Abuse and neglect in childhood: Relationship to personality disorder diagnoses
Abuse and neglect in childhood: Relationship to personality disorder diagnoses
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DOI：
10.1017/s1092852900019118
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发表时间：
2003-10-01
期刊：
影响因子：
3.3
通讯作者：
Siever, LJ
中科院分区：
文献类型：
--
作者：
Bierer, LM;Yehuda, R;Siever, LJ
背景资料：童年虐待和忽视史与人格障碍有关，并在有自杀和自伤终身史的受试者中观察到。大多数这些研究结果已产生从住院clinical samples.Methods：本研究评估了自我评价指数的持续童年虐待和忽视的门诊样本的特征良好的人格障碍的科目（n=182），以确定儿童期创伤指数的相对关联，以特定的人格障碍诊断或集群和终身史的自杀企图或姿态。受试者符合轴II诊断标准，24%的受试者报告有自杀企图。童年创伤问卷的管理，以评估五个方面的童年创伤暴露（情感，身体和性虐待，情感和身体忽视）。采用逻辑回归分析评估每个集群的创伤措施，人格障碍，自杀未遂和自我伤害史之间的显着预测。所有的分析控制的性别distribution.Results：78%的科目符合二分标准的某种形式的童年创伤，大多数报告的情感虐待和忽视。整体创伤严重程度的二分法标准预测了B类、边缘型和反社会型人格障碍的诊断。创伤评分与聚类A呈正相关，与聚类C呈负相关，但与聚类B诊断无显著相关性。在包括聚类A的具体诊断中，偏执障碍单独被性虐待、身体虐待和情感虐待预测。在聚类B中，只有反社会人格障碍与创伤评分有显著相关性，并通过性虐待和身体虐待进行具体预测。对于边缘型人格障碍，个体预测因素存在性别相互作用，情绪虐待是唯一重要的创伤预测因素，并且仅在男性中存在。自杀手势的历史与整个样本中的情感虐待和妇女只自残行为与情感abuse in men.Conclusion：这些结果表明，儿童期情感虐待和忽视广泛代表人格障碍，并与临床严重程度的指标与边缘型人格障碍患者。儿童期性虐待和身体虐待被强调为偏执和反社会人格障碍的预测因子。这些结果有助于定性儿童期性虐待与边缘型人格障碍之间的关联的先前观察。
Background: Childhood history of abuse and neglect has been associated with personality disorders and has been observed in subjects with lifetime histories of suicidality and self-injury. Most of these findings have been generated from inpatient clinical samples.Methods: This study evaluated self-rated indices of sustained childhood abuse and neglect in an outpatient sample of well-characterized personality disorder subjects (n=182) to determine the relative associations of childhood trauma indices to specific personality disorder diagnoses or clusters and to lifetime history of suicide attempts or gestures. Subjects met criteria for similar to2.5 Axis II diagnoses and 24% reported past suicide attempts. The Childhood Trauma Questionnaire was administered to assess five dimensions of childhood trauma exposure (emotional, physical, and sexual abuse, and emotional and physical neglect). Logistic regression was employed to evaluate salient predictors among the trauma measures for each cluster, personality disorder, and history of attempted suicide and self-harm. All analyses controlled for gender distribution.Results: Seventy-eight percent of subjects met dichotomous criteria for some form of childhood trauma; a majority reported emotional abuse and neglect. The dichotomized criterion for global trauma severity was predictive of cluster B, borderline, and antisocial personality disorder diagnoses. Trauma scores were positively associated with cluster A, negatively with cluster C, but were not significantly associated with cluster B diagnoses. Among the specific diagnoses comprising cluster A, paranoid disorder alone was predicted by sexual, physical, and emotional abuse. Within cluster B, only antisocial personality disorder showed significant associations with trauma scores, with specific prediction by sexual and physical abuse. For borderline personality disorder, there were gender interactions for individual predictors, with emotional abuse being the only significant trauma predictor, and only in men. History of suicide gestures was associated with emotional abuse in the entire sample and in women only; self-mutilatory behavior was associated with emotional abuse in men.Conclusion: These results suggest that childhood emotional abuse and neglect are broadly represented among personality disorders, and associated with indices of clinical severity among patients with borderline personality disorder. Childhood sexual and physical abuse are highlighted as predictors of both paranoid and antisocial personality disorders.. These results help qualify prior observations of the association of childhood sexual abuse with borderline personality disorder.