Faculdade Israelita de Ciências da Saúde Albert Einstein, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
J Interpers Violence. 2023 Feb;38(3-4):4240-4266. doi: 10.1177/08862605221114151. Epub 2022 Jul 28.
Some individuals show abnormal reactions to extreme fear and life-threatening situations, including tonic immobility (TI) and peri-traumatic dissociation (PTD). We aimed to investigate the association of TI and PTD with posttraumatic stress disorder (PTSD) in women who experienced sexual violence and the risk factors for PTD occurrence. We compared PTSD severity in 86 young adult women with PTSD after a sexual violence exposure grouped according to the presence of PTD and TI. In addition, we investigated whether PTD is associated with depression and anxiety symptoms and assessed potential risk factors for PTD reaction. We found a significant positive correlation between PTSD severity and PTD occurrence ( = .132; = .001). PTD was also positively correlated with all clusters of PTSD symptoms except the Clinician-Administered PTSD Scale avoidance cluster ( = .058). PTD was strongly correlated with anxiety ( = .619; < .001) and depressive symptoms ( = .547; < .001). Multiple logistic regression showed that history of physical abuse (odds ratio []: 1.386; = .011) and sexual abuse (: 1.947; = .004) during childhood were associated with PTD occurrence. Other risk factors for PTD were having less years of study (: 0.216; = .016) and lower income (: 7.403; = .028). TI measures were available for a subsample of 29 women. We found no association between TI and PTSD severity. PTD, but not TI, is significantly associated with more severe PTSD, depressive, and anxiety symptoms. Less-educated women with a history of childhood abuse and a lower income are at risk of PTD occurrence during a sexual violence episode.
一些人在面对极度恐惧和危及生命的情况时会出现异常反应,包括强直不动(TI)和创伤前解离(PTD)。我们旨在研究 TI 和 PTD 与经历性暴力的女性创伤后应激障碍(PTSD)之间的关联,以及 PTD 发生的危险因素。我们比较了 86 名年轻成年女性在经历性暴力后 PTSD 的严重程度,这些女性根据是否存在 PTD 和 TI 进行分组。此外,我们还研究了 PTD 是否与抑郁和焦虑症状有关,并评估了 PTD 反应的潜在危险因素。我们发现 PTSD 严重程度与 PTD 发生率呈显著正相关( = .132; = .001)。PTD 还与 PTSD 症状的所有集群呈正相关,除了临床医生管理的 PTSD 量表回避集群( = .058)。PTD 与焦虑( = .619; < .001)和抑郁症状( = .547; < .001)呈强相关。多因素逻辑回归显示,童年时期有身体虐待史(比值比 []:1.386; = .011)和性虐待史(比值比 []:1.947; = .004)与 PTD 发生有关。PTD 的其他危险因素包括受教育年限较少(比值比 []:0.216; = .016)和收入较低(比值比 []:7.403; = .028)。TI 测量值可用于 29 名女性的亚样本。我们没有发现 TI 与 PTSD 严重程度之间的关联。PTD 与 PTSD、抑郁和焦虑症状更严重显著相关,而不是 TI。有童年虐待史和较低收入的受教育程度较低的女性在性暴力事件中发生 PTD 的风险较高。