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儿童虐待会带来痛苦吗?对儿童虐待中创伤周围疼痛的探索。

Is Child Maltreatment Painful? An Exploration of Peritraumatic Pain in Child Maltreatment.

作者信息

Tsur Noga, Katz Carmit, Shemesh Nofar

机构信息

Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.

The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel.

出版信息

J Child Adolesc Trauma. 2025 Jan 4;18(2):293-303. doi: 10.1007/s40653-024-00682-x. eCollection 2025 Jun.

Abstract

Substantial findings point to the risk of chronic pain following child maltreatment (CM). However, a coherent explanation for the mechanisms underlying pain following CM is lacking. Although peritraumatic pain may encompass a significant role in these processes, a systematic quantification of peritraumatic pain in CM has never been conducted. This study was conducted to provide an initial exploration of peritraumatic pain characteristics in CM, and its links with CM characteristics, pain expression, and later posttraumatic outcomes. Two samples of adult CM survivors ( = 160 and  = 120, respectively) filled out self-report questionnaires assessing peritraumatic pain characteristics, CM characteristics, peritraumatic dissociation, and complex posttraumatic-stress symptoms (cPTSD). Peritraumatic pain was reported by 42.2% (76 participants) and 57% (69 participants) in Samples 1 and 2, respectively. While pain was most prevalent in physical abuse (90%), it was also prevalent in sexual (63%) and emotional abuse (37.5%; (3) = 14.65,  = .002). Peritraumatic pain was most prevalent when the perpetrator was a family member ( (3) = 14.65,  = .002), longer CM duration ( < .001), and in fight-or-flight peritraumatic responses ( (2) = 7.13,  = .028). Peritraumatic pain expression did not differ for CM type ( > .083), and most participants reported that the perpetrator ignored their pain (73.9%). Explicit and concealing expressions of pain were associated with later cPTSD symptoms ( < .047). The findings provide an initial understanding of peritraumatic pain characteristics and phenomenology, demonstrating that pain is a substantial constituent of CM experiences and potential posttraumatic outcomes.

摘要

大量研究结果表明儿童虐待(CM)后存在慢性疼痛风险。然而,对于CM后疼痛的潜在机制,目前尚无连贯的解释。尽管创伤期间疼痛可能在这些过程中起重要作用,但从未对CM中的创伤期间疼痛进行过系统量化。本研究旨在初步探索CM中创伤期间疼痛的特征,及其与CM特征、疼痛表现和后期创伤后结果的联系。两组成年CM幸存者样本(分别为160人和120人)填写了自我报告问卷,评估创伤期间疼痛特征、CM特征、创伤期间解离和复杂创伤后应激症状(cPTSD)。样本1和样本2中分别有42.2%(76名参与者)和57%(69名参与者)报告了创伤期间疼痛。虽然疼痛在身体虐待中最为普遍(90%),但在性虐待(63%)和情感虐待中也很常见(37.5%;χ²(3)=14.65,p=.002)。当施暴者为家庭成员时,创伤期间疼痛最为普遍(χ²(3)=14.65,p=.002),CM持续时间越长(p<.001),以及在战斗或逃跑的创伤期间反应中(χ²(2)=7.13,p=.028)。创伤期间疼痛表现因CM类型而异(p>.083),大多数参与者报告施暴者忽视了他们的疼痛(73.9%)。疼痛的显性和隐性表达与后期cPTSD症状相关(p<.047)。这些发现为创伤期间疼痛特征和现象学提供了初步认识,表明疼痛是CM经历和潜在创伤后结果的重要组成部分。

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本文引用的文献

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Peritraumatic Pain in Child Maltreatment: A Systematic Literature Review.儿童虐待中的创伤后疼痛:系统文献综述。
Trauma Violence Abuse. 2024 Jul;25(3):1725-1736. doi: 10.1177/15248380231194069. Epub 2023 Sep 1.

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