Mulder R T, Beautrais A L, Joyce P R, Fergusson D M
Department of Psychological Medicine, Christchurch School of Medicine, New Zealand.
Am J Psychiatry. 1998 Jun;155(6):806-11. doi: 10.1176/ajp.155.6.806.
The aim of this study was to examine the relationship between childhood sexual abuse, childhood physical abuse, current psychiatric illness, and measures of dissociation in an adult population.
The authors used a randomly selected sample of 1,028 individuals. Each subject completed a semistructured face-to-face interview that included measures of childhood sexual abuse, childhood physical abuse, DSM-III-R psychiatric diagnoses, and selected items from the Dissociative Experiences Scale.
Many individuals experienced occasional dissociative symptoms, and 6.3% of the population suffered from three or more frequently occurring dissociative symptoms. Among these individuals, the rate of childhood sexual abuse was two and one-half times as high, the rate of physical abuse was five times as high, and the rate of current psychiatric disorder was four times as high as the respective rates for the other subjects. Logistic regression modeling showed that physical abuse and current psychiatric illness were directly related to a high rate of dissociative symptoms but sexual abuse was not. The influence of sexual abuse was due to its associations with current psychiatric illness and with childhood physical abuse. Childhood physical abuse was not directly related to current psychiatric illness. Its association appeared to be mediated by its link to childhood sexual abuse.
This study confirms that a small proportion (approximately 6%) of the general population suffer from high levels of dissociative symptoms. It calls into question the hypothesized direct relationship between childhood sexual abuse and adult dissociative symptoms.
本研究旨在探讨成年人群中儿童期性虐待、儿童期身体虐待、当前精神疾病与分离症状测量指标之间的关系。
作者使用了一个随机抽取的包含1028人的样本。每位受试者都完成了一次半结构化的面对面访谈，其中包括儿童期性虐待、儿童期身体虐待的测量指标、DSM-III-R精神疾病诊断以及解离体验量表中的选定项目。
许多人偶尔会出现解离症状，6.3%的人群存在三种或更多频繁出现的解离症状。在这些人中，儿童期性虐待发生率是其他受试者的2.5倍，身体虐待发生率是其他受试者的5倍，当前精神疾病发生率是其他受试者的4倍。逻辑回归模型显示，身体虐待和当前精神疾病与高比例的解离症状直接相关，但性虐待并非如此。性虐待的影响归因于它与当前精神疾病以及儿童期身体虐待的关联。儿童期身体虐待与当前精神疾病没有直接关系。其关联似乎是由它与儿童期性虐待的联系所介导的。
本研究证实，一小部分（约6%）普通人群存在高水平的解离症状。这对儿童期性虐待与成人解离症状之间假设的直接关系提出了质疑。
