Trauma, Dissociation, and Posttraumatic Stress Disorder in Female Borderline Patients With and Without Substance Abuse Problems
Trauma, Dissociation, and Posttraumatic Stress Disorder in Female Borderline Patients With and Without Substance Abuse Problems
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有或没有药物滥用问题的女性边缘患者的创伤、解离和创伤后应激障碍
DOI：
10.1046/j.1440-1614.2003.01199.x
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发表时间：
2003
影响因子：
4.6
通讯作者：
W. van den Brink
中科院分区：
文献类型：
--
作者：
L. M. van den Bosch;R. Verheul;W. Langeland;W. van den Brink
目的：在有和没有药物滥用的女性边缘型人格障碍（BPD）患者中，研究儿童期创伤经历和儿童期忽视与分离经历和创伤后应激障碍（PTSD）的相关性。方法：64例女性BPD患者。童年创伤经历和童年忽视的测量使用结构化创伤访谈，分离的经验与分离的经验量表，和创伤后应激障碍与结构化临床访谈DSM-IV。结果如下：一般来说，解离得分较高的那些历史的童年创伤和忽视，特别是那些谁报告的性虐待和身体虐待16岁之前，一个以上的肇事者和严重的母亲功能障碍。PTSD的患病率与儿童期性虐待（CSA）的严重程度明显相关，包括CSA期间的渗透、家庭内CSA、CSA持续时间超过1年和一个以上的肇事者。共病药物滥用问题修改了所观察到的协会，使上述协会也存在或甚至更明显的那些没有药物滥用，而没有协会被发现在那些药物滥用。结论：结果表明童年创伤和忽视与解离和创伤后应激障碍之间存在中等强度的相关性。然而，创伤-分离和创伤-PTSD联系仅在没有成瘾问题的BPD患者中观察到。研究结果与文献基本一致。潜在的解释缺乏创伤解离和创伤创伤后应激障碍的链接成瘾亚组进行了讨论。
Objective: To examine the associations of childhood traumatic experiences and childhood neglect with dissociative experiences and posttraumatic stress disorder (PTSD) in a population of female borderline personality disorder (BPD) patients with and without substance abuse. Method: The sample included 64 female patients with BPD. Childhood traumatic experiences and childhood neglect were measured using the Structured Trauma Interview, dissociative experiences with the Dissociative Experiences Scale, and PTSD with the Structured Clinical Interview for DSM-IV. Results: In general, dissociation scores were higher among those with a history of childhood trauma and neglect, in particular among those who reported both sexual and physical abuse before age 16, more than one perpetrator and severe maternal dysfunction. The prevalence of PTSD was clearly associated with the severity of childhood sexual abuse (CSA) in terms of the occurrence of penetration during CSA, intrafamilial CSA, a duration of CSA longer than 1 year and more than one perpetrator. Comorbid substance abuse problems modified the observed associations such that the associations mentioned above were also present or even more pronounced among those without substance abuse, whereas no associations were found in those with substance abuse. Conclusions: The results suggest a moderately strong association between childhood trauma and neglect with dissociation and PTSD. However, trauma-dissociation and trauma-PTSD links were only observed among BPD patients without addictive problems. The findings are largely consistent with the literature. Potential explanations for the lack of a trauma-dissociation and trauma-PTSD link in the addicted subgroup are discussed.
DOI：
10.1176/ajp.149.5.664
发表时间：
1992-05
期刊：
The American journal of psychiatry
影响因子：
--
作者：
L. Cottler;W. Compton;D. Mager;E. Spitznagel;A. Janča
通讯作者：
L. Cottler;W. Compton;D. Mager;E. Spitznagel;A. Janča
影响因子：
2.3
作者：
M. Zanarini;F. Frankenburg
通讯作者：
M. Zanarini;F. Frankenburg
影响因子：
--
作者：
R. Spitzer;Janet B W Williams;M. Gibbon;M. First
通讯作者：
R. Spitzer;Janet B W Williams;M. Gibbon;M. First