Department of Psychiatry and Clinical Psychology, Zahedan University of Medical Sciences, Zahedan, Iran.
Department of Psychology, Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
BMC Psychiatry. 2021 May 24;21(1):266. doi: 10.1186/s12888-021-03290-3.
Although numerous studies have supported the role of childhood maltreatment in the etiology of psychosis, underlying mechanisms have not been well understood yet. The present study aimed to investigate the mediating role of particular forms of dissociation in the relationship between five major types of childhood abuse and psychotic symptoms among patients with schizophrenia spectrum and other psychotic disorders.
In this cross-sectional correlation study, 70 first-episode psychotic patients and 70 chronic psychotic patients were selected by systematic random sampling (with the sampling interval of 3) from among inpatients and outpatients referring to Baharan Psychiatric hospital, Zahedan, Iran, and were matched based on age, gender, and education level. Moreover, 70 age-, gender-, and education level-matched community controls were recruited from hospital staff and their relatives and friends. All of the participants completed a research interview and questionnaires. Data on experiences of childhood maltreatment, psychosis, dissociation, and demographics were collected and analyzed by SPSS V25 software.
The obtained results revealed that the mean scores of sexual abuse, emotional abuse, and physical abuse were higher in psychotic patients than community controls (without any significant difference between first-episode psychotic patients and chronic psychotic patients). Furthermore, the highest mean scores of dissociative experiences belonged to chronic psychotic patients. Multiple-mediation also indicated that absorption and dissociative amnesia played a mediating role in the relationship between sexual abuse and positive symptoms. Moreover, this study demonstrated the role of physical abuse in predicting psychotic symptoms even in the absence of sexual abuse.
This study illustrated specific associations among childhood maltreatment, dissociative experiences, and psychotic symptoms in the clinical population. Thus, to provide appropriate interventions, patients with schizophrenia spectrum and other psychotic disorders were asked about a wide range of possible adverse childhood experiences and dissociative experiences. Nevertheless, further studies using prospective or longitudinal designs need to be carried out to realize the differential contribution of various forms of childhood maltreatment and their potential interactions, more precisely.
尽管许多研究支持儿童期虐待在精神病发病机制中的作用，但潜在机制仍未得到很好的理解。本研究旨在调查特定形式的分离在五种主要类型的儿童虐待与精神分裂症谱系和其他精神病障碍患者的精神病症状之间的关系中的中介作用。
在这项横断面相关性研究中，通过系统随机抽样（抽样间隔为 3）从伊朗扎黑丹巴兰精神病院的住院患者和门诊患者中选择了 70 名首发精神病患者和 70 名慢性精神病患者，并根据年龄、性别和教育水平进行匹配。此外，从医院工作人员及其亲属和朋友中招募了 70 名年龄、性别和教育水平匹配的社区对照者。所有参与者都完成了一项研究访谈和问卷调查。使用 SPSS V25 软件收集和分析有关童年期虐待、精神病、分离和人口统计学数据。
研究结果表明，性虐待、情感虐待和身体虐待的平均得分在精神病患者中高于社区对照组（首发精神病患者和慢性精神病患者之间没有显著差异）。此外，分离体验的平均得分最高的是慢性精神病患者。多重中介分析表明，吸收和分离性遗忘在性虐待与阳性症状之间起中介作用。此外，本研究表明，即使没有性虐待，身体虐待也可以预测精神病症状。
本研究说明了临床人群中儿童期虐待、分离体验和精神病症状之间的特定关联。因此，为了提供适当的干预措施，要求精神分裂症谱系和其他精神病障碍患者广泛询问可能的不良童年经历和分离体验。然而，需要进一步开展使用前瞻性或纵向设计的研究，以更准确地了解各种形式的儿童虐待的差异贡献及其潜在相互作用。
