生存、依恋与治愈:从进化的角度看与创伤有关的分离干预。

IF 2.8 3区 心理学 Q2 PSYCHOLOGY, CLINICAL
Psychology Research and Behavior Management Pub Date : 2024-06-18 eCollection Date: 2024-01-01 DOI:10.2147/PRBM.S402456
Lisa Burback, Christine Forner, Olga Karolina Winkler, Huda F Al-Shamali, Yahya Ayoub, Jacquelyn Paquet, Myah Verghese
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引用次数: 0

摘要

目的:解离是我们威胁反应系统的必要组成部分,是所有动物物种的共同特征,通常在受到极端或不可避免的威胁时会暂时启动。然而,病态的解离会在最初的威胁过去后继续发生,以对提醒或无法获得安全和保障做出反应。反复出现的解离症状与严重的创伤暴露、不安全的依恋、治疗无效以及药物使用、自杀和自残等适应不良的应对行为有关。然而,测试针对分离过程的治疗方法的实证研究仍然很少。这篇叙述性综述总结了现有的研究,并从理论、神经生物学和进化论的角度阐述了解离过程和病理性解离的治疗方法:于 2023 年 4 月 13 日对五个数据库(MEDLINE、EMBASE、APA PsycINFO、CINAHL plus、Scopus)进行了系统检索。结果进行了专题分析和总结。对结果进行了专题分析和总结:结果:共发现 69 项研究,主要集中于创伤后应激障碍、创伤暴露人群和边缘型人格障碍。72.5%的研究对心理疗法进行了研究;其他干预措施包括药物和神经刺激。尽管干预方法多种多样,但大多数研究都取得了积极的成果。然而,只有少数研究以治疗解离症状为主要目标:病态解离是一种复杂的现象,涉及大脑和身体系统,旨在感知和应对严重威胁,需要采取个性化的方法。有关帮助受反复出现的解离症状影响的潜在循证治疗方法的文献正在不断涌现。从神经生物学和进化论的角度来看,这些治疗方法可以被理解为促进内部和/或关系的安全感,从而减轻症状。要探索治疗分离症状的有效方法,还需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Survival, Attachment, and Healing: An Evolutionary Lens on Interventions for Trauma-Related Dissociation.

Purpose: Dissociation is a necessary part of our threat response system, common to all animal species, normally temporarily activated under conditions of extreme or inescapable threat. Pathological dissociation, however, continues to occur after the initial threat has passed, in response to reminders or inaccessibility of safety and security. Present across the spectrum of psychiatric diagnoses, recurrent dissociative symptoms are linked to severe trauma exposure, insecure attachment, treatment non-response, and maladaptive coping behaviors such as substance use, suicidality, and self-harm. However, empirical studies testing treatments specific to dissociative processes remain scarce. This narrative review summarizes existing studies and provides theoretical, neurobiological, and evolutionary perspectives on dissociative processes and treatments for pathological dissociation.

Methods: A systematic search of five databases (MEDLINE, EMBASE, APA PsycINFO, CINAHL plus, Scopus) was conducted on April 13, 2023. Peer-reviewed clinical studies with adult participants, assessing intervention effects on dissociative symptoms, were included. Results were thematically analyzed and summarized.

Results: Sixty-nine studies were identified, mainly focused on posttraumatic stress disorder, trauma-exposed populations, and borderline personality disorder. Psychotherapy was studied in 72.5% of studies; other interventions included medications and neurostimulation. The majority reported positive outcomes, despite the heterogeneous spectrum of interventions. However, treatment of dissociative symptoms was the primary objective in only a minority.

Conclusion: Pathological dissociation is a complex phenomenon involving brain and body systems designed for perceiving and responding to severe threats, requiring an individualized approach. A literature is emerging regarding potentially evidence-based treatments to help those impacted by recurrent dissociative symptoms. When contextualized within a neurobiological and evolutionary perspective, these treatments can be understood as facilitating an internal and/or relational sense of safety, resulting in symptom reduction. Further studies are needed to explore effective treatments for dissociative symptoms.

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来源期刊
CiteScore
4.50
自引率
4.70%
发文量
341
审稿时长
16 weeks
期刊介绍: Psychology Research and Behavior Management is an international, peer-reviewed, open access journal focusing on the science of psychology and its application in behavior management to develop improved outcomes in the clinical, educational, sports and business arenas. Specific topics covered in the journal include: -Neuroscience, memory and decision making -Behavior modification and management -Clinical applications -Business and sports performance management -Social and developmental studies -Animal studies The journal welcomes submitted papers covering original research, clinical studies, surveys, reviews and evaluations, guidelines, expert opinion and commentary, case reports and extended reports.
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