揭示交叉点:包括产后女性在内的受创伤临床样本中的分离性和类精神病性体验。
Unveiling the intersection: Dissociative and psychotic-like experiences among a trauma-exposed clinical sample including postpartum women.
作者信息
Monette Mahogany A, Minor Kyle S, Ward Marissa J, Miller Michelle L
机构信息
Department of Psychology, Indiana University Indianapolis.
Department of Psychiatry, Indiana University School of Medicine.
出版信息
Psychol Trauma. 2025 Jun 2. doi: 10.1037/tra0001926.
OBJECTIVE
Trauma exposure is associated with elevated risk for psychotic-like experiences, including subthreshold hallucinations and delusions. Dissociative symptoms may link these two experiences and warrant further exploration.
METHOD
The present study examined if dissociative symptoms accounted for additional variance in the association between posttraumatic stress disorder (PTSD) symptoms and hallucinations and delusions in a sample of patients ( = 63) seeking treatment for PTSD using the Dissociative Subtype of PTSD Scale; PTSD Checklist for Fifth Edition; and Diagnostic Interview for Anxiety, Mood, and Obsessive-Compulsive Disorder and Related Neuropsychiatric Disorders hallucinations and delusions screener in a sample of predominantly White women, the majority of whom met criteria for PTSD. Exploratory analyses were conducted to examine if the postpartum subsample endorsed our variables of interest more frequently than our overall sample.
RESULTS
As hypothesized, PTSD symptoms and dissociative symptoms exhibited a small, significant correlation with psychotic-like experiences. Furthermore, dissociative symptoms accounted for additional variance in our models in psychotic-like experiences; however, the additional variance accounted for did not reach the level of significance. However, this study was limited by cross-sectional data with a predominantly White, woman sample. Future studies should examine these associations longitudinally among marginalized groups.
CONCLUSIONS
Clinicians must provide thorough assessments to parse out PTSD symptoms, dissociative symptoms, and psychotic-like experiences, especially for clients seeking treatment for complex PTSD and/or a history of traumatic birth experience. Clinicians must conduct thorough assessments using validated tools like the Dissociative Experiences Scale and the Structured Interview for Psychosis-Risk Syndromes and could use interventions such as narrative exposure therapy that address maladaptive thoughts and dissociative experiences related to traumatic experiences. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
目的
创伤暴露与类似精神病性体验的风险升高有关,包括阈下幻觉和妄想。分离性症状可能将这两种体验联系起来,值得进一步探究。
方法
本研究在一个使用创伤后应激障碍(PTSD)分离亚型量表、《精神障碍诊断与统计手册》第五版PTSD检查表以及焦虑、情绪、强迫症及相关神经精神障碍诊断访谈中的幻觉和妄想筛查工具的样本中,检验了分离性症状是否在PTSD症状与幻觉和妄想之间的关联中解释了额外的方差变异。该样本主要为白人女性,她们中的大多数符合PTSD标准。进行了探索性分析,以检验产后子样本是否比总体样本更频繁地认可我们感兴趣的变量。
结果
正如所假设的,PTSD症状和分离性症状与类似精神病性体验呈现出小而显著的相关性。此外,分离性症状在我们关于类似精神病性体验的模型中解释了额外的方差变异;然而,所解释的额外方差变异未达到显著水平。然而,本研究受到横断面数据以及主要为白人女性样本的限制。未来的研究应该在边缘化群体中纵向研究这些关联。
结论
临床医生必须进行全面评估,以区分PTSD症状、分离性症状和类似精神病性体验,特别是对于寻求治疗复杂性PTSD和/或有创伤性分娩经历的患者。临床医生必须使用经过验证的工具,如分离体验量表和精神病风险综合征结构化访谈进行全面评估,并可以采用诸如叙事暴露疗法等干预措施,来处理与创伤经历相关的适应不良思维和分离性体验。(PsycInfo数据库记录(c)2025美国心理学会,保留所有权利)
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