Cohen P, Brown J, Smaile E
New York State Psychiatric Institute, New York 10032, USA.
Dev Psychopathol. 2001 Fall;13(4):981-99.
Child abuse and neglect have repeatedly been shown to be risks for psychiatric and personality disorders. However, much of this evidence is based on retrospective reports of adults. In addition, little is known about the developmental course of psychopathology among those exposed to child maltreatment. In this study, we report mental disorders assessed from early childhood to adulthood in those later identified as victims of abuse or neglect by official or self-report. Findings show elevated rates of mental disorders and symptoms in each of four groups relative to the normative sample. Groups included those who had been victims of physical abuse or neglect according to official report and those who had been victims of physical or sexual abuse by self-report. As expected, the maltreated groups were quite different demographically from the community comparison sample, especially those with official reports. The group with retrospective self-reports of physical abuse differed only modestly from the comparison group on the symptom and disorder measures, while the sexually abused group showed the most consistently elevated patterns, even after controls for demographic differences were taken into account. The disorder and symptom patterns differed both by group and by age: neglect cases showed a partial remission in adulthood, while official physical abuse cases showed an increasingly consolidated pattern of antisocial and impulsive behavior.
虐待和忽视儿童已被反复证明是导致精神疾病和人格障碍的风险因素。然而,这些证据大多基于成年人的回顾性报告。此外,对于遭受儿童虐待者的精神病理学发展过程知之甚少。在本研究中,我们报告了那些后来被官方认定或自我报告为虐待或忽视受害者的人从幼儿期到成年期的精神障碍评估情况。研究结果显示,相对于正常样本,四组中的每一组精神障碍和症状的发生率都有所升高。这些组包括根据官方报告曾遭受身体虐待或忽视的人,以及自我报告曾遭受身体或性虐待的人。不出所料,受虐待组在人口统计学上与社区对照样本有很大不同,尤其是那些有官方报告的人。自我报告有身体虐待史的组在症状和障碍测量方面与对照组仅有适度差异,而即使在考虑了人口统计学差异的控制因素后,性虐待组的模式显示出最持续升高的情况。障碍和症状模式因组和年龄而异:忽视案例在成年期有部分缓解,而官方记录的身体虐待案例显示出反社会和冲动行为模式越来越巩固。