Original Article

대한불안의학회지 (18권2호 72-79)

The Association Between Childhood Interpersonal Trauma and Psychiatric Symptom Complexity, and the Mediating Impact of Dissociation

아동기 대인관계 외상, 정신 증상의 복잡성 및 해리의 매개 효과

Yaeseul Kim, MD1 , Seok Hyeon Kim, MD, PhD1,2, Daeho Kim, MD, PhD1,3, Eun Kyoung Kim, PhD3,4, Jiyeong Kim, PhD5 , and Nayeon Choi, MS5

1 Department of Psychiatry, Hanyang University College of Medicine, Seoul, 2 Department of Psychiatry, Hanyang University Medical Center, Seoul, 3 Department of Psychiatry, Hanyang University Guri Hospital, Guri, 4 Department of Premedicine, Hanyang University College of Medicine, Seoul, 5 Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, Korea

Abstract

Objectives : Any traumatic event can be a risk factor, for subsequent mental disorder. However, childhood trauma, especially in interpersonal nature, is associated with later development of complex symptom patterns. This study examined the role of dissociation as a mediator between childhood trauma and symptom complexity.

Methods : A pooled data of 369 psychiatric outpatients at a university-affiliated hospital was analyzed for descriptive statistics, group differences, and bivariate correlation analysis to verify a structural model. The questionnaires included the Symptom Checklist-90-Revised, the Trauma History Screen, the Dissociative Experiences Scale-Taxon, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist.

Results : When other trauma variables were controlled, childhood interpersonal trauma had significant correlation with symptom complexity (r=0.155, p=0.003). Among the paths analyzed, that of childhood interpersonal trauma and dissociation showed the greatest impact on symptom complexity (b=9.34, t=5.75, p<0.001). Based on the significance of the indirect impact, the results suggest a complete mediation impact of dissociation on symptom complexity.

Conclusions : This study validated that childhood interpersonal trauma impacts symptom complexity, through the sequential mediating impact of dissociation. Thus, clinicians should understand childhood interpersonal trauma, dissociation, and symptom patterns in a complex and interacting mode, and develop effective pertinent treatment strategies. (Anxiety and Mood 2022;18(2):72-79)

Keywords

Childhood trauma; Child abuse; Interpersonal trauma; Dissociation; Symptom complexity; Psychiatric outpatients

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