有创伤史大学生的儿童期创伤和分裂人格特质与安全感的关系

目的:在有儿童期虐待史的大学生人群中,探讨儿童期虐待、分裂人格特质及安全感三者之间的关系。方法:以湖南中医药大学大一新生为对象,使用儿童期创伤问卷简化版、安全感量表、Chapman分裂型人格倾向量表,分发1115份问卷,回收有效问卷1088份,其中258人存在儿童期创伤史。结果:相关分析结果显示,安全感量表的人际安全感得分与分裂人格特质得分、儿童期创伤量表的情感虐待、情感忽视和躯体忽视呈显著的负相关(r=-0.184～-0.557,P0.05)。安全感量表的确定控制感得分与分裂人格特质得分、儿童期创伤量表的情感虐待和情感忽视呈显著的负相关(r=-0.219～-0.541,P0.05)。进一步分析发现,儿童期情感忽视在分裂人格特质和安全感之间起中介作用。结论:儿童期情感忽视和分裂人格特质负向影响安全感形成。儿童期情感忽视在分裂人格特质和安全感之间起中介作用。     

南充市两所大学大学生儿童期虐待经历调查

目的:了解南充市两所大学大学生的儿童期虐待经历情况并探讨其影响因素,为预防儿童虐待的发生和维护儿童的健康成长提供参考依据。方法:采用随机整群抽样的方法使用自编问卷对南充市两所高校共918名大学生进行不记名调查。结果:大学生儿童期虐待经历的发生率为67.43%,5种虐待的发生率依次为躯体忽视38.89%、情感忽视36.82%、情感虐待35.29%、躯体虐待16.45%、性虐待7.08%。男生躯体虐待(χ~2=12.774,P0.05)、躯体忽视(χ~2=4.173,P0.05)和性虐待(χ~2=14.240,P0.05)发生率高于女生。不同家庭经济的学生儿童期至少经历1种虐待(χ~2=12.257,P0.05)、情感虐待(χ~2=7.971,P0.05)、情感忽视(χ~2=13.629,P0.05)和躯体忽视(χ~2=10.014,P0.05)的发生率不同。结论:大学生在儿童期经历虐待问题较普遍,以忽视和情感虐待为主,男性和家庭经济状况差的儿童更容易遭受儿童虐待。     

大学生的儿童期创伤史及孤独特质与执行功能失常的关系

目的:探讨大学生儿童期创伤史及孤独特质与执行功能失常的关系。方法:使用儿童期创伤问卷(CTQ)评估湖南两所高校2757例大学生的儿童期创伤情况,根据Bernstein等人定义中-重度虐待暴露的阈值定义有无儿童期创伤史,选出有、无创伤史的学生各63例和93例,使用孤独症谱系障碍问卷(AQ)、抑郁自评量表(SDS)和执行功能失常问卷(DEX)测量孤独特质、抑郁水平和执行功能失常。最后,将问卷得分上下27%作为高低分组的界限定义不同类型的创伤组和孤独特质组。结果:高、低情感虐待组,高、低躯体虐待组,高、低性虐待组,高、低情感忽视组,高、低躯体忽视组以及高、低孤独特质组之间的执行功能失常问卷得分差异均有统计学意义(均P0.05),且高变量组的执行功能失常问卷得分均高于低变量组。回归分析显示,儿童期创伤问卷的情感虐待、孤独症谱系障碍问卷得分、SDS得分对执行功能失常问卷得分均有正向预测作用(β=0.17~0.32,均P0.05)。中介分析表明,SDS得分是情感虐待与DEX得分、孤独特质与DEX得分之间的中介变量,中介效应95%的可信区间分别是0.05~0.32和0.07~0.55。结论:儿童期创伤史与孤独特质正向预测执行功能失常,且抑郁在情感虐待与执行功能失常、孤独特质与执行功能失常之间起到中介作用。     

