Type and timing of childhood maltreatment and severity of shutdown dissociation in patients with schizophrenia spectrum disorder.
Type and timing of childhood maltreatment and severity of shutdown dissociation in patients with schizophrenia spectrum disorder.
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DOI：
10.1371/journal.pone.0127151
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Teicher MH
中科院分区：
文献类型：
--
作者：
Schalinski I;Teicher MH
分离，特别是感觉、运动和语言系统的关闭，被认为是易感个体对创伤应激的一种防御性反应。相比之下，其他人表现出从极度觉醒到严重威胁的迹象。一个关键的问题是，在发育的特定阶段暴露于特定类型的应激事件是否能使个人对随后的压力源产生强烈的分离性反应。对75例精神分裂症谱系障碍住院患者(男46例，女29例，年龄31±10岁)进行了持续关机分离易感性的评估，并与儿童期或成年期经历或目睹的创伤事件的数量有关。使用虐待和虐待暴露年表(MACE)收集儿童时期每一年遭受10种虐待的回顾。关机分离的严重程度与童年创伤事件的数量有关，但与成人创伤事件的数量无关。使用条件树的随机森林回归表明，儿童期虐待的类型和时间可以预测地解释关闭分离的变异的31%(p<；0.003)，易受伤害的高峰期出现在13-14岁，暴露于情绪忽视之后是各种形式的情绪虐待。这些发现表明，关机分离的发展可能存在易损性窗口。研究结果支持这样一种假设，即亲身经历的事件比亲眼目睹的事件更重要，但对“危及生命的”事件是关键决定因素的假设提出了挑战。
Dissociation, particularly the shutting down of sensory, motor and speech systems, has been proposed to emerge in susceptible individuals as a defensive response to traumatic stress. In contrast, other individuals show signs of hyperarousal to acute threat. A key question is whether exposure to particular types of stressful events during specific stages of development can program an individual to have a strong dissociative response to subsequent stressors. Vulnerability to ongoing shutdown dissociation was assessed in 75 inpatients (46M/29F, M = 31±10 years old) with schizophrenia spectrum disorder and related to number of traumatic events experienced or witnessed during childhood or adulthood. The Maltreatment and Abuse Chronology of Exposure (MACE) scale was used to collect retrospective recall of exposure to ten types of maltreatment during each year of childhood. Severity of shutdown dissociation was related to number of childhood but not adult traumatic events. Random forest regression with conditional trees indicated that type and timing of childhood maltreatment could predictably account for 31% of the variance (p < 0.003) in shutdown dissociation, with peak vulnerability occurring at 13-14 years of age and with exposure to emotional neglect followed by various forms of emotional abuse. These findings suggest that there may be windows of vulnerability to the development of shutdown dissociation. Results support the hypothesis that experienced events are more important than witnessed events, but challenge the hypothesis that “life-threatening” events are a critical determinant.
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影响因子：
1.9
作者：
BERNSTEIN, EM;PUTNAM, FW
通讯作者：
PUTNAM, FW
影响因子：
3.3
作者：
Friedman, Matthew J.
通讯作者：
Friedman, Matthew J.
暴露于父母言语虐待的年轻人中白质异常的初步证据。
影响因子：
10.6
作者：
Choi, Jeewook;Jeong, Bumseok;Rohan, Michael L.;Polcari, Ann M.;Teicher, Martin H.
通讯作者：
Teicher, Martin H.
影响因子：
17.7
作者：
Briere, J;Scott, C;Weathers, F
通讯作者：
Weathers, F
影响因子：
6.6
作者：
Fisher, Helen L.;Craig, Thomas K.;Morgan, Craig
通讯作者：
Morgan, Craig