男性暴力罪犯的冲动、攻击性人格特点及其与童年期受虐待的关系

目的 探讨暴力犯罪人员的冲动、攻击性人格特点,及其与童年期受虐待关系,为减少或预防暴力犯罪提供科学依据.方法 采用冲动性和攻击性量表、童年期创伤史问卷(Childhood Tmuma Questionnaire.CTQ)及自行编制的在押服刑罪犯一般情况登记表,对符合纳入、排除标准的400名犯人的资料进行收集、整理,然后对资料进行统计分析.结果 暴力犯组的运动冲动性、冲动总水平、躯体攻击性、言语攻击性、愤怒水平、敌意水平、自我攻击水平及攻击性总分等因子得分高于非暴力犯组,差异均有统计学意义(P<0.01).暴力犯中无计划冲动性、认知冲动性、冲动总水平和童年期创伤各因子均呈正相关;敌意水平、自我攻击水平、攻击总水平与童年期创伤的五个因子均呈正相关,而躯体攻击性、言语攻击性、愤怒水平与情感虐待、躯体虐待和性虐待呈正相关.结论 暴力犯有明显的冲动及攻击性,更容易失去理智,产生暴力攻击行为;童年遭受虐待可增加个体的冲动、攻击性,从而增加暴力犯罪的可能.     

抑郁障碍与童年期被虐待经历的关系

目的评估成年抑郁障碍与童年期被虐待经历的关系。方法使用童年期创伤性经历问卷（CTQ）对120例抑郁障碍患者进行评估，并与120例正常人群做对照。结果抑郁障碍组情感忽视、性虐待平均秩次分别为134.94、129.45与对照组比较差异有统计学意义（P〈0.05）。男性抑郁障碍组情感忽视平均秩次为102.21与对照组比较差异有显著性（P〈0.05）。女性抑郁障碍组情感忽视、性虐待平均秩次分别为107.72、109.86与对照组比较差异有统计学意义（P〈0.05）。结论儿童期情感忽视、性虐待是成年抑郁障碍的危险因素，情感忽视是男性成年抑郁障碍的危险因素，情感忽视、性虐待是女性成年抑郁障碍的危险因素。     

儿童期虐待对新兵社会支持及应对方式的影响

目的研究儿童期虐待对新兵社会支持及应对方式的影响。方法对505名入伍新兵进行儿童受虐问卷（CTQ-SF）、简易应对方式问卷（SCSQ）、青少年社会支持量表评定。结果遭受儿童期虐待的新兵在应付方式选择及社会支持上显著低于无虐待组（P〈0．05）。简单相关分析显示儿童期情感虐待、情感忽视、躯体忽视及总虐待分均与积极应对呈负相关（P〈0．01）;儿童期经历过情感虐待、情感忽视、性虐待、躯体虐待、躯体忽视及虐待总分均与消极应对呈正相关（P〈0．05,P〈0．01）。儿童期情感虐待、躯体虐待、情感忽视、躯体忽视及总虐待分均与社会支持总分、客观支持、支持利用度呈负相关（P〈0．01）;儿童期经历过情感虐待、情感忽视、性虐待、躯体虐待、躯体忽视及虐待总分均与主观支持成负相关（P〈0．05,P〈0．01）。情感忽视、躯体忽视与积极应对方式呈负相关（P=0．000,P=0．003）;虐待总分、情感虐待与消极应对方式呈正相关（P=0．032,P=0．026）,与社会支持总分呈负相关（P=0．000,P=0．011）。结论儿童期遭受虐待的新兵在应对方式上往往采取消极应对,且社会支持不良。     

儿童期虐待对成人自杀可能性的影响

目的 了解儿童期虐待对于成年后自杀可能性的影响.方法 分层随机抽取≥18岁的天津市区居民564例,使用儿童期虐待问卷（CTQ-SF）、自制自杀态度量表作为工具进行调查.结果 男性被调查者儿童期躯体虐待评分高于女性（P＜0.01）,女性被调查者儿童期情感忽视评分高于男性（P＜0.05）.男性有自杀意念人数显著低于女性（P＜0.05）.相关分析显示儿童期躯体虐待、情感虐待、性虐待及情感忽视与被调查者的自杀意念呈负相关（P＜0.01）;儿童期躯体虐待、情感虐待及性虐待与被调查者自杀未遂呈负相关（P＜0.05,P＜0.01）;而儿童期躯体虐待、情感虐待、性虐待及情感忽视与被调查者的自杀接受程度呈正相关（P＜0.05,P＜0.01）.回归分析显示情感虐待、性虐待和情感忽视为被调查者自杀意念的独立影响因素（P＜0.05）.结论 成年人的自杀意念、自杀未遂及自杀接受态度与其儿童期虐待有关.     

