Prigerson H G, Shear M K, Bierhals A J, Zonarich D L, Reynolds C F
Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pennsylvania, USA.
Anxiety. 1996;2(5):234-41. doi: 10.1002/(SICI)1522-7154(1996)2:5<234::AID-ANXI5>3.0.CO;2-M.
The purpose of this study was to examine the ways in which childhood adversity, attachment and personality styles influenced the likelihood of having an anxiety disorder among aged caregivers for terminally ill spouses. We also sought to determine how childhood adversity and attachment/personality styles jointly influenced the likelihood of developing an anxiety disorder among aged caregivers. Data were derived from semistructured interviews with 50 spouses (aged 60 and above) of terminally ill patients. The Childhood Experience of Care and Abuse (CECA) record provided retrospective, behaviorally based information on childhood adversity. Measures of attachment and personality styles were obtained from self-report questionnaires, and the Structured Clinical Interview for the DSM-III-R (SCID) was used to determine diagnoses for anxiety disorders. Logistic regression models estimated the effects of childhood adversity, attachment/personality disturbances, and the interaction between the two on the likelihood of having an anxiety disorder. Results indicated that childhood adversity and paranoid, histrionic and self-defeating styles all directly increase the odds of having an anxiety disorder as an elderly spousal caregiver. In addition, childhood adversity in conjunction with borderline, antisocial and excessively dependent styles increased the likelihood of having an anxiety disorder. The results indicate the need to investigate further the interaction between childhood experiences and current attachment/personality styles in their effects on the development of anxiety disorders.
本研究的目的是探讨童年逆境、依恋和人格类型如何影响绝症配偶老年照料者患焦虑症的可能性。我们还试图确定童年逆境与依恋/人格类型如何共同影响老年照料者患焦虑症的可能性。数据来自对50名绝症患者配偶（年龄在60岁及以上）的半结构化访谈。童年照料与虐待经历（CECA）记录提供了基于行为的童年逆境回顾性信息。依恋和人格类型的测量来自自我报告问卷，使用《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）结构化临床访谈来确定焦虑症的诊断。逻辑回归模型估计了童年逆境、依恋/人格障碍以及两者之间的相互作用对患焦虑症可能性的影响。结果表明，童年逆境以及偏执、表演型和自我挫败型人格类型都会直接增加老年配偶照料者患焦虑症的几率。此外，童年逆境与边缘型、反社会型和过度依赖型人格类型相结合会增加患焦虑症的可能性。结果表明，有必要进一步研究童年经历与当前依恋/人格类型之间的相互作用对焦虑症发展的影响。
