우울 및 불안장애 외래 환자의 아동기 외상과 증상의 복합성
Childhood Trauma and Symptom Complexity among Outpatients with Depressive and Anxiety Disorder
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Objective: Childhood trauma predicts later development of diverse adult psychiatric disorders and a complex pattern of symptomatology. This complex features were highlighted by recent addition of complex posttraumatic stress disorder (PTSD) to ICD-11. Our study aimed to examine association between lifetime traumatic experiences,both interpersonal and non-interpersonal nature and diversity of symptoms in depressive and anxiety disorders. Methods: We analyzed a psychometric data of 219 psychiatric outpatients with DSM-IV depressive or anxiety disorders at a university affiliated hospital. The questionnaires included the Symptom Checklist – 90 –Revised (SCL-90-R), the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. The symptomcomplexity was measured with Positive Symptom Total subscale of the SCL-90-R. Results: Childhood interpersonal trauma, adult interpersonal trauma, and adult non-interpersonal trauma were associated with symptom complexity. However, when interrelation between trauma experiences were controlled, childhood interpersonal and adult non-interpersonal trauma remained statistically significant. Conclusion: Thisstudy showed close associations of childhood interpersonal and adult non-interpersonal trauma with diverse self-reported symptomatology in adult patients with depressive and anxiety disorders. Clinicians working with depressive or anxiety disorders need to evaluate past trauma when encountered with diverse and complex symptom patterns.
Abstract
Objective: Childhood trauma predicts later development of diverse adult psychiatric disorders and a complex pattern of symptomatology. This complex features were highlighted by recent addition of complex posttraumatic stress disorder (PTSD) to ICD-11. Our study aimed to examine association between lifetime traumatic experiences,both interpersonal and non-interpersonal nature and diversity of symptoms in depressive and anxiety disorders. Methods: We analyzed a psychometric data of 219 psychiatric outpatients with DSM-IV depressive or anxiety disorders at a university affiliated hospital. The questionnaires included the Symptom Checklist – 90 –Revised (SCL-90-R), the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. The symptomcomplexity was measured with Positive Symptom Total subscale of the SCL-90-R. Results: Childhood interpersonal trauma, adult interpersonal trauma, and adult non-interpersonal trauma were associated with symptom complexity. However, when interrelation between trauma experiences were controlled, childhood interpersonal and adult non-interpersonal trauma remained statistically significant. Conclusion: Thisstudy showed close associations of childhood interpersonal and adult non-interpersonal trauma with diverse self-reported symptomatology in adult patients with depressive and anxiety disorders. Clinicians working with depressive or anxiety disorders need to evaluate past trauma when encountered with diverse and complex symptom patterns.
참고문헌 (39)
- Kelleher I, "Childhood trauma and psychosis in a prospective cohort study : cause, effect, and directionality", Am J Psychiatry, 170, pp.734~741 (2013)
- Edwards VJ, "Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents : results from the adverse childhood experiences study", Am J Psychiatry, 160, pp.1453~1460 (2003)
- Evans CB, "Cumulative bullying victimization : An investigation of the dose-response relationship between victimization and the associated mental health outcomes, social supports, and school experiences of rural adolescents", Child Youth Serv Rev, 44, pp.256~264 (2014)
- Cromer LD, "Making meaning of trauma : Trauma exposure doesn’t tell the whole story", J Contemp Psychother, 40, pp.65~72 (2010)
- Curran E, "Profiles of childhood trauma and psychopathology : US National Epidemiologic Survey", Soc Psychiatry Psychiatr Epidemiol, 53, pp.1207~1219 (2018)
- Cook A, "Complex trauma in children and adolescents", Psychiatric Annals, 35, pp.390~398 (2005)
- D’Andrea W, "Understanding interpersonal trauma in children : why we need a developmentally appropriate trauma diagnosis", Am J Orthopsychiatry, 82, pp.187~200 (2012)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders", pp.271~280 (2013), American Psychiatric Association
- Li M, "Maltreatment in childhood substantially increases the risk of adult depression and anxiety in prospective cohort studies : systematic review, meta-analysis, and proportional attributable fractions", Psychol Med, 46, pp.717~730 (2016)
