Luntz B K, Widom C S
University at Albany School of Criminal Justice, NY 12222.
Am J Psychiatry. 1994 May;151(5):670-4. doi: 10.1176/ajp.151.5.670.
the authors' goal in this study was to examine the extent to which having been abused and/or neglected in childhood raises a person's risk for having an adult DSM-III-R diagnosis of antisocial personality disorder.
Children who had experienced substantiated child abuse and/or neglect from 1967 to 1971 in a Midwestern metropolitan county area were matched on the basis of age, race, sex, and approximate family social class with a group of nonabused and nonneglected children and followed prospectively into young adulthood. Subjects were located and participated in a 2-hour interview consisting of a series of structured and semistructured questions, rating scales, and a psychiatric assessment using the National Institute of Mental Health Diagnostic Interview Schedule. Interviews were completed with 699 young adult subjects (416 abused and/or neglected and 283 comparison subjects).
Childhood victimization was a significant predictor of the number of lifetime symptoms of antisocial personality disorder and of a diagnosis of antisocial personality disorder, despite the fact that controls for demographic characteristics and arrest history were introduced.
These findings suggest the importance of inquiring about a patient's childhood history of abuse and/or neglect when antisocial symptoms are evident. In addition to speculation about a possible saturation model for the consequences of childhood victimization, these findings also reinforce a multiple causation model of antisocial personality disorder.
本研究中作者的目标是检验童年期遭受虐待和/或忽视会在多大程度上增加一个人成年后被诊断为DSM-III-R反社会人格障碍的风险。
1967年至1971年期间在中西部一个大都市县地区遭受确凿的儿童虐待和/或忽视的儿童,根据年龄、种族、性别和大致家庭社会阶层与一组未受虐待和未被忽视的儿童进行匹配,并前瞻性地追踪至青年期。找到研究对象并让他们参与一次为时两小时的访谈,访谈包括一系列结构化和半结构化问题、评定量表以及使用美国国立精神卫生研究所诊断访谈表进行的精神病学评估。对699名青年期研究对象(416名曾遭受虐待和/或忽视的儿童以及283名对照对象)完成了访谈。
童年期受侵害是反社会人格障碍终生症状数量以及反社会人格障碍诊断的一个重要预测因素,尽管已对人口统计学特征和被捕史进行了控制。
这些发现表明,当反社会症状明显时,询问患者童年期受虐待和/或忽视的病史很重要。除了对童年期受侵害后果可能的饱和模型进行推测外,这些发现还强化了反社会人格障碍的多重因果关系模型。