童年虐待对精神分裂症患者认知功能和临床症状的影响

目的:探讨精神分裂症患者的童年虐待经历对其认知功能和临床症状的影响。方法:对46例精神分裂症患者依据儿童期虐待问卷(CTQ)评分分为轻度虐待组(27例)和重度虐待组(19例);并采用阳性和阴性症状量表(PANSS)、临床总体印象量表(CGI)及CogState量表(CSB)评估其临床症状及认知功能;分析童年虐待与认知功能和临床症状的关系。结果:重度虐待组CTQ总分及情感虐待、躯体虐待、性虐待、躯体忽视评分显著高于轻度虐待组(P均0.01);PANSS总分、阳性因子及CGI评分明显高于轻度虐待组(P0.05或P0.01);CSB中的注意力及警觉高于轻度虐待组,工作记忆评分明显低于轻度虐待组(P0.05或P0.01)。结论:童年经历严重虐待的精神分裂症患者其精神症状更重,认知功能损害更明显。     

早年创伤对女性创伤后应激障碍患者焦虑症状及人格改变的远期影响

目的探讨早年创伤对女性创伤后应激障碍（PTSD）患者焦虑症状及人格改变的远期影响。方法早年创伤定义：躯体虐待、性虐待、躯体忽视≥8分;情感虐待≥10分和／或情感忽视≥15分。共收集15例符合DSM—IV诊断标准的曾经遭受过早年创伤的PTSD患者（研究组）,17例经历早年创伤无PTSD者（时照1组）,20名健康人（对照2组）。所有受试者均为女性。采用儿童期创伤问卷（CTQ）评估是否存在儿童期精神创伤,状态特质焦虑问卷（STAI）评估焦虑症状;明尼苏迭多相人格测验（MMPI）评估人格特征。结果状态焦虑和特质焦虑的情绪体验严重程度依次是研究组、对照1组、对照2组（P〈0．01）。MMPI测验显示癔症、精神病态、男一女性化、精神衰弱、精神分裂、轻躁狂3组间比较差异无统计学意义（P〉0．05）。3组对象抑郁、社会内向严重程度依次为研究组、对照1组、对照2组（P〈0．01）。研究组、对照1组疑病和偏执因子得分均高于对照2组（P〈0．01）。结论早年创伤从某种程度上可能影响PTSD的焦虑情绪及人格改变,且与创伤的严重程度有关。     

伴自伤行为的女性青少年抑郁障碍患者家庭功能与童年创伤经历的相关性

目的探索伴自伤行为的女性青少年抑郁障碍患者所感知的家庭功能健康状况与其童年创伤经历的关系,为对其进行有针对性的家庭心理干预提供参考。方法纳入符合《国际疾病分类(第10版)》(ICD-10)抑郁障碍诊断标准且伴有自伤行为的青少年女生为研究组(n=50),选取年龄和家庭结构与研究组相匹配的正常青少年女生为对照组(n=42)。采用贝克抑郁自评量表第2版(BDI-II)、家庭功能评定量表(FAD)、童年创伤问卷(CTQ)评定两组抑郁程度、家庭功能和童年创伤经历。结果除行为控制维度外,研究组FAD其余各分量表评分均高于对照组(P均0.01),CTQ总评分及各因子评分均高于对照组(P0.05或0.01)。研究组FAD中问题解决、沟通、角色、情感反应、情感介入、行为控制、总体功能评分与CTQ中躯体忽视、情感虐待、情感忽视评分均呈正相关(r=0.285～0.677,P0.05或0.01);FAD中问题解决、沟通、角色、行为控制、总体功能评分与CTQ中躯体虐待、性虐待评分均呈正相关(r=0.232～0.470,P0.05或0.01)。多重回归分析显示,情感忽视评分与家庭总体功能正向关联(β=0.318,P0.05)。结论伴自伤行为的女性青少年抑郁障碍患者所感知的家庭功能健康状况较差,可能与其童年创伤经历有关,尤其与情感忽视有关。     

