Griffin M G, Resick P A, Mechanic M B
Department of Psychology, University of Missouri-St. Louis 63121, USA.
Am J Psychiatry. 1997 Aug;154(8):1081-8. doi: 10.1176/ajp.154.8.1081.
The aims of this study were to investigate psychophysiological changes associated with peritraumatic dissociation in female victims of recent rape and to assess the relation between these changes and symptoms of posttraumatic stress disorder (PTSD).
Eighty-five rape victims were examined in a laboratory setting within 2 weeks after the rape, and measures of heart rate, skin conductance, and nonspecific movement were collected. Self-report indexes of reactions to the trauma and interviews to assess PTSD symptoms and peritraumatic dissociation were also completed. On the basis of their scores on the Peritraumatic Dissociation Index, the subjects were classified as having low or high levels of dissociation.
Items from the index exhibited good internal consistency, and scores were approximately normally distributed. Individuals in the high peritraumatic dissociation group showed a significantly different pattern of physiological responses from those of the low dissociation group. In general, there was a suppression of autonomic physiological responses in the high dissociation group. This group also contained a larger proportion of subjects (94%) identified as meeting PTSD symptom criteria. Also, among the high dissociation subjects there was a discrepancy between self-reports of distress and objective physiological indicators of distress in the laboratory setting.
The results provide preliminary support for the idea that there is a dissociative subtype of persons with PTSD symptoms who exhibit diminished physiological reactivity. The results also underscore the importance of assessing dissociative symptoms in trauma survivors.
本研究旨在调查近期遭受强奸的女性受害者与创伤相关解离有关的心理生理变化,并评估这些变化与创伤后应激障碍(PTSD)症状之间的关系。
85名强奸受害者在强奸发生后2周内于实验室环境中接受检查,收集心率、皮肤电导率和非特异性运动的测量数据。还完成了对创伤反应的自我报告指标以及评估PTSD症状和创伤相关解离的访谈。根据她们在创伤相关解离指数上的得分,将受试者分为解离水平低或高的两组。
该指数的项目显示出良好的内部一致性,得分大致呈正态分布。高创伤相关解离组个体的生理反应模式与低解离组显著不同。总体而言,高解离组存在自主生理反应抑制。该组中被确定符合PTSD症状标准的受试者比例也更高(94%)。此外,在高解离受试者中,实验室环境下痛苦的自我报告与痛苦的客观生理指标之间存在差异。
研究结果为以下观点提供了初步支持,即存在一种PTSD症状的解离亚型,其生理反应性降低。研究结果还强调了评估创伤幸存者解离症状的重要性。