Factors predicting PTSD, depression, and dissociative severity in female treatment-seeking childhood sexual abuse survivors
Factors predicting PTSD, depression, and dissociative severity in female treatment-seeking childhood sexual abuse survivors
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DOI：
10.1016/s0145-2134(00)00225-8
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发表时间：
2001-01-01
影响因子：
4.8
通讯作者：
Chard, KM
中科院分区：
文献类型：
--
作者：
Johnson, DM;Pike, JL;Chard, KM
目的：提出两个主要问题：（1）哪些虐待特征与儿童性虐待（CSA）成年幸存者的创伤后应激障碍（PTSD）、抑郁和解离严重程度相关； (2)哪些虐待特征会影响CSA期间分离的严重程度。方法：采用标准化措施评估89名女性CSA幸存者当前的PTSD、抑郁和分离症状。此外，还通过结构化访谈评估了虐待特征（例如发病年龄、创伤周围分离）。结果：相关分析表明，创伤周围分离与所有三种症状严重程度密切相关。其他事后相关分析显示，经历过阴茎插入、相信其他人/物会被杀死和/或因虐待而受伤的女性表现出更严重的创伤周围解离。回归分析表明，创伤周围分离是显着预测跨症状类型或疾病的症状严重程度的唯一变量。此外，不同的虐待特征可预测成人症状的严重程度和创伤周围解离。结论：创伤周围解离与成人症状之间的关系最有趣，并且具有两个主要临床意义：（1）向一些 CSA 幸存者传授参与策略，希望在虐待后立即控制解离症状；（2）在有需要的情况下，在一些成年 CSA 幸存者的治疗中纳入基于暴露的干预措施。 (C) 2001 Elsevier Science Ltd. 保留所有权利。
Objective: Two main questions were asked: (1) what abuse characteristics relate to PTSD, depressive, and dissociative severity in adult survivors of child sexual abuse (CSA); and (2) what abuse characteristics influence the severity of dissociation during CSA.Method: 89 female CSA survivors' current symptoms of PTSD, depression, and dissociation were assessed with standardized measures. Additionally, abuse characteristics (e.g., age of onset, peritraumatic dissociation) were assessed with a structured interview.Results: Correlational analyses indicated that peritraumatic dissociation was most strongly related to all three types of symptom severity. Additional posthoc correlational analyses revealed that women who experienced penile penetration, believed someone/thing else would be killed, and/or were injured as a result of the abuse exhibited more severe peritraumatic dissociation. Regression analyses indicated that peritraumatic dissociation was the only variable to significantly predict symptom severity across symptom type or disorder. Furthermore, different abuse characteristics predicted adult symptom severity and peritraumatic dissociation.Conclusions: The relation between peritraumatic dissociation and adult symptomatology was most intriguing and has two main clinical implications: (1) teaching engagement strategies to some CSA survivors in hopes of containing dissociative symptoms immediately following the abuse and (2) the inclusion of exposure-based interventions in the treatment of some adult CSA survivors where indicated. (C) 2001 Elsevier Science Ltd. All rights reserved.