惊恐障碍患者童年期创伤经历与疾病严重程度关系研究

目的研究惊恐障碍患者童年期创伤经历是否与疾病严重程度相关。方法采用儿童期创伤问卷(CTQ)对在四川省人民医院心身医学科住院患者中,符合《精神障碍诊断与统计手册(第4版)》(DSM-IV)惊恐障碍诊断标准的早年(16岁以前)有过负性经历的90名患者进行调查,采用惊恐障碍严重程度量表(PDSS)评估惊恐障碍严重程度,分析童年期创伤经历与疾病严重程度的关系。结果根据CTQ结果,90名惊恐障碍患者中,情感虐待的检出率为64.8%,躯体虐待检出率为40.7%,性虐待检出率为31.9%,情感忽视检出率为89.0%,躯体忽视检出率为91.2%。CTQ总评分(40.65±11.34)分,PDSS评分(12.75±5.61)分,CTQ总评分及各种创伤经历与惊恐严重程度无线性相关。结论惊恐障碍患者童年期创伤经历与惊恐障碍严重程度无线性相关。     

反社会型人格障碍共病边缘型人格障碍特质的影响因素

目的:探讨反社会型人格障碍(ASPD)共病边缘型人格障碍(BPD)的人口学及心理环境影响因素。方法:对1 804名服刑人员使用人格障碍诊断问卷(PDQ-4)进行评估,筛选出反社会型、边缘型及共病人群,采用自编一般资料问卷、患者健康问卷抑郁量表(PHQ-9)、广泛性焦虑量表(GAD-7)、儿童期虐待量表(CTQ-SF)、冲动性量表(BIS-11)、自杀意念量表(SIOSS)进行问卷调查。结果:ASPD共病BPD组在冲动性、儿童期虐待、焦虑、抑郁、自杀意念各个维度和因子的得分均高于ASPD组和BPD组,除儿童虐待中躯体虐待和性虐待外,其他维度和因子均存在显著差异(P0.05或P0.01)。Logstic回归显示,情感忽视、抑郁、绝望对ASPD形成共病人格产生影响。结论:童年期情感忽视和情绪问题可能是ASPD患者发展成ASPD共病BPD患者的影响因素。     

童年期创伤、神经认知功能与精神分裂症发病风险的研究

目的:探索童年期创伤和神经认知功能对精神分裂症发病风险的交互效应。方法:采用中文版本的童年期创伤问卷-简版(CTQ-SF)及计算机自动化成套剑桥神经认知测试(CANTAB)对146例首发未用药精神分裂症患者(患者组)及141名匹配的健康对照者(对照组)进行童年期创伤及神经认知功能评估;采用中介分析,将神经认知功能作为中介变量,探索童年期创伤与精神分裂症发病的关系。结果:患者组在CTQ-SF中的情感虐待(28.8%)、情感忽视(54.1%)、躯体忽视(41.8%)及性虐待(21.2%)的童年期创伤比率明显高于对照组(9.9%、23.4%、19.1%、9.2%)(P均0.05,经过多重校正);患者组CANTAB中38个神经认知功能测验结果显著差于对照组(P均0.001);进一步分析成功地建立了27个有统计学显著性的中介模型;童年期创伤主要通过影响延迟匹配(DMS)、快速视觉信息处理(RVP)两个认知范式的相关指标影响精神分裂症发病,其平均因果效应为情感虐待(0.0054～0.0078)、情感忽视(0.0035～0.0107)、躯体忽视(0.0060～0.0147)、性虐待(0.0162)(P均0.001,经过多重校正)。结论:童年期创伤可通过影响神经认知功能升高精神分裂症的发病风险。     

Association between childhood trauma and aggression in male prisoners

Childhood trauma and aggression were examined in 540 male prisoners. The Thus 540 male prisoners had a psychiatric interview, completed the Childhood Trauma Questionnaire (CTQ), and were assessed with the Brown-Goodwin Lifetime History of Aggression (BGHA) interview. There were significant correlations between CTQ scores and BGHA scores. Also prisoners with CTQ scores above the median had significantly higher BGHA scores than prisoners with CTQ scores below the median. Significantly more of the prisoners with CTQ scores above the median had more than one conviction, and significantly more had convictions as minors, and had exhibited violent behavior in prison. However, in logistic regression analyses that included possible confounding variables, CTQ scores related only to violence in prison while BGHA scores related to violent crime, having more than one conviction, conviction as a minor, and violence in prison. The relationship between CTQ and BGHA scores suggests the possibility that childhood trauma may be one determinant of aggression in prisoners.     

