Background

Experience of childhood abuse has been suggested to increase the severity of post-traumatic stress disorder (PTSD) in adulthood. We hypothesized that resilience and coping strategies, which could be altered by experiencing childhood abuse, may mediate the effects of childhood abuse on PTSD severity in adulthood.

Methods

Crime victims with PTSD (n = 212, 38 men, aged 20–65 years) were recruited from South Korea. PTSD severity, a history of childhood abuse, resilience level, and use of coping strategies were assessed using structured clinical interviews and self-report questionnaires. Upon identifying the key factors that were associated with childhood abuse and PTSD severity, mediating roles of these key factors were examined using structural equation modeling and bootstrapping in simple and multiple mediation analyses.

Results

Resilience and dysfunctional coping strategies mediated the association between childhood abuse and lifetime PTSD severity in the adulthood, after covarying for the number of repeated trauma exposure (total effect: β = 0.44, P = 0.01, 95% CI [0.10, 0.77]; direct effect: β = 0.02, P = 0.90, 95% CI [−0.34, 0.38]; indirect effect: β = 0.42, P = 0.003, 95% CI [0.14, 0.69]).

Limitations

Recall of childhood abuse experience and lifetime PTSD severity can be biased in crime victims.

Conclusions

These findings may suggest that resilience and coping strategies mediate the detrimental effects of childhood abuse on lifetime PTSD severity. Targeted treatments that are designed to enhance resilience as well as deter the use of dysfunctional coping strategies may be of help in crime victims with a history of childhood abuse.

中文翻译：

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成人犯罪受害者的创伤后应激障碍和童年虐待的严重程度由低复原力和功能失调的应对策略介导

背景

有人建议，童年虐待的经历会增加成年后创伤后应激障碍 (PTSD) 的严重程度。我们假设可以通过经历童年虐待而改变的复原力和应对策略可能会调节童年虐待对成年后创伤后应激障碍严重程度的影响。

方法

 从韩国招募了患有 PTSD 的犯罪受害者（n = 212，38 名男性，年龄在 20-65 岁之间）。使用结构化临床访谈和自我报告问卷评估 PTSD 严重程度、儿童虐待史、复原力水平和应对策略的使用。在确定与儿童虐待和 PTSD 严重程度相关的关键因素后，使用结构方程模型和简单和多重中介分析中的自举来检查这些关键因素的中介作用。

结果

在对反复创伤暴露次数进行共变后，复原力和功能失调的应对策略介导了童年虐待与成年期终生 PTSD 严重程度之间的关联（总效应：β  = 0.44, P  = 0.01, 95% CI [0.10, 0.77]；直接影响：β  = 0.02, P  = 0.90, 95% CI [−0.34, 0.38]；间接影响：β  = 0.42, P  = 0.003, 95% CI [0.14, 0.69]）。

限制

回忆童年受虐经历和终生创伤后应激障碍严重程度可能会对犯罪受害者产生偏见。

结论

这些发现可能表明，复原力和应对策略调节了童年虐待对终生 PTSD 严重程度的不利影响。旨在增强复原力并阻止使用功能失调的应对策略的有针对性的治疗可能对有童年虐待史的犯罪受害者有所帮助。