Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Germany; Diagnostics in Healthcare and E-Health, University of Trier, Germany.
J Affect Disord. 2021 Aug 1;291:126-134. doi: 10.1016/j.jad.2021.05.006. Epub 2021 May 14.
The broad range of adverse health outcomes following child maltreatment (child maltreatment) underscores the need to investigate shared trajectories that contribute to associated physical and mental health problems. Previous research focused on different mechanisms, such as emotion regulation or attachment. In the present study, we propose personality functioning, comprising self- and interpersonal regulation and perception, to mediate between child maltreatment and mental and physical health.
In a German representative sample (N = 2,508), we assessed remembered child maltreatment, levels of personality functioning, and different health outcomes in adulthood, namely somatic symptoms, general mental distress, and body dysmorphic concern. We conducted path analyses to investigate mediation effects in the total sample as well as in female and male subsamples.
Child maltreatment significantly predicted the assessed health outcomes and showed significant associations with lower levels of personality functioning. Personality functioning partially mediated all health outcomes assessed by significant indirect effects and lowered direct effects of child maltreatment on health outcomes. An exploratory analysis of different facets of personality functioning revealed a pronounced impact of identity perception and self-reflective capacities in mediating between child maltreatment and physical and mental health. Comparable results were found in female and male participants.
Major limitations of the study are the reliance on cross-sectional data and the use of a screening measure to assess experienced child maltreatment.
Personality functioning may represent a transdiagnostic link to different somatic and psychological symptoms in the aftermath of child maltreatment.
儿童虐待（child maltreatment）会导致广泛的健康不良后果，这突显了需要研究导致相关身心健康问题的共同轨迹。以前的研究侧重于不同的机制，如情绪调节或依恋。在本研究中，我们提出人格功能，包括自我和人际调节和感知，来介导儿童虐待与心理和身体健康之间的关系。
在德国有代表性的样本（N=2508）中，我们评估了成年后记忆中的儿童虐待、人格功能水平以及不同的健康结果，即躯体症状、一般心理困扰和身体变形障碍。我们进行了路径分析，以调查总样本以及女性和男性亚样本中的中介效应。
儿童虐待显著预测了评估的健康结果，与较低的人格功能水平显著相关。人格功能部分中介了所有评估的健康结果，通过显著的间接效应降低了儿童虐待对健康结果的直接影响。对人格功能不同方面的探索性分析表明，身份感知和自我反思能力在儿童虐待与身心健康之间的中介作用中起着重要作用。在女性和男性参与者中也发现了类似的结果。
该研究的主要局限性是依赖于横断面数据和使用筛选措施来评估经历过的儿童虐待。
人格功能可能代表了儿童虐待后不同躯体和心理症状的一种跨诊断联系。
