Abstract

The study presented in the following verifies some assumptions of the novel ‘unsafe world’ model of selective mutism (SM). According to this model, SM is a stress reaction to situations erroneously experienced via cognition without awareness as ‘unsafe’. It assumes a high sensitivity to unsafety, whereby the nervous system triggers dissociation or freeze mode at relatively low thresholds. We examine whether there is a correlation between SM, sensory-processing sensitivity and dissociation. We compared a sample of 28 children and adolescents with SM (mean age 12.66 years; 18 females) to 33 controls without SM (mean age 12.45 years; 21 females). Both groups were compared using a medical history sheet, the ‘Selective Mutism Questionnaire’ (SMQ), a ‘Checklist for Speaking Behaviour’ (CheckS), the ‘Highly Sensitive Person Scale’ (HSPS), the ‘Child Dissociative Checklist’ (CDC), the ‘Adolescent Dissociative Experience Scale’ (A-DES) and the ‘Social Phobia and Anxiety Inventory for Children’ (SPAIK). Appropriate parametric and non-parametric tests were conducted to examine differences between groups. The results indicate that sensory-processing sensitivity was significantly higher in the group of children and adolescents with SM [X²(1) = 7.224, p = 0.0007; d = 1.092]. Furthermore, dissociative symptoms were more common in children and adolescents with SM than in controls [F(1, 33) = 13.004, p = 0.001; d = 0.986]. The results indicate that sensory-processing sensitivity and dissociation are important factors of SM that may hold important implications for the treatment.

Trial Registration

This study is registered with the ClinicalTrials.gov number NCT04233905.

中文翻译：

---

被神经系统背叛：一项调查选择性缄默症的“不安全世界”模型的对照组研究

摘要

下面介绍的研究验证了选择性缄默症 (SM) 的新型“不安全世界”模型的一些假设。根据这个模型，SM 是对通过认知错误体验的情况的压力反应，而没有意识到“不安全”。它假定对不安全的高度敏感，从而神经系统在相对较低的阈值下触发解离或冻结模式。我们检查了 SM、感觉处理敏感性和解离之间是否存在相关性。我们将 28 名患有 SM 的儿童和青少年样本（平均年龄 12.66 岁；18 名女性）与 33 名没有 SM 的对照组（平均年龄 12.45 岁；21 名女性）进行了比较。使用病史表、“选择性缄默问卷”（SMQ）、“说话行为检查表”（CheckS）、“高度敏感的人量表”（HSPS）、“儿童分离检查表”（CDC）、“青少年分离体验量表”（A-DES）和“儿童社交恐惧症和焦虑量表”（SPAIK）。进行了适当的参数和非参数测试以检查组之间的差异。结果表明 SM 儿童和青少年组的感觉处理敏感性显着更高 [X ² (1) = 7.224，p  = 0.0007；d  = 1.092]。此外，SM 儿童和青少年的分离症状比对照组更常见 [ F (1, 33) = 13.004, p  = 0.001; d  = 0.986]。结果表明，感觉处理敏感性和分离是 SM 的重要因素，可能对治疗具有重要意义。

试用注册

本研究已在 ClinicalTrials.gov 注册号 NCT04233905。