Wayne State University School of Social Work, 5447 Woodward Avenue, Detroit, MI 48202, United States of America.
Department of Obstetrics and Gynecology, Albany Medical Center, 391 Myrtle Ave #2, Albany, NY 12208, United States of America.
Child Abuse Negl. 2022 Sep;131:105744. doi: 10.1016/j.chiabu.2022.105744. Epub 2022 Jun 21.
High betrayal trauma (HBT), or interpersonal trauma perpetrated by someone close, is linked to dissociation and shame, while trauma perpetrated by someone less close, low betrayal trauma (LBT) is associated with post-traumatic stress disorder (PTSD).
Child interpersonal trauma is common among women with chronic pelvic pain (CPP) and can negatively impact physical and mental health-related quality of life (HRQOL). Our study investigates unexplored connections between these variables.
PARTICIPANTS & SETTING: Survey data were analyzed from 96 English-speaking female patients with CPP at a women's health clinic (mean age = 33, 59 % White non-Hispanic, 62 % married or cohabitating, 61.5 % completed post-high school degree); prevalence of HBT and LBT were 65.2 % and 45.6 %, respectively.
Multiple regression analyzed relationships between mental and physical HRQOL and dissociation, shame, and PTSD. Parallel mediation analyses examined indirect relationships between mental and physical HRQOL and exposure to childhood HBT and LBT.
Dissociation was related to worse physical HRQOL, while shame was related to worse physical and mental HRQOL. Dissociation and shame mediated relationships between childhood HBT and current mental (R = 0.08, p = .01) and physical (R = 0.11, p = .002) HRQOL. Shame, but not PTSD, mediated relationships between childhood LBT and current mental (R = 0.14, p < .001) and physical (R = 0.16, p < .001) HRQOL.
Our study provides preliminary evidence that dissociation and shame negatively impact HRQOL among individuals with CPP in the context of exposure to different types of childhood betrayal trauma. Replication studies to validate our results with larger samples and longitudinal designs are encouraged.
高度背叛创伤（HBT），或由亲近的人实施的人际创伤，与解离和羞耻感有关，而由不太亲近的人实施的创伤，即低度背叛创伤（LBT），则与创伤后应激障碍（PTSD）有关。
儿童人际创伤在慢性盆腔疼痛（CPP）女性中较为常见，会对身心健康相关生活质量（HRQOL）产生负面影响。我们的研究探讨了这些变量之间未被探索的联系。
对一家妇女健康诊所的 96 名讲英语的 CPP 女性患者的调查数据进行了分析（平均年龄 33 岁，59%为白人非西班牙裔，62%已婚或同居，61.5%完成高中后教育）；HBT 和 LBT 的患病率分别为 65.2%和 45.6%。
多元回归分析了精神和身体 HRQOL 与解离、羞耻和 PTSD 之间的关系。平行中介分析考察了精神和身体 HRQOL 与儿童期 HBT 和 LBT 暴露之间的间接关系。
解离与较差的身体 HRQOL 相关，而羞耻与较差的身体和精神 HRQOL 相关。童年 HBT 与当前精神（R=0.08，p=0.01）和身体（R=0.11，p=0.002）HRQOL 之间的关系由解离和羞耻感中介。羞耻感，但不是 PTSD，在儿童 LBT 与当前精神（R=0.14，p<.001）和身体（R=0.16，p<.001）HRQOL 之间的关系中起中介作用。
我们的研究提供了初步证据，表明在暴露于不同类型的儿童期背叛创伤的情况下，解离和羞耻感会对 CPP 个体的 HRQOL 产生负面影响。鼓励使用更大样本和纵向设计的复制研究来验证我们的结果。
