Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University Zurich, Neumunsterallee 3, P.O. Box 233, 8032, Zurich, Switzerland.
Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wurzburg, Würzburg, Germany.
J Neural Transm (Vienna). 2021 Sep;128(9):1433-1443. doi: 10.1007/s00702-021-02404-1. Epub 2021 Aug 14.
The study presented in the following verifies some assumptions of the novel 'unsafe world' model of selective mutism (SM). According to this model, SM is a stress reaction to situations erroneously experienced via cognition without awareness as 'unsafe'. It assumes a high sensitivity to unsafety, whereby the nervous system triggers dissociation or freeze mode at relatively low thresholds. We examine whether there is a correlation between SM, sensory-processing sensitivity and dissociation. We compared a sample of 28 children and adolescents with SM (mean age 12.66 years; 18 females) to 33 controls without SM (mean age 12.45 years; 21 females). Both groups were compared using a medical history sheet, the 'Selective Mutism Questionnaire' (SMQ), a 'Checklist for Speaking Behaviour' (CheckS), the 'Highly Sensitive Person Scale' (HSPS), the 'Child Dissociative Checklist' (CDC), the 'Adolescent Dissociative Experience Scale' (A-DES) and the 'Social Phobia and Anxiety Inventory for Children' (SPAIK). Appropriate parametric and non-parametric tests were conducted to examine differences between groups. The results indicate that sensory-processing sensitivity was significantly higher in the group of children and adolescents with SM [X(1) = 7.224, p = 0.0007; d = 1.092]. Furthermore, dissociative symptoms were more common in children and adolescents with SM than in controls [F(1, 33) = 13.004, p = 0.001; d = 0.986]. The results indicate that sensory-processing sensitivity and dissociation are important factors of SM that may hold important implications for the treatment. TRIAL REGISTRATION: This study is registered with the ClinicalTrials.gov number NCT04233905.
本研究验证了选择性缄默症（SM）新的“不安全世界”模型中的一些假设。根据该模型，SM 是对通过认知错误地体验为“不安全”的情境的应激反应。它假设对不安全的高度敏感性，即神经系统在相对较低的阈值下触发解离或冻结模式。我们检查 SM、感觉处理敏感性和解离之间是否存在相关性。我们比较了 28 名患有 SM 的儿童和青少年（平均年龄 12.66 岁；18 名女性）与 33 名无 SM 的对照组（平均年龄 12.45 岁；21 名女性）。使用病史表、“选择性缄默症问卷”（SMQ）、“说话行为检查表”（CheckS）、“高度敏感人士量表”（HSPS）、“儿童解离检查表”（CDC）、“青少年解离体验量表”（A-DES）和“儿童社交恐惧症和焦虑量表”（SPAIK）比较两组。进行适当的参数和非参数检验以检查组间差异。结果表明，患有 SM 的儿童和青少年的感觉处理敏感性明显更高 [X(1) = 7.224，p = 0.0007；d = 1.092]。此外，患有 SM 的儿童和青少年的解离症状比对照组更为常见 [F(1, 33) = 13.004，p = 0.001；d = 0.986]。结果表明，感觉处理敏感性和解离是 SM 的重要因素，这可能对治疗具有重要意义。试验注册：本研究在 ClinicalTrials.gov 注册号为 NCT04233905。
