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Abstract：
Background: Childhood maltreatment (CM) can be divided into: emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN). CM is associated with (Complex)Posttraumatic stress disorder (PTSD/CPTSD) and substance use disorder (SUD).Objective: This cross-sectional study examined the relationships between CM-subtypes with PTSD-severity and CPTSD in patients with SUD-PTSD.Method: Participants (N = 209) were treatment-seeking SUD-PTSD patients who completed the Childhood Trauma Questionnaire-short form, the Clinician-Administered PTSD Scale for DSM-5 and the International Trauma Questionnaire. Regression analyses and a model selection procedure to select an optimal model were used to examine CM-subtypes as predictors of (C)PTSD, adjusted for sex and age.Results: Total CM and all CM-types significantly predicted PTSD-severity in the univariate regression analysis, with EA begin the strongest predictor. In the multiple regression only SA predicted PTSD-severity. Subsequently, model selection indicated that the optimal model to predict PTSD-severity included EA and SA. In the univariate analyses total CM, EA, and PN significantly predicted CPTSD-classification, and total CM and all CM-types significantly predicted CPTSD-severity. In the multiple regression for CPTSD-classification only EA and PA were significant predictors and for CPTSD-severity EA, PA and SA were significant predictors. In post-hoc multiple regression analyses, only EA was a significant predictor of CPTSD-classification and CPTSD-severity. Finally, in the model selection the most parsimonious model only included EA for both CPTSD-classification and CPTSD-severity. Sex was not a moderator in the relationship between CM and PTSD, nor in CM and CPTSD.Conclusions: These findings indicate that for SUD-PTSD patients, several CM-types have predictive value for (C)PTSD-severity, however SA and especially EA appear to contribute to these complaints. Since EA does not constitute an A-criterion, it is generally more overlooked in PTSD treatment. Its impact should therefore be underlined, and clinicians should be attentive to EA in their treatment.
All types of Childhood Maltreatment are associated with PTSD severity.Emotional Abuse and Sexual Abuse are most predictive for PTSD severity.Emotional Abuse is most predictive for CPTSD classification and symptom severity.
All types of Childhood Maltreatment are associated with PTSD severity.Emotional Abuse and Sexual Abuse are most predictive for PTSD severity.Emotional Abuse is most predictive for CPTSD classification and symptom severity.
摘要：
背景：童年虐待（CM）可分为：情感虐待（EA），身体虐待（PA），性虐待(SA),情感忽视（EN），和身体忽视(PN)。CM与（复杂）创伤后应激障碍（PTSD/CPTSD）和物质使用障碍（SUD）有关。目的：这项横断面研究检查了SUD-PTSD患者中CM亚型与PTSD严重程度和CPTSD之间的关系。方法：参与者（N=209）是寻求治疗的SUD-PTSD患者，他们完成了儿童创伤问卷简表，DSM-5的临床医生管理的PTSD量表和国际创伤问卷。回归分析和选择最佳模型的模型选择程序用于检查CM亚型作为（C）PTSD的预测因子，根据性别和年龄进行调整。结果：在单变量回归分析中，总CM和所有CM类型显着预测PTSD严重程度，与EA开始最强的预测。在多元回归中，只有SA预测PTSD严重程度。随后，模型选择表明，预测PTSD严重程度的最佳模型包括EA和SA。在单变量分析总CM中，EA,和PN显著预测CPTSD分类，总CM和所有CM类型均显着预测CPTSD严重程度。在CPTSD分类的多元回归中，只有EA和PA是重要的预测因子，而对于CPTSD严重程度的EA，PA和SA是重要的预测因子。在事后多元回归分析中，只有EA是CPTSD分类和CPTSD严重程度的重要预测因子。最后,在模型选择中，最简约的模型仅包括CPTSD分类和CPTSD严重性的EA。性别不是CM和PTSD之间关系的调节者，在CM和CPTSD中也是如此。结论：这些结果表明，对于SUD-PTSD患者，几种CM类型对(C)创伤后应激障碍严重程度有预测价值，然而，SA，尤其是EA似乎有助于这些投诉。由于EA不构成A标准，在创伤后应激障碍治疗中通常更容易被忽视。因此，应该强调其影响，临床医生在治疗中应注意EA。
所有类型的儿童虐待都与PTSD严重程度相关。情感虐待和性虐待最能预测PTSD的严重程度。情感虐待对CPTSD分类和症状严重程度最具预测性。
所有类型的儿童虐待都与PTSD严重程度相关。情感虐待和性虐待最能预测PTSD的严重程度。情感虐待对CPTSD分类和症状严重程度最具预测性。