大学生情绪调节自我效能感在虐待与抑郁间的中介作用

目的:探讨大学生情绪调节自我效能感与儿童期虐待经历的关系,以及情绪调节自我效能感在虐待与抑郁间的中介作用。方法:从哈尔滨市4所高校选取475名大学生,采用情绪调节自我效能感量表(RES)的中文版、儿童期虐待问卷(CTQ)、流调中心用抑郁量表(CES-D)进行测查,其中CTQ采用回顾性调查。结果:躯体忽视和躯体虐待负向预测调节积极情绪效能感(POS)(β=-0.38、-0.52);情感忽视和性虐待负向预测调节沮丧/痛苦情绪效能感(DES)(β=-0.35、-0.31);躯体忽视负向预测调节生气/愤怒情绪效能感(ANG)(β=-0.23);躯体忽视和躯体虐待正向预测抑郁(β=0.78、3.20)。POS在情感忽视、躯体忽视、性虐待与抑郁之间具有中介作用(中介效应介于0.021~0.029);DES在情感忽视、躯体忽视、躯体虐待、性虐待与抑郁之间起着中介作用(中介效应介于0.017~0.040);ANG在情感忽视、躯体忽视与抑郁之间存在中介作用(中介效应介于0.016~0.019)。结论:低情绪调节自我效能感可能与儿童期虐待经历有关,情绪调节自我效能感在虐待与抑郁之间具有中介作用。     

成年男性严重躯体暴力行为与儿重期受虐的关系

目的:通过研究成年男性严重躯体施暴行为与儿童期受虐的关系,为家庭暴力行为的成因与干预提供依据。方法:采用单独访谈及问卷评估(冲突策略问卷与儿童期虐待简式问卷),结合当地公安司法部门、妇联等机构备案登记存在严重家庭暴力的资料,对四川省绵阳市某社区38例严重躯体施暴者与38例非施暴者根据年龄、婚姻状况、文化程度、经济状况基本一致配对进行研究。结果:①严重躯体施暴组年龄集中在18～29岁(65.8%);②严重躯体暴力组儿童期虐待问卷各分量表分值及量表总分均高于非暴力组(P<0.05);③严重躯体暴力组目前躯体虐待及躯体虐待严重程度、情感虐待、性虐待分量表分值均高于非施暴组(P<0.05),与访谈结果基本一致;④严重躯体施暴组的CTQ-SF躯体虐待分量表分值与CTS-2躯体虐待分值均呈正相关(P<0.05)。结论:男性儿童期遭受躯体虐待对其成年后严重躯体施暴行为的形成有一定影响;严重躯体施暴者存在其他施暴形式,包括情感虐待与性虐待,单一的施暴形式较为少见。     

大学生抑郁症症状水平与儿童期创伤经历关系初探

目的研究大学生抑郁症症状水平与儿童期创伤经历的关系。方法对抑郁症组39名大学生进行抑郁症症状的评定,同时发放儿童期创伤经历问卷(CTQ-SF);给正常组77名大学生发放儿童期创伤经历问卷(CTQ-SF)。结果与正常组相比,重度抑郁症组情感虐待、情感忽视的汉密尔顿抑郁量表(HAMD)得分显著偏高(t=2.506,3.117;P均0.05),轻中度抑郁症组情感忽视的HAMD得分显著偏高(t=2.831,P0.05);情感虐待因子、性虐待因子分别进入抑郁症症状水平与焦虑症症状水平的回归方程(标准偏回归系数分别为0.342和0.372)。结论情感虐待、情感忽视是影响大学生抑郁症症状水平的重要因素,性虐待则是影响大学生抑郁症患者焦虑症状的重要因素。     

慢性酒精依赖患者认知功能与童年创伤经历的相关性

目的:探讨慢性酒精依赖患者的认知功能与其童年创伤的关系。方法:纳入37例符合ICD-10酒精依赖综合征诊断标准的慢性酒精依赖患者,和年龄性别匹配的正常对照30例。采用酒精使用障碍筛查量表(AUDIT)、公认认知成套测验(MCCB)、儿童期创伤问卷(CTQ)分别测试两组酒精依赖程度、认知功能、童年创伤经历。结果:酒依赖组MCCB总分[(25.3±10.7) vs.(37.1±10.8)]和各因子得分均低于正常对照组(均P0.05),CTQ总分[(41.3±10.6) vs.(34.8±5.5)]及情感虐待、躯体虐待、性虐待、情感忽视得分高于正常对照组(均P0.05)。酒依赖组CTQ情感忽视与MCCB信息处理速度、注意警觉性、视觉学习得分呈现负相关(r=-0.43、-0.34、-0.38,均P0.05)。多重回归分析显示情感忽视得分与MCCB总分负向关联(β=-0.48,P0.05)。结论:慢性酒精依赖患者存在明显的认知功能损害,可能与其童年创伤经历有关。     