Myers Briggs Type Indicator and Tridimensional Personality Questionnaire differences between bipolar patients and unipolar depressed patients

Objectives: The current study was designed to compare personality differences between bipolar patients and unipolar depressed patients, as evaluated on the Myers Briggs Type Indicator (MBTI) and the Tridimensional Personality Questionnaire (TPQ).

Methods: A group of bipolar and a group of unipolar depressed patients filled out the MBTI, the TPQ, the Beck Depression Inventory, and the CAGE questionnaire. The two groups were compared with each other as to responses on the above surveys, and subgroups of bipolar depressed and bipolar patients with manic symptoms were also compared.

Results: Bipolar patients were found to be significantly more extroverted (p=0.004) and less judging (p=0.007) on the MBTI. They were significantly more novelty seeking (p=0.004) and less harm avoidant (p=0.002) on the TPQ. Of the above differences, only the TPQ harm avoidance scale appeared strongly linked to the patients' level of depression.

Conclusion: Significant differences in personality exist between bipolar disorder and unipolar depressed patients.     

Relationship of temperament and behaviour measures to the prolactin response to fenfluramine in depressed men

Low central nervous systems (CNS) serotonin has been linked to aggression, impulsivity and disinhibition in both animal and human studies. Low cerebrospinal fluid (CSF) 5-hydroxindoleacetic acid (5HIAA) has been reported in violent criminals, arsonists and violent suicide attempters. Reduced prolactin response to fenfluramine has been found in aggressive patients and criminal offenders. Cloninger's dimension of harm avoidance is hypothesised to be related to CNS serotonin levels, but studies have reported contradictory results. Forty-eight men with major depression received a fenfluramine challenge as well as a number of measures of temperament and behaviour: the Tridimensional Personality Questionnaire (TPQ); the Eysenck Personality Questionnaire (EPQ); the Barratt Impulsivity Scale (BIS); the Hopkins Symptom Checklist (SCL-90); and clinician-rated personality disorder symptoms. The prolactin response to fenfluramine was not related to EPQ or TPQ measures except the TPQ dimension of reward dependence and the EPQ Lie scale. The prolactin response to fenfluramine was not related to BIS measures or to SCL-90 measures except the SCL-90 somatization scale. The prolactin response to fenfluramine was not related to personality disorder diagnoses or to a measure of repeated self-harm. Thus, in a sample of moderately depressed male outpatients, there was very little relationship between personality, behavioural measures and the prolactin response to fenfluramine. We suggest that alterations in serotonin functioning, when measured using the prolactin response to fenfluramine, may be more commonly linked to behavioural abnormalities in personality-disordered or criminal samples.     

Childhood trauma and hostility as an adult: relevance to suicidal behavior

The objective of this study is to look for a relationship between childhood trauma and hostility as an adult. Toward this end, 294 recently abstinent cocaine or opiate dependent patients were asked to complete two questionnaires: the Childhood Trauma Questionnaire (CTQ) and the Hostility and Direction of Hostility Questionnaire (HDHQ). It was found that there were significant correlations between the HDHQ total hostility score and scores on the CTQ for childhood emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect. Thus, these results suggest the possibility that childhood trauma may be a determinant of the personality dimension of hostility as an adult.     

Dimensions of temperament and bright light response in seasonal affective disorder

Scale scores on the Tridimensional Personality Questionnaire (TPQ)-novelty seeking (NS), harm avoidance (HA), and reward dependence (RD)-can predict response to antidepressants. This study examined 89 patients with Bipolar Disorder (I, II) or Major Depressive Disorder, both with recurrent winter seasonal pattern. The TPQ was administered while the patients were depressed, following 10-14 days of bright light therapy (30 min, 10,000 lux) and after spontaneous springtime remission. The Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorder Version (SIGH-SAD) assessed the severity of depression. At baseline, there were no significant differences between diagnostic subgroups or responders and non-responders on the TPQ or SIGH-SAD scales, though baseline RD scores were significantly higher in women than men. Furthermore, neither severity of depression nor magnitude of post-treatment clinical improvement was significantly correlated with baseline TPQ scores. Only HA scores decreased after treatment, with responders showing the greatest effect. HA scores also decreased from the baseline to springtime assessments for the group as a whole, with no difference between responders and non-responders. This is the first study to demonstrate that HA is state- rather than trait-dependent in seasonal affective disorder. The TPQ dimensions of temperament do not predict response to light therapy.     