- Lindert J, "Sexual and physical abuse in childhood is associated with depression and anxiety over the life course : systematic review and metaanalysis", Int J Public Health, 59, pp.359~372 (2014)
- Gardner MJ, "The association between five forms of child maltreatment and depressive and anxiety disorders : A systematic review and meta-analysis", Child Abuse Negl, 96, pp.104082~ (2019)
- Hovens JG, "Impact of childhood life events and trauma on the course of depressive and anxiety disorders", Acta Psychiatr Scand, 126, pp.198~207 (2012)
- Rhebergen D, "The 7-year course of depression and anxiety in the general population", Acta Psychiatr Scand, 123, pp.297~306 (2011)
- Briere J, "Phenomenology and psychological assessment of complex posttraumatic states", J Trauma Stress, 18, pp.401~412 (2005)
- Ruscio AM, "Applying empirically supported treatments to complex cases : ethical, empirical, and practical considerations", Clin Psychol : Sci Pract, 13, pp.146~162 (2006)
- Briere J, "Accumulated childhood trauma and symptom complexity", J Trauma Stress, 21, pp.223~226 (2008)
- Cloitre M, "A developmental approach to complex PTSD : childhood and adult cumulative trauma as predictors of symptom complexity", J Trauma Stress, 22, pp.399~408 (2009)
- Park SC, "Prevalence and symptomatic correlates of interpersonal trauma in South Korean outpatients with major depressive disorder", Compr Psychiatry, 66, pp.46~52 (2016)
- Gerger H, "Specific and nonspecific psychological interventions for PTSD symptoms : A meta-analysis with problem complexity as a moderator", J Clin Psychol, 70, pp.601~615 (2014)
- 이건석, "Exploratory Factor Analysis of the Beck Anxiety Inventory and the Beck Depression Inventory-II in a Psychiatric Outpatient Population", Journal of Korean Medical Science, 33(16), pp.40~50 (2018), 대한의학회
- Carlson EB, "Development and validation of a brief self-report measure of trauma exposure : the Trauma History Screen", Psychol Assess, 23, pp.463~477 (2011)
- Müller JM, "Comparison of eleven short versions of the Symptom Checklist 90-Revised(SCL-90-R)for use in the assessment of general psychopathology", J Psychopathol Behav Assess, 32, pp.246~254 (2010)
- Derogatis LR, "The SCL-90 and the MMPI : a step in the validation of a new self-report scale", Br J Psychiatry, 128, pp.280~289 (1976)
- Beck AT, "Manual for the Beck Depression Inventory-II" (1996), Psychological Corporation
- 성형모, "한국어판 백 우울 설문지 2판의 신뢰도 및 타당도 연구", 생물치료정신의학, 14(2), pp.201~212 (2008), 대한생물치료정신의학회
- Beck AT, "An inventory for measuring clinical anxiety : psychometric properties", J Consult Clin Psychol, 56, pp.893~897 (1988)
- Yook S, "A clinical study on the Korean version of Beck Anxiety Inventory : comparative study of patient and non-patient", Kor J Clin Psychol, 16, pp.185~197 (1997)
- Bernstein EM, "Development, reliability, and validity of a dissociation scale", J Nerv Ment Dis, 174, pp.727~735 (1986)
- Waller NG, "Types of dissociation and dissociative Types : A taxometric analysis of dissociative experiences", Psychol Methods, 1, pp.300~321 (1996)
- Lang AJ, "An abbreviated PTSD checklist for use as a screening instrument in primary care", Behav Res Ther, 43, pp.585~594 (2005)
- Bensley L, "Childhood family violence history and women’s risk for intimate partner violence and poor health", Am J Prev Med, 25, pp.38~44 (2003)
- Forbes D, "Trauma at the hands of another : longitudinal study of differences in the posttraumatic stress disorder symptom profile following interpersonal compared with noninterpersonal trauma", J Clin Psychiatry, 73, pp.372~376 (2012)
- Curran E, "Profiles of childhood trauma and psychopathology : US National Epidemiologic Survey", Soc Psychiatry Psychiatr Epidemiol, 53, pp.1207~1219 (2018)
- Baker DE, "Interpersonal vs. non-interpersonal cumulative traumas and psychiatric symptoms in treatment-seeking incarcerated women", J Trauma Dissociation, 22, pp.249~264 (2021)
- Pratchett LC, "Foundations of posttraumatic stress disorder : does early life trauma lead to adult posttraumatic stress disorder?", Dev Psychopathol, 23, pp.477~491 (2011)
- Spinhoven P, "Comorbidity of PTSD in anxiety and depressive disorders : prevalence and shared risk factors", Child Abuse Negl, 38, pp.1320~1330 (2014)
- Maercker A, "Development of the new CPTSD diagnosis for ICD-11", Borderline Personal Disord Emot Dysregul, 8, pp.7~ (2021)
- 김종기, "Childhood Trauma and Treatment Implications in Major Depressive Disorder in South Korea: Comparison with Medical Outpatients and Two-Year Follow-Up", Mood and Emotion, 17(3), pp.89~98 (2019), 대한우울조울병학회
- 김동주, "공황장애 외래 환자의 아동기 외상과 약물치료 유지", 정신신체의학, 28(1), pp.53~62 (2020), 한국정신신체의학회