血浆生长因子、失眠和儿童期创伤与抑郁症的关系

目的:探讨血浆VEGF和NGF、儿童期创伤、失眠与抑郁症的关系及儿童期创伤与抑郁严重程度间可能的中介作用。方法:(1)采用病例对照,将纳入的51名抑郁症患者作为病例组,同期选取健康体检中心的61名健康人群为对照组;(2)采用汉密尔顿抑郁量表(HAMD-24)、28项简版儿童期创伤量表(CTQ-SF)、阿森斯睡眠量表(AIS)对所有研究对象的临床症状、睡眠及儿童创伤史进行评估;(3)采用酶联免疫吸附测定(ELISA)法测定血浆VEGF、NGF水平。结果:(1)与健康对照组相比,病例组血浆VEGF水平显著升高(t=2.957,P0.05),情感虐待、躯体虐待、性虐待、情感忽视及躯体忽视得分、HAMD-24总分、AIS总分也明显高于对照组(t=39.275,9.962,6.521,4.857,3.032;P0.05);(2)Logistic回归分析显示,情感虐待(OR=12.836,P0.01)、失眠(OR=10.637,P0.01)可能是抑郁症患病的危险因素;(3)中介分析显示,失眠在情感虐待与抑郁严重程度间具有部分中介作用。结论:情感虐待和失眠可能是抑郁症患病风险因素。     

儿童期虐待、执行功能与农村青少年情绪行为问题的结构方程模型

目的:探讨儿童期虐待、执行功能与青少年情绪行为问题的关系模型.方法:研究对象为816名农村青少年,调查的问卷包括儿童期创伤问卷(Childhood Trauma Questionnaire,CTQ)、长处和困难量表自评版(Strengths and Difficulties Questionnaire,SDQ)、执行功能行为评定量表自评版(Behavior Rating Inventory of Executive Function-Self Report Version,BRIEF-SR).结果:相关分析表明,除情感忽视与行为管理,躯体虐待、性虐待、情感忽视与元认知,躯体虐待与多动注意不能无相关(均P＞0.05),其余各因子、各变量间都呈不同程度的显著正相关.结构方程模型结果显示,儿童期虐待和执行功能对农村青少年情绪行为问题有显著正向预测作用,儿童期虐待除对青少年情绪行为问题有直接作用外,还通过执行功能起到间接作用.结论:儿童期虐待和执行功能对青少年情绪行为问题的形成有重要影响.执行功能在儿童期虐待与青少年情绪行为问题的关系中起部分中介作用.     

大学生儿童期虐待经历及其与家庭因素的关系

目的本文通过对2653名大一新生进行儿童期虐待问卷调查,描述大学生儿童期虐待经历的状况,并探究虐待经历与家庭因素的相互关系。方法采用儿童期虐待问卷及一般信息调查表进行调查。结果大学生儿童期情感虐待、躯体虐待、性虐待、情感忽视及躯体忽视的发生率分别为:64.8%、17.38%、22.58%、80.44%及70%。父母婚姻状况稳定是避免儿童期虐待的保护因素,父母虐待经历及父母赌博是儿童期虐待的危险因素。结论儿童期虐待现象是普遍存在的,家庭因素对其有重要预测作用。     

Childhood trauma and depression in alcoholics: relationship to hostility

OBJECTIVE: To examine for a relationship between childhood trauma and depression in alcoholics. METHODS: Euthymic depressed alcoholics (N = 23) were compared with never depressed alcoholics (N = 20) for their scores on the Childhood Trauma Questionnaire (CTQ). Subjects also completed the Hostility and Direction of Hostility Questionnaire (HDHQ). RESULTS: Euthymic depressed alcoholics had significantly higher scores on the CTQ for childhood emotional abuse, physical abuse, sexual abuse, and emotional neglect. They also had significantly higher hostility scores on the HDHQ. There were significant correlations between adult hostility scores and CTQ scores for childhood emotional neglect, physical neglect, sexual abuse and total childhood trauma. CONCLUSION: A history of childhood trauma was correlated with adult depression in male alcoholics: a hostile personality dimension might be a mediating variable. LIMITATION: Subjects were queried on their memories of childhood traumas. Prospective studies are needed.     

