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依恋和情绪调节障碍在城市内样本中儿童期虐待与 PTSD 之间的关系中的作用。

The roles of attachment and emotion dysregulation in the association between childhood maltreatment and PTSD in an inner-city sample.

机构信息

Department of Psychology, Pennsylvania State University, USA.

Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, USA; Atlanta VA Medical Center, Mental Health Services, USA.

出版信息

Child Abuse Negl. 2021 Aug;118:105139. doi: 10.1016/j.chiabu.2021.105139. Epub 2021 Jun 3.

Abstract

BACKGROUND

Most people will experience a traumatic event in their lifetime, but only a subset (<10%) will develop posttraumatic stress disorder (PTSD).

OBJECTIVE

To facilitate prevention and intervention of PTSD, it is important to understand how risk and resilience factors interact with one another to explain individual differences in risk for PTSD, especially in underprivileged groups, who often experience greater burden of trauma and PTSD.

METHOD

The current study utilized multiple and moderated regression to examine the relation between childhood maltreatment and adulthood PTSD risk in the context of various attachment patterns and emotion dysregulation in a sample (n = 856) of mostly low-income, African American participants.

RESULTS

Moderation analysis indicated that the strongest association between self-reported childhood maltreatment and PTSD symptoms was manifest in participants reporting the highest levels of both attachment anxiety and attachment avoidance (b = 0.22, 95% CI [0.15, 0.29], p < .001), whereas, among those low on both these dimensions (i.e., more securely attached participants), there was no significant association between childhood maltreatment and current PTSD (b = 0.07, 95% CI [-0.01, 0.14], p = .07). Separately, multiple regression predicting current PTSD symptoms revealed an effect size for the two attachment dimensions similar to that of emotion dysregulation, while controlling for childhood maltreatment.

CONCLUSIONS

These findings suggest more secure attachment may buffer against the deleterious effects of childhood maltreatment, and both attachment difficulties and emotion dysregulation serve as robust correlates of adulthood PTSD.

摘要

背景

大多数人在一生中都会经历创伤性事件,但只有一小部分(<10%)会发展为创伤后应激障碍(PTSD)。

目的

为了促进 PTSD 的预防和干预,了解风险和弹性因素如何相互作用以解释 PTSD 风险的个体差异非常重要,特别是在弱势群体中,他们经常经历更大的创伤和 PTSD 负担。

方法

本研究在一个主要由低收入、非裔美国参与者组成的样本(n=856)中,利用多种和调节回归来检查在各种依恋模式和情绪调节的背景下,童年期虐待与成年期 PTSD 风险之间的关系。

结果

调节分析表明,在报告最高水平的依恋焦虑和依恋回避的参与者中(b=0.22,95%CI [0.15,0.29],p<.001),自我报告的童年期虐待与 PTSD 症状之间的最强关联,而在这两个维度都较低的参与者中(即更安全依恋的参与者),童年期虐待与当前 PTSD 之间没有显著关联(b=0.07,95%CI [0.01,0.14],p=0.07)。另外,预测当前 PTSD 症状的多元回归显示,这两个依恋维度的效应大小与情绪调节相似,同时控制了童年期虐待。

结论

这些发现表明,更安全的依恋可能会缓冲童年期虐待的有害影响,而依恋困难和情绪调节都是成年 PTSD 的强有力相关因素。

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