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自耻感在儿童期虐待与 PTSD、抑郁和焦虑症状水平之间起中介作用。

Self-stigma mediates the relationships between childhood maltreatment and symptom levels of PTSD, depression, and anxiety.

机构信息

Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.

New York State Psychiatric Institute, New York, NY, USA.

出版信息

Eur J Psychotraumatol. 2024;15(1):2370174. doi: 10.1080/20008066.2024.2370174. Epub 2024 Jul 10.

Abstract

Childhood maltreatment is a risk factor for developing multiple forms of psychopathology, including depression, posttraumatic stress disorder (PTSD), and anxiety. Yet, the mechanisms linking childhood maltreatment and these psychopathologies remain less clear. Here we examined whether self-stigma, the internalization of negative stereotypes about one's experiences, mediates the relationship between childhood maltreatment and symptom severity of depression, PTSD, and anxiety. Childhood trauma survivors (= 685, age = 36.8) were assessed for childhood maltreatment, self-stigma, and symptoms of depression, PTSD, and anxiety. We used mediation analyses with childhood maltreatment as the independent variable. We then repeated these mediation models separately for childhood abuse and neglect, as well as the different subtypes of childhood maltreatment. Self-stigma significantly mediated the relationship between childhood maltreatment and depression, PTSD, and anxiety symptoms. For sexual abuse - but not physical or emotional abuse - a significant mediation effect of self-stigma emerged on all symptom types. For childhood neglect, self-stigma significantly mediated the relationship between both emotional and physical neglect and all symptom types. Our cross-sectional study suggests that different types of childhood maltreatment experiences may relate to distinct mental health problems, potentially linked to increased self-stigma. Self-stigma may serve as an important treatment target for survivors of childhood abuse and neglect.

摘要

儿童虐待是发展多种精神病理学的风险因素,包括抑郁症、创伤后应激障碍(PTSD)和焦虑症。然而,将儿童虐待与这些精神病理学联系起来的机制仍不明确。在这里,我们研究了自我污名化(对自己经历的负面刻板印象的内化)是否在儿童虐待与抑郁、PTSD 和焦虑症状严重程度之间起中介作用。对 685 名童年创伤幸存者(年龄=36.8 岁)进行了儿童虐待、自我污名化以及抑郁、PTSD 和焦虑症状的评估。我们使用中介分析,将儿童虐待作为自变量。然后,我们分别针对儿童期虐待和忽视,以及儿童虐待的不同亚型,重复了这些中介模型。自我污名化显著中介了儿童虐待与抑郁、PTSD 和焦虑症状之间的关系。对于性虐待 - 而不是身体或情感虐待 - 自我污名化在所有症状类型上都表现出显著的中介效应。对于儿童忽视,自我污名化显著中介了情感忽视和身体忽视与所有症状类型之间的关系。我们的横断面研究表明,不同类型的儿童虐待经历可能与不同的心理健康问题有关,这可能与自我污名化的增加有关。自我污名化可能是儿童期虐待和忽视幸存者的一个重要治疗目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/040e/11238652/1c920a86e062/ZEPT_A_2370174_F0001_OB.jpg

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