童年虐待及应对方式与强迫症的关联研究

目的 探讨童年虐待和应对方式与强迫症的相关性。方法 选取60例安徽省精神卫生中心门诊及住院强迫症患者作为研究组,以54例年龄、性别、教育年限匹配的成年人作为对照组,采用儿童期虐待问卷（CTQ）、简易应对方式问卷（SCSQ）、耶鲁-布朗强迫量表（Y-BOCS）对研究组和对照组进行施测并比较。结果 ①在童年虐待上,研究组各维度得分和总分均高于对照组,差异具有统计学意义（P＜0.05）;在应对方式上,研究组在积极应对方式上得分均低于对照组,在消极应对方式上得分高于对照组,差异具有统计学意义（P＜0.05）。②在童年期虐待和应对方式分布上,研究组有童年期虐待经历组38例（76.00%）,无童年期虐待经历22例（34.44%）;积极应对方式组23例（33.82%）,消极应对方式组37例（80.43%）,差异有统计学意义（P＜0.05）。③强迫障碍患者研究组中,积极应对方式与情感虐待、躯体虐待、性虐待、情感忽视存在显著负相关（P＜0.01）;消极应对方式与情感虐待、性虐待存在正相关（P＜0.05）。④在控制性别、年龄、教育年限后,消极应对方式组中,有童年期虐待的OR为6.012,而积极应对方式组中,有童年期虐待的OR仅为2.604。结论 积极应对方式是强迫症的保护性因素,而消极应对方式、童年期虐待是强迫症的危险因素。     

大学生B群人格障碍患者童年期创伤性经历的研究

目的：了解大学生B群人格障碍被试童年期创伤性经历的特点。方法：先用PDQ＋4问卷筛查，冉以PDI—IV对筛查的阳性被试进行半定式查询确诊B群人格障碍患者，然后用童年期创伤性经历问卷（CTQ）测查所有被试的章年负性经历。结果：除情感忽视因子外，B群人格障碍组CTQ各因子和总分均显著高于正常对照组。进一步将边缘型人格障碍（Borderline Personality Disordel ，BPD）组和自恋型人格障碍（Narcissistic Personality Disorder．NPD）组分别与正常对照组比较．发现BPD组情感虐待和情感忽视的因子分和总分屁著高于正常对照组。NPD组与对照组比较无鼎著性差异。结论：大学生B群人格障碍被试的童年期创伤较正常组严重。BPD在情感方面的创伤性经历尤其明显，提示情感虐待和忽视是大学生BPD发病的特征性因素。     

Childhood trauma and neuroticism as an adult: possible implication for the development of the common psychiatric disorders and suicidal behaviour

BACKGROUND: Neuroticism is an important personality dimension associated with depressive and anxiety disorders. Both genetic and social factors are thought to contribute to neuroticism. This study aims to examine whether early childhood adversity may be a determinant of neuroticism. METHOD: Five hundred and thirty-two abstinent substance dependent patients completed both the Childhood Trauma Questionnaire (CTQ) and the Eysenck Personality Questionnaire (EPQ). RESULTS: There was a significant relationship between total childhood trauma scores on the CTQ and neuroticism scores on the EPQ. There were also significant relationships between neuroticism and CTQ subscores for emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect. CONCLUSIONS: Childhood trauma may be a determinant of neuroticism. This may be one way in which childhood trauma plays a role in the development of psychiatric disorders. General population studies are needed.     

Association of child maltreatment and psychiatric diagnosis in Brazilian children and adolescents

OBJECTIVES:

The objective of this study was to evaluate the association between different types of child maltreatment and the presence of psychiatric disorders in highly vulnerable children and adolescents served by a multidisciplinary program.

METHODS:

In total, 351 patients with a mean age of 12.47, of whom 68.7% were male and 82.1% lived in shelters, underwent psychiatric evaluations based on the Kiddie-Sads-Present and Lifetime Version. Two different methods were used to evaluate maltreatment: medical records were reviewed to identify previous diagnoses related to socioeconomic and psychosocial circumstances, and the Childhood Trauma Questionnaire was used to obtain a structured history of trauma. Bivariate associations were evaluated between psychiatric disorders and evidence of each type and the frequency of abuse.

RESULTS:

The most frequent psychiatric diagnoses were substance use disorders, affective disorders and specific disorders of early childhood, whereas 13.67% of the sample had no psychiatric diagnosis. All patients suffered neglect, and 58.4% experienced physical or sexual abuse. The presence of a history of multiple traumas was only associated with a diagnosis of substance use disorder. Mental retardation showed a strong positive association with reported physical abuse and emotional neglect. However, a negative correlation was found when we analyzed the presence of a history of multiple traumas and mental retardation.

CONCLUSION:

All children living in adverse conditions deserve careful assistance, but we found that physical abuse and emotional neglect were most strongly associated with mental retardation and multiple traumas with substance abuse.     

