Department of Psychology, Division of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands.
Psychologische Hochschule Berlin, Berlin, Germany.
Eur J Psychotraumatol. 2024;15(1):2348345. doi: 10.1080/20008066.2024.2348345. Epub 2024 May 13.
While several studies documented a positive correlation between childhood maltreatment severity and dissociation severity, it is currently unknown whether specific dissociative symptoms cluster together among individuals with childhood trauma histories ranging from none to severe. We aimed to explore symptom constellations across the whole spectrum of dissociative processing from patients with severe dissociative disorders to healthy controls and relate these to maltreatment severity and sociodemographic characteristics. We employed latent profile analysis to explore symptom profiles based on five subscales, measuring absorption, depersonalization, derealization, somatoform and identity alteration, based on the 20 items of the German short version of the Dissociative Experiences Scale-II (20) in a large aggregate sample ( = 3,128) overrepresenting patients with trauma-related disorders. We then related these profiles to maltreatment severity as measured by the five subscales of the Childhood Trauma Questionnaire as well as sociodemographic characteristics. Based on the five FDS subscales, six clusters differentiated by symptom severity, but not symptom constellations, were identified. Somatoform dissociation varied in accordance with the remaining symptom clusters. The cluster with the highest overall symptom severity entailed nearly all subjects diagnosed with Dissociative Identity Disorder and was characterized by extreme levels of childhood maltreatment. Both abuse and neglect were predictive of cluster membership throughout. The higher the severity of dissociative processing in a cluster, the more subjects reported high severity and multiplicity of childhood maltreatment. However, some subjects remain resilient to the development of dissociative processing although they experience extreme childhood maltreatment.
虽然有几项研究记录了儿童期虐待严重程度与解离严重程度之间的正相关关系，但目前尚不清楚在从无创伤史到严重创伤史的个体中，是否存在特定的分离症状群聚集在一起。我们旨在探索从严重分离障碍患者到健康对照组的整个分离处理过程中的症状组合，并将这些症状组合与虐待严重程度和社会人口学特征相关联。我们采用潜在剖面分析，根据 20 项德国短版分离体验量表-II（20）的五个分量表，即吸收、人格解体、现实解体、躯体化和身份改变，探索基于大样本（=3128）的症状模式，该样本主要代表与创伤相关的障碍患者。然后，我们将这些模式与童年期创伤问卷的五个分量表测量的虐待严重程度以及社会人口学特征相关联。基于五个 FDS 分量表，我们确定了六个根据症状严重程度而不是症状组合区分的聚类。躯体化分离与其他症状集群不一致。具有最高总体症状严重程度的聚类几乎包含所有被诊断为分离性身份障碍的患者，其特点是童年期虐待程度极高。虐待和忽视在整个过程中都是聚类成员的预测因素。聚类中分离处理的严重程度越高，报告的童年期虐待严重程度和多发性越高。然而，尽管一些个体经历了极端的童年期虐待，但他们仍然具有对分离性处理发展的抵抗力。
