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创伤后认知可预测分离性身份障碍女性的扭曲身体知觉。

Posttraumatic cognitions predict distorted body perceptions in women with dissociative identity disorder.

机构信息

McLean Hospital, Belmont, MA, USA.

McLean Hospital, Belmont, MA, USA; Department of Psychology, Northern Illinois University, USA.

出版信息

J Psychiatr Res. 2021 Feb;134:166-172. doi: 10.1016/j.jpsychires.2020.12.053. Epub 2020 Dec 19.

Abstract

BACKGROUND

Dissociative identity disorder (DID) is a psychobiological syndrome associated with a history of exposure to childhood abuse and neglect. The consequences of these traumatic events often include a profound impact on the way individuals inhabit and experience their bodies. Despite this, there is a paucity of empirical research on the subject. The aim of this study was to systematically document the occurrence of distorted body perceptions in DID and examine childhood maltreatment, posttraumatic stress disorder (PTSD) symptom severity, and posttraumatic cognitions as predictors of distorted body perceptions in DID.

METHODS

Participants were adult women with histories of childhood abuse and neglect and a current DID diagnosis receiving treatment at a psychiatric care facility. Data were obtained through a battery of self-report measures, including the Body Uneasiness Test, Childhood Trauma Questionnaire, PTSD Checklist for DMS-5, and Posttraumatic Cognitions Inventory.

RESULTS

A series of unpaired t-tests documented elevated levels of weight phobia, body image concerns, body avoidance, compulsive self-monitoring, and depersonalization in DID compared to published non-clinical data on the Body Uneasiness Test. A series of multiple regression models including measures of childhood trauma, PTSD symptoms, and posttraumatic cognitions demonstrated that over and above childhood trauma and PTSD symptom severity, posttraumatic cognitions significantly predicted distorted body perceptions.

CONCLUSIONS

In a treatment-seeking sample of women with DID, distorted body perceptions were elevated. Furthermore, posttraumatic cognitive distortions significantly predicted distorted body perceptions when controlling for childhood maltreatment and PTSD symptom severity. This suggests that distorted cognitions are a key target for therapeutic intervention.

摘要

背景

分离性身份障碍(DID)是一种与儿童期虐待和忽视史相关的心理生物学综合征。这些创伤事件的后果常常包括对个体体验和感知身体的方式产生深远影响。尽管如此,关于这一主题的实证研究却很少。本研究旨在系统记录 DID 中扭曲的身体感知的发生,并研究童年期虐待、创伤后应激障碍(PTSD)症状严重程度和创伤后认知作为 DID 中扭曲的身体感知的预测因素。

方法

参与者为在精神保健机构接受治疗的有儿童期虐待和忽视史且目前患有 DID 的成年女性。通过一系列自我报告措施获取数据,包括身体不适测试、儿童期创伤问卷、DSM-5 创伤后检查表和创伤后认知清单。

结果

一系列非配对 t 检验记录了 DID 组在体重恐惧症、身体意象问题、身体回避、强迫性自我监测和人格解体方面的水平高于身体不适测试发表的非临床数据。一系列包括童年创伤、PTSD 症状和创伤后认知的多元回归模型表明,除了童年创伤和 PTSD 症状严重程度之外,创伤后认知显著预测了扭曲的身体感知。

结论

在一个寻求治疗的 DID 女性样本中,扭曲的身体感知升高。此外,在控制童年期虐待和 PTSD 症状严重程度后,创伤后认知扭曲显著预测了扭曲的身体感知。这表明扭曲的认知是治疗干预的关键目标。

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