The role of childhood interpersonal trauma in depersonalization disorder.
The role of childhood interpersonal trauma in depersonalization disorder.
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童年人际创伤在人格解体障碍中的作用。
DOI：
10.1176/appi.ajp.158.7.1027
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
Knutelska,M
中科院分区：
文献类型：
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作者：
Simeon,D;Guralnik,O;Schmeidler,J;Sirof,B;Knutelska,M
目的 与创伤与其他解离障碍的关系相反，创伤与人格解体障碍的关系尚不清楚。本研究的目的是系统地调查童年人际创伤在人格解体障碍中的作用。 方法对 49 名患有 DSM-IV 人格解体障碍的受试者和 26 名没有一生轴 I 和 II 障碍且年龄和性别相当的健康对照受试者进行分离体验量表和童年创伤访谈，测量分离或失落、身体忽视、情感虐待、身体虐待、目睹暴力和性虐待。 结果童年人际创伤作为一个整体，高度预测人格解体障碍的诊断以及表示分离、病理性分离和人格解体的评分。情感虐待，无论是总分还是最大严重程度，都是诊断人格解体障碍和表示人格解体的分数的最重要预测因素，但不是一般解离分数的最重要预测因素，而一般解离分数通过结合情绪虐待和性虐待可以更好地预测。大多数精神虐待的肇事者都是父母之一或双方。尽管不同类型的创伤有一定的相关性，但其中只有少数关系具有统计显着性，这强调了在研究中全面考虑不同类型创伤的重要性。结论童年人际创伤，特别是情感虐待可能在人格解体障碍的发病机制中发挥作用。与其他类型的童年创伤相比，情感虐待是精神病学研究中相对被忽视的实体，值得更多关注。
OBJECTIVEIn contrast to trauma’s relationship with the other dissociative disorders, the relationship of trauma to depersonalization disorder is unknown. The purpose of this study was to systematically investigate the role of childhood interpersonal trauma in depersonalization disorder.METHODForty-nine subjects with DSM-IV depersonalization disorder and 26 healthy comparison subjects who were free of lifetime axis I and II disorders and of comparable age and gender were administered the Dissociative Experiences Scale and the Childhood Trauma Interview, which measures separation or loss, physical neglect, emotional abuse, physical abuse, witnessing of violence, and sexual abuse.RESULTSChildhood interpersonal trauma as a whole was highly predictive of both a diagnosis of depersonalization disorder and of scores denoting dissociation, pathological dissociation, and depersonalization. Emotional abuse, both in total score and in maximum severity, emerged as the most significant predictor both of a diagnosis of depersonalization disorder and of scores denoting depersonalization but not of general dissociation scores, which were better predicted by combined emotional and sexual abuse. The majority of the perpetrators of emotional abuse were either or both parents. Although different types of trauma were modestly correlated, only a few of these relationships were statistically significant, underscoring the importance of comprehensively considering different types of trauma in research studies.CONCLUSIONSChildhood interpersonal trauma and, in particular, emotional abuse may play a role in the pathogenesis of depersonalization disorder. Compared to other types of childhood trauma, emotional maltreatment is a relatively neglected entity in psychiatric research and merits more attention.