Association of low-activity MAOA allelic variants with violent crime in incarcerated offenders

The main enzyme for serotonin degradation, monoamine oxidase (MAO) A, has recently emerged as a key biological factor in the predisposition to impulsive aggression. Male carriers of low-activity variants of the main functional polymorphism of the MAOA gene (MAOA-uVNTR) have been shown to exhibit a greater proclivity to engage in violent acts. Thus, we hypothesized that low-activity MAOA-uVNTR alleles may be associated with a higher risk for criminal violence among male offenders. To test this possibility, we analyzed the MAOA-uVNTR variants of violent (n = 49) and non-violent (n = 40) male Caucasian and African-American convicts in a correctional facility. All participants were also tested with the Childhood Trauma Questionnaire (CTQ), Barratt Impulsivity Scale (BIS-11) and Buss-Perry Aggression Questionnaire (BPAQ) to assess their levels of childhood trauma exposure, impulsivity and aggression, respectively. Our results revealed a robust (P < 0.0001) association between low-activity MAOA-uVNTR alleles and violent crime. This association was replicated in the group of Caucasian violent offenders (P < 0.01), but reached only a marginal trend (P = 0.08) in their African American counterparts. While violent crime charges were not associated with CTQ, BIS-11 and BPAQ scores, carriers of low-activity alleles exhibited a mild, yet significant (P < 0.05) increase in BIS-11 total and attentional-impulsiveness scores. In summary, these findings support the role of MAOA gene as a prominent genetic determinant for criminal violence. Further studies are required to confirm these results in larger samples of inmates and evaluate potential interactions between MAOA alleles and environmental vulnerability factors.     

精神分裂症患者一级亲属人格特征的研究

目的 探讨精神分裂症患者一级亲属的人格特征.方法 采用分裂型人格问卷(SPQ)及三维人格问卷(TPQ)评定181例精神分裂症患者一级亲属(高危组)、321名正常对照个体(对照组)的人格特征.结果 高危组sPQ阴性分裂型人格维度评分[(9.80±7.05)分]高于对照组[(8.42±5.87)分],差异有统计学意义(P＜0.05).高危组在TPQ寻求新奇维度评分[(15.60±5.62)分]、奖赏依赖维度评分[(17.41 ±1.13)分]与对照组[(14.20±2.83)分,(18.22±3.26)分]的差异均有统计学意义(P均＜0.01).高危组的阴性分裂型人格维度分数与寻求新奇维度、奖赏依赖维度分数显著相关(r=0.17和-0.23).结论 精神分裂症患者一级亲属具有阴性分裂型维度、寻求新奇维度、奖赏依赖维度的人格特征.     

The tridimensional personality of male heroin users treated with methadone in Taiwan

It was our assumption that male heroin users have the personality traits of high impulsivity and low social interaction. Compliance regarding methadone maintenance therapy (MMT) is hypothesized to be related to personality features. We recruited 43 patients that had been receiving MMT and 43 healthy volunteers. All participants completed a Tridimensional Personality Questionnaire (TPQ). Information related to the Opiate Treatment Index (OTI) was gathered from the heroin group. The personality dimensions in the heroin user group and the control group were compared. We further investigated the association between TPQ and OTI. The heroin group presented with lower reward dependence than the control group. Regarding sub-dimensions, heroin users showed higher impulsivity and fatigability, and lower exploratory excitability and social dependence. The explosive (borderline) pattern was more common among the heroin users. The odds ratio of explosive pattern developing to heroin dependence was 4.19. Q scores of heroin use and the maximal methadone dose were associated with persistence.     

精神分裂症患者发病前犯罪行为特征分析

目的：探讨早期精神分裂症犯罪暴力行为特征。方法：采用一般情况调查表和司法鉴定评估表,对28例精神分裂症罪犯与32名精神正常罪犯进行回顾性对照分析。结果：两组在职业、作案动机、作案预谋、作案性质、辨认、控制能力、作案后果判断能力、自我保护能力和刑事责任能力方面差异具有统计学意义。结论：早期精神分裂症发病前作案的行为特征表现为无明显的作案动机、无预谋准备、缺乏有效的自我保护能力、对作案行为及其后果的分析判断能力明显削弱,虽辨认能力大部分存在,但控制能力基本削弱。早期精神分裂症犯罪应加强识别,预防犯罪。