ISSN 2586-0151 (Print) | ISSN 2586-0046 (Online)
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
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)
Childhood trauma; Child abuse; Interpersonal trauma; Dissociation; Symptom complexity; Psychiatric outpatients