Childhood maltreatment and internalized shame in adults with a diagnosis of bipolar disorder

Relatively little is understood regarding the aetiology of bipolar disorder (BD) other than for the influence of a large genetic component on the development of the disorder and the impact of stressful life events on changes in current mood. However, amongst a range of psychiatric diagnoses, research consistently demonstrates a higher frequency of reports of childhood abuse and neglect compared with individuals in the general population. In addition, those who report experiences of childhood maltreatment also report high levels of internalized shame in adulthood, although there is little research demonstrating this association amongst clinical populations. An adult sample of 35 participants with a diagnosis of BD and a control group of 35 participants with no psychiatric diagnoses completed measures of childhood abuse and neglect, and internalized shame. Participants in the BD group reported a significantly greater frequency of high levels of childhood trauma compared with participants in the control group, with the reported frequency of childhood emotional abuse and neglect being particularly high. Levels of current internalized shame were also significantly higher amongst participants in the BD group. Significant correlations were observed between current internalized shame and reports of childhood emotional abuse and neglect. Clinical implications of the study's findings are discussed, and limitations of the methodology are considered. Copyright ? 2011 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: The frequency of reports of childhood trauma would appear to be higher amongst adults with a diagnosis of BD compared with individuals with no psychiatric diagnoses. Levels of internalized shame in adulthood are also likely to be higher than those in the general population, although the current literature does not shed light on the relationship between childhood abuse and neglect, mood-related behaviour, and shame. Experiences of childhood abuse and neglect, particularly childhood emotional abuse and emotional neglect, are likely to be frequently reported by clients with a diagnosis of BD. Clinicians should therefore explicitly consider these experiences in their assessment, formulation and intervention with clients with a diagnosis of BD.     

违法劳教人员及其B群人格障碍患者童年期被虐待经历的研究

目的：了解违法劳教群体及其B群人格障碍患者章年期被虐待经历的情况。方法：先用PDQ＋4筛查，再以PDI—IV对筛查的阳性被试做半定式查询确定B群人格障碍患者，然后用章年期创伤性经历问卷（CTQ）测查所有被试的童年被虐待经历。结果：劳教人员B群人格障碍组的章年期躯体和情感虐待性经历较对照组严重（P〈0．05）。性虐待、躯体和情感忽视两组无显著性差异（P〉0．05）。进一步住反社会人格障碍组和对照组、其他人格障碍组和对照组之间比较发现五种形式的虐待均无显著性差异（P〉0．05）。结论：违法人群中，多种人格障碍共病的个体童年期受到的虐待较非人格障碍者严重。     

强迫障碍患者与其童年期创伤性经历的关系

目的研究强迫障碍(Obsessive-Com pu lsive D isorder,OCD)患者的发病与其童年期创伤性经历的关系。方法符合DSM-IV临床诊断标准的45例OCD患者为被试,用童年期创伤问卷(CTQ-SF)施测。另招募正常对照50例施测CTQ-SF。结果 OCD患者除情感虐待、性虐待外,情感忽视、躯体忽视、躯体虐待3因素进入Log istic回归方程。情感忽视(W ald卡方=13.473,P<0.001),躯体忽视(W ald卡方=4.602,P<0.05),躯体虐待(W ald卡方=9.977,P<0.05)。其中情感忽视(b=0.429,exp(b)=1.536)、躯体忽视(b=0.242,exp(b)=1.273)两因素的回归系数(b)均>0、比值比(OR)=exp(b)均>1,而躯体虐待(b=-0.559,exp(b)=0.572)的回归系数(b)<0、比值比(OR)=exp(b)<1。结论 OCD患者的童年期的情感忽视和躯体忽视是OCD发病的危险因素,而躯体虐待则不是OCD发病的危险因素。     

Childhood abuse and neglect histories in low-income women: prevalence in a menopausal population

OBJECTIVES: To examine the prevalence of self-reported childhood abuse and neglect in a primary care population of menopausal women. DESIGN: A cross-sectional questionnaire-based study. RESULTS: Three of four women (119/160, 74%) reported histories of childhood abuse and neglect. The prevalence of emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect were 43%, 35%, 33%, 49%, and 44%, respectively. Eleven percent of the sample reported maltreatment in all five categories of trauma. Fifteen percent of women studied met criteria for severe-extreme levels of maltreatment, usually in more than one category. CONCLUSIONS: A high prevalence of self-reported childhood trauma was detected in our low-income population of menopausal women attending primary care clinics. Because of the potential impact of childhood trauma on physical and mental health, clinicians need to inquire about childhood maltreatment in women of menopausal age and appropriately refer women to mental health intervention and treatment.