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Psychiatric and Physical Sequelae of Childhood Physical and Sexual Abuse and Forced Sexual Trauma Among Individuals With Serious Mental Illness

Journal of Traumatic Stress

Published online on

Abstract

Trauma and posttraumatic stress disorder (PTSD) frequently co‐occur with serious mental illness, yet the unique mental and physical health influences of childhood physical abuse (CPA), childhood sexual abuse (CSA), and forced sexual trauma on individuals with serious mental illness remain unevaluated. The present study of 172 individuals with serious mental illness investigated the adverse effects of CPA, CSA, and forced sexual trauma on severity of PTSD and depression, and overall mental and physical health functioning. Data analysis consisted of chi‐square tests, independent t tests, bivariate odds ratios, and linear regressions. Prevalence of CPA (44.8%), CSA (29.1%), and forced sexual trauma (33.1%) were elevated, and nearly one third of participants (31.4%) reported clinical PTSD. Participants exposed to CSA or forced sexual trauma evidenced bivariate ORs ranging from 4.13 to 7.02 for PTSD, 2.44 to 2.50 for major depression, and 2.14 to 2.31 for serious physical illness/disability. Sexual trauma exposure associated with heightened PTSD and depression, and reduced mental and physical health functioning, with CSA uniquely predicting PTSD, depression, and physical health difficulties. CPA less significantly affected these clinical domains. Sexual traumas have profound negative effects on mental and physical health outcomes among individuals with serious mental illness; increased screening and treatment of sexual traumas is needed. 標題:在嚴重精神病患者中,童年身體和性侵犯及強迫性性創傷的精神和身體後遺症 撮要:創傷和創傷後壓力症(PTSD)常與嚴重精神病(SMI)共同出現,但SMI病者中童年身體受虐(CPA),童年性侵犯(CSA)和強迫性性創傷的精神和身體健康方面的獨特影響卻甚少探討。樣本為172名SMI病者,檢查CPA,CSA,強迫性性創傷對PTSD和抑鬱症嚴重程度的壞影響,和綜合精神及身體功能。數據分析包括卡方測試,獨立t測試,二元奇比和綫性回歸。CPA(45%),CSA(29%)和強迫性性創傷(33%)的流行率都上升了,而且近三份之一人(31%)報告患上臨床PTSD。經歷CSA或強迫性性創傷者的二元ORs分別是:PTSD為4.13 ‐ 7.02,抑鬱症為2.44 ‐ 2.50,和嚴重身體疾病或傷殘為2.14 ‐ 2.31。性創傷經歷與PTSD和抑鬱症上升相關,但與精神和健康功能下降相連,而CSA則獨特地預測PTSD、抑鬱症和身體健康問題。性創傷對SMI患者的精神和身體健康有極壞影響,所以加強篩查和性創傷治療是需要的。 标题:在严重精神病患者中,童年身体和性侵犯及强迫性性创伤的精神和身体后遗症 撮要:创伤和创伤后压力症(PTSD)常与严重精神病(SMI)共同出现,但SMI病者中童年身体受虐(CPA),童年性侵犯(CSA)和强迫性性创伤的精神和身体健康方面的独特影响却甚少探讨。样本为172名SMI病者,检查CPA,CSA,强迫性性创伤对PTSD和忧郁症严重程度的坏影响,和综合精神及身体功能。数据分析包括卡方测试,独立t测试,二元奇比和线性回归。CPA(45%),CSA(29%)和强迫性性创伤(33%)的流行率都上升了,而且近三份之一人(31%)报告患上临床PTSD。经历CSA或强迫性性创伤者的二元ORs分别是:PTSD为4.13 ‐ 7.02,忧郁症为2.44 ‐ 2.50,和严重身体疾病或伤残为2.14 ‐ 2.31。性创伤经历与PTSD和抑郁症上升相关,但与精神和健康功能下降相连,而CSA则独特地预测PTSD、忧郁症和身体健康问题。性创伤对SMI患者的精神和身体健康有极坏的影响,所以加强筛查和性创伤治疗是需要的。