVID-19 ASD (p = .032), but not in fear of COVID-19 (p = .65). Mediation analyses demonstrated two significant paths: in the first, CA was associated with elevated fear of COVID-19 (effect = .061, .059; p < 0.05) and COVID-19 ASD (effect = .14, .084; p < 0.05) through the mediation of CPTSD; in the second path, when controlling for the mediation of CPTSD, CA was associated with reduced fear of COVID-19 (effect = -.15; p = 0.001), and COVID-19 ASD (effect = -.12; p = 0.024).

CONCLUSIONS

The findings reveal a complex pattern, indicating that CPTSD may be a risk factor for elevated levels of COVID-19 distress among individuals who experienced CA. However, some CA survivors may express reduced COVID-19 distress.

摘要

背景

COVID-19 大流行不仅使个体面临与健康相关的风险,还使个体面临心理社会恐惧和急性应激。先前的研究表明,经历过儿童期虐待(CA)的个体,尤其是患有复杂创伤后应激障碍(CPTSD)的个体,在面对应激性生活事件时,更有可能产生恐惧和应激反应。

目的

检验 CA 是否与 COVID-19 相关恐惧和急性应激的高风险有关,以及 CPTSD 是否介入这一过程。

参与者和设置

837 名成年人在以色列 COVID-19 首次高峰期间参与了这项研究。

方法

参与者完成了自我报告问卷,评估儿童期身体、性和情感虐待、CPTSD(ITQ)、COVID-19 相关急性应激障碍(COVID-19 ASD;ASDS)和对 COVID-19 的恐惧。

结果

双变量分析显示,经历过 CA 的参与者比没有经历过 CA 的参与者在 COVID-19 ASD 方面得分更高(p =.032),但在对 COVID-19 的恐惧方面没有差异(p =.65)。中介分析显示存在两条显著路径:在第一条路径中,CA 通过 CPTSD 与对 COVID-19 的恐惧(效应 =.061,.059;p < 0.05)和 COVID-19 ASD(效应 =.14,.084;p < 0.05)升高相关;在第二条路径中,当控制 CPTSD 的中介作用时,CA 与对 COVID-19 的恐惧降低(效应 = -.15;p = 0.001)和 COVID-19 ASD(效应 = -.12;p = 0.024)相关。

结论

研究结果揭示了一种复杂的模式,表明 CPTSD 可能是经历过 CA 的个体 COVID-19 痛苦水平升高的一个风险因素。然而,一些 CA 幸存者可能表现出对 COVID-19 痛苦的降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebf1/7430290/6f6f68c6a152/gr1_lrg.jpg

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