Belastungen in der Kindheit und dissoziative Symptomatik bei Patienten mit psychischen Störungen
Abstract
Theoretischer Hintergrund: Dissoziative Symptome treten bei verschiedenen psychischen Störungen auf und werden bei einigen Störungen mit traumatischen Erfahrungen assoziiert. Fragestellung: Wird der Zusammenhang zwischen dissoziativer Symptomatik und belastenden Erfahrungen moduliert durch die Art der Erfahrung und das Alter zum Zeitpunkt der Belastung? Methode: Bei 82 Patienten (Borderline-Persönlichkeitsstörung, BPS; Major Depression Disorder, MDD) und 54 gesunden Kontrollpersonen wurden per Interview belastende Erfahrungen während Kindheit und Jugend (3 – 16 Jahre) ermittelt. Zusammenhänge zwischen Belastung und dissoziativer Symptomatik wurden regressionsanalytisch unter Berücksichtigung von Diagnose und komorbider Posttraumatischer Belastungsstörung (PTBS) untersucht. Ergebnisse: Dissoziative Symptomatik korreliert bei BPD und MDD (mit komorbider PTBS) positiv mit emotionalem (neben sexuellem) Missbrauch und mit Belastungen in der Pubertät. Schlussfolgerung: Therapeutische Berücksichtigung emotionaler und pubertärer Belastung könnte die (Behandlung erschwerende) dissoziative Symptomatik reduzieren.
Background: Dissociative symptoms in mental disorders have been related to traumatic experience. Objective: The aim is to evaluate the relationship between domain of childhood adversities and age of experience and dissociative symptoms across diagnoses. Method: Adverse experiences in four domains at ages 3 – 16 years were screened in 82 patients with primary ICD diagnoses of borderline personality disorder (BPD) or major depressive disorder (MDD), and 54 healthy controls. Dissociative symptoms were regressed to domain, age period, primary diagnoses and comorbid posttraumatic stress disorder (PTSD). Results: In BPD and MDD patients with comorbid PTSD, more dissociative symptoms varied with more emotional (along with sexual) abuse and pubescent stress. Conclusions: As dissociations may affect the success of treatment, addressing emotional and pubescent stress might have beneficial effects on treatment.
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