Somatoform Dissociation, Reported Abuse and Animal Defence-Like Reactions
Somatoform Dissociation, Reported Abuse and Animal Defence-Like Reactions
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躯体形式解离、虐待报告和动物防御样反应
DOI：
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发表时间：
2004
期刊：
影响因子：
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通讯作者：
K. Steele
中科院分区：
文献类型：
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作者：
E. Nijenhuis;O. van der Hart;Karlien Kruger;K. Steele
目的：检验以下假设：在普通精神科门诊患者中，躯体形式解离与创伤后应激症状和报告的潜在创伤事件相关，尤其是涉及个人身体威胁的事件，同时考虑报告的发病年龄、持续时间和潜在创伤事件的主观评价影响。方法：使用连续和未经选择的精神科门诊患者样本（n = 153）进行自我报告调查问卷，评估躯体形式和心理形式分离、创伤后应激症状和报告的创伤事件的严重程度。结果：躯体形式解离与创伤后应激症状以及报告的累积创伤密切相关，通过两种不同的自我报告创伤问卷进行评估。在多种创伤类型中，来自人的身体威胁最能预测躯体形式分离。情感忽视和年龄进一步改善了预测，但当未报告人际对身体的威胁时，情感忽视和虐待并不能预测躯体形式分离。当分析中包括报告的发病年龄、持续时间和报告的创伤的主观影响时，身体形式的解离也可以通过身体威胁得到最好的预测。结论：这项回顾性研究表明，反复出现的人际身体威胁可能会唤起类似动物防御的心理生物系统，表现为躯体形式解离，并且这种类型的威胁常常伴随着情感忽视。这些假设现在应该在前瞻性研究中得到检验。
Objective: To test the hypotheses that among general psychiatric outpatients, somatoform dissociation is associated with posttraumatic stress symptoms and with reported potentially traumatizing events, especially with events that involve bodily threat from a person, also when reported age at onset, duration and subjectively rated impact of potentially traumatizing events are considered. Method: Administration of self-report questionnaires evaluating the severity of somatoform and psychoform dissociation, posttraumatic stress-symptoms, and reported traumatizing events, using samples of consecutive and unselected psychiatric outpatients (n = 153). Results: Somatoform dissociation was strongly correlated with posttraumatic stress symptoms and with reported cumulative traumatization as assessed with two different self-report trauma questionnaires. Among a wide range of trauma types, bodily threat from a person best predicted somatoform dissociation. Emotional neglect and age further improved the prediction, but emotional neglect and abuse did not predict somatoform dissociation when interpersonal threat to the body was not reported. Somatoform dissociation was also best predicted by bodily threat when reported age at onset, duration and subjective impact of reported traumatization were included in the analyses. Conclusion: This retrospective study suggests that recurrent interpersonal bodily threat may evoke animal defence-like psychobiological systems manifesting as somatoform dissociation and that this type of threat is often accompanied by emotional neglect. These hypotheses should now be tested in prospective studies.