Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands.
Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.
Eur J Psychotraumatol. 2024;15(1):2367179. doi: 10.1080/20008066.2024.2367179. Epub 2024 Jun 27.
Childhood maltreatment (CM) can be divided into: emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN). CM is associated with (Complex)Posttraumatic stress disorder (PTSD/CPTSD) and substance use disorder (SUD). This cross-sectional study examined the relationships between CM-subtypes with PTSD-severity and CPTSD in patients with SUD-PTSD. Participants ( = 209) were treatment-seeking SUD-PTSD patients who completed the Childhood Trauma Questionnaire-short form, the Clinician-Administered PTSD Scale for DSM-5 and the International Trauma Questionnaire. Regression analyses and a model selection procedure to select an optimal model were used to examine CM-subtypes as predictors of (C)PTSD, adjusted for sex and age. Total CM and all CM-types significantly predicted PTSD-severity in the univariate regression analysis, with EA begin the strongest predictor. In the multiple regression only SA predicted PTSD-severity. Subsequently, model selection indicated that the optimal model to predict PTSD-severity included EA and SA. In the univariate analyses total CM, EA, and PN significantly predicted CPTSD-classification, and total CM and all CM-types significantly predicted CPTSD-severity. In the multiple regression for CPTSD-classification only EA and PA were significant predictors and for CPTSD-severity EA, PA and SA were significant predictors. In post-hoc multiple regression analyses, only EA was a significant predictor of CPTSD-classification and CPTSD-severity. Finally, in the model selection the most parsimonious model only included EA for both CPTSD-classification and CPTSD-severity. Sex was not a moderator in the relationship between CM and PTSD, nor in CM and CPTSD. These findings indicate that for SUD-PTSD patients, several CM-types have predictive value for (C)PTSD-severity, however SA and especially EA appear to contribute to these complaints. Since EA does not constitute an A-criterion, it is generally more overlooked in PTSD treatment. Its impact should therefore be underlined, and clinicians should be attentive to EA in their treatment.
儿童虐待（CM）可分为：情感虐待（EA）、身体虐待（PA）、性虐待（SA）、情感忽视（EN）和身体忽视（PN）。CM 与（复杂）创伤后应激障碍（PTSD/CPTSD）和物质使用障碍（SUD）有关。本横断面研究调查了 SUD-PTSD 患者中 CM 亚型与 PTSD 严重程度和 CPTSD 的关系。参与者（n=209）为寻求治疗的 SUD-PTSD 患者，他们完成了儿童期创伤问卷-短式、临床医生管理的 PTSD 量表 5 版和国际创伤问卷。回归分析和模型选择程序用于检查 CM 亚型作为（C）PTSD 的预测因子，调整性别和年龄。在单变量回归分析中，总 CM 和所有 CM 类型均显著预测 PTSD 严重程度，EA 是最强的预测因子。在多元回归中，只有 SA 预测 PTSD 严重程度。随后，模型选择表明，预测 PTSD 严重程度的最佳模型包括 EA 和 SA。在单变量分析中，总 CM、EA 和 PN 显著预测 CPTSD 分类，总 CM 和所有 CM 类型显著预测 CPTSD 严重程度。在多元回归中，只有 EA 和 PA 是 CPTSD 分类的显著预测因子，EA、PA 和 SA 是 CPTSD 严重程度的显著预测因子。在事后多元回归分析中，只有 EA 是 CPTSD 分类和 CPTSD 严重程度的显著预测因子。最后，在模型选择中，最简约的模型仅包括 EA 用于 CPTSD 分类和 CPTSD 严重程度。性别不是 CM 与 PTSD 之间关系的调节因素，也不是 CM 与 CPTSD 之间关系的调节因素。这些发现表明，对于 SUD-PTSD 患者，几种 CM 类型对（C）PTSD 严重程度具有预测价值，然而 SA 尤其是 EA 似乎对这些投诉有贡献。由于 EA 不构成 A 标准，因此在 PTSD 治疗中通常更容易被忽视。因此，应该强调其影响，临床医生应该在治疗中注意 EA。
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