Nijenhuis E R, Spinhoven P, van Dyck R, van der Hart O, Vanderlinden J
Department of Psychiatry, Vrije Universiteit at Amsterdam, The Netherlands.
J Trauma Stress. 1998 Oct;11(4):711-30. doi: 10.1023/A:1024493332751.
In this study, the prevalence and severity of traumatic experiences as reported by patients with dissociative disorders and with other DSM-IV psychiatric diagnoses were compared. Furthermore, the predictive value of emotional, physical, and sexual trauma with respect to somatoform and psychological dissociation was analyzed. In contrast with comparison patients, dissociative disorder patients reported severe and multifaceted traumatization. Physical and sexual trauma predicted somatoform dissociation, sexual trauma predicted psychological dissociation as well. According to the memories of the dissociative disorder patients, this abuse occurred in an emotionally neglectful and abusive social context. Pathological dissociation was best predicted by early onset of reported intense, chronic and multiple traumatization. Methodological limitations restricting causal inferences between reported trauma and dissociation are discussed.
在本研究中,对分离性障碍患者和其他符合《精神疾病诊断与统计手册第四版》(DSM-IV)精神科诊断的患者所报告的创伤经历的患病率和严重程度进行了比较。此外,还分析了情感、身体和性创伤对躯体形式解离和心理解离的预测价值。与对照患者相比,分离性障碍患者报告了严重且多方面的创伤经历。身体和性创伤可预测躯体形式解离,性创伤也可预测心理解离。根据分离性障碍患者的记忆,这种虐待发生在情感上被忽视且具有虐待性的社会环境中。报告的强烈、慢性和多重创伤的早期发作最能预测病理性解离。本文讨论了限制所报告的创伤与解离之间因果推断的方法学局限性。