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分离性障碍患者的分离诱导羞耻感:使用 vignettes 评估关系背景的影响。

Dissociation-Induced Shame in Those with a Dissociative Disorder: Assessing the Impact of Relationship context using Vignettes.

作者信息

Dorahy Martin J, Yogeeswaran Kumar, Middleton Warwick

机构信息

School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand.

The Cannan Institute, Belmont Private Hospital, Brisbane, Australia.

出版信息

J Trauma Dissociation. 2023 Oct-Dec;24(5):674-691. doi: 10.1080/15299732.2023.2195402. Epub 2023 Mar 29.

Abstract

Some evidence in non-clinical groups suggests that the relationship context in which dissociation is experienced might moderate its association with shame. The current study used vignettes detailing either dissociative symptoms or the expression of sadness occurring in three different relationship contexts: with a friend, an acquaintance, or when alone. Ratings of emotional (e.g. shame, anxiety) and behavioral (e.g. leave, talk) reactions were made on single-item measures, and shame feelings were further assessed with the State Shame Scale. Participants were in treatment for either dissociative identity disorder ( = 31) or other specified dissociative disorder ( = 3;  = 34). Feelings of shame were elevated in the acquaintance condition compared to when with a close friend or alone regardless of whether dissociation or sadness was experienced. In the acquaintance context, participants exposed to dissociation or sadness reported feeling annoyed at themselves, having a greater desire to leave, and a lesser desire to talk compared to when these experiences happened with a close friend or alone. Results suggest those with a dissociative disorder appraise themselves as more vulnerable to shame if experiencing dissociation or sadness when with an acquaintance, potentially because the risk of not being understood and rejected is heightened.

摘要

非临床群体中的一些证据表明,体验分离的关系背景可能会调节其与羞耻感的关联。本研究使用了一些短文,详细描述了在三种不同关系背景下出现的分离症状或悲伤情绪表达:与朋友在一起、与熟人在一起或独自一人时。通过单项测量对情绪(如羞耻感、焦虑)和行为(如离开、交谈)反应进行评分,并使用状态羞耻量表进一步评估羞耻感。参与者患有分离性身份障碍(n = 31)或其他特定分离性障碍(n = 3;n = 34)正在接受治疗。与和亲密朋友在一起或独自一人时相比,在与熟人在一起的情况下,无论经历的是分离还是悲伤,羞耻感都会增强。在与熟人在一起的背景下,与和亲密朋友在一起或独自一人经历这些情况相比,经历分离或悲伤的参与者报告称对自己感到恼火,更想离开,而交谈的欲望更低。结果表明,患有分离性障碍的人如果在与熟人在一起时经历分离或悲伤,会认为自己更容易感到羞耻,这可能是因为不被理解和被拒绝的风险增加了。

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