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成年创伤样本中儿童期虐待亚型与创伤后应激障碍症状:睡眠的机制性作用

Subtypes of childhood maltreatment and posttraumatic stress disorder symptoms in an adult trauma sample: The mechanistic role of sleep.

作者信息

Harb Farah, González-Van Wart Alexandra, Brzezinski John, deRoon-Cassini Terri A, Larson Christine L

机构信息

Department of Psychology, University of Wisconsin-Milwaukee.

Department of Psychology, Marquette University.

出版信息

Psychol Trauma. 2025 Feb;17(2):353-362. doi: 10.1037/tra0001716. Epub 2024 May 2.

Abstract

OBJECTIVE

Childhood maltreatment is indisputably linked to adverse mental health outcomes, including an increased risk to develop posttraumatic stress disorder (PTSD) in adulthood. The role of childhood maltreatment in the context of recovery from a trauma later in adulthood is not well understood. A variable related to both childhood maltreatment and PTSD symptoms, and a potential link between the two, is sleep. The current study aimed to understand how sleep disturbances may play a mechanistic role in the effect of subtypes of childhood maltreatment on PTSD symptom severity in an adult trauma sample.

METHOD

160 adults (90 women; = 33.73, = 10.86) were recruited from the emergency department at a Level-1 trauma center in southeastern Wisconsin after experiencing a traumatic injury. Experiences of childhood maltreatment and sleep were self-reported at 2-week and 3-month posttrauma, respectively. PTSD symptoms were clinically assessed 6 months later.

RESULTS

Sleep disturbances 3-month posttrauma mediated the effect of emotional abuse, physical neglect, and emotional neglect on PTSD symptom 6 months after the traumatic injury. The effect of sexual and physical abuse on PTSD symptoms was not significantly mediated by sleep disturbances.

CONCLUSIONS

These findings highlight the differential impact of subtypes of childhood maltreatment on PTSD symptoms, the mechanistic role of sleep, and the need to consider early life adversity when assessing adult posttrauma experiences. These results also suggest that interventions aimed at improving sleep quality might improve PTSD symptoms in those who have experienced childhood maltreatment and a subsequent traumatic injury in adulthood. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

摘要

目的

儿童期受虐与不良心理健康后果无疑存在关联,包括成年后患创伤后应激障碍(PTSD)的风险增加。儿童期受虐在成年后期从创伤中恢复的背景下所起的作用尚未得到充分理解。睡眠是一个与儿童期受虐和PTSD症状均相关的变量,也是两者之间的一个潜在联系。本研究旨在了解睡眠障碍在成年创伤样本中,如何在儿童期受虐亚型对PTSD症状严重程度的影响中发挥机制性作用。

方法

从威斯康星州东南部一级创伤中心的急诊科招募了160名成年人(90名女性;年龄 = 33.73岁,标准差 = 10.86),他们均经历过创伤性损伤。分别在创伤后2周和3个月时自我报告儿童期受虐经历和睡眠情况。6个月后对PTSD症状进行临床评估。

结果

创伤后3个月的睡眠障碍介导了情感虐待、身体忽视和情感忽视对创伤性损伤后6个月PTSD症状的影响。性虐待和身体虐待对PTSD症状的影响未通过睡眠障碍得到显著介导。

结论

这些发现突出了儿童期受虐亚型对PTSD症状的不同影响、睡眠的机制性作用,以及在评估成人创伤后经历时考虑早期生活逆境的必要性。这些结果还表明,旨在改善睡眠质量的干预措施可能会改善那些经历过儿童期受虐并在成年后遭受后续创伤性损伤的人的PTSD症状。(PsycInfo数据库记录(c)2025美国心理学会,保留所有权利)

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