{"title":"虐待儿童痛苦吗?儿童虐待中创伤周围疼痛的探讨。","authors":"Noga Tsur, Carmit Katz, Nofar Shemesh","doi":"10.1007/s40653-024-00682-x","DOIUrl":null,"url":null,"abstract":"<p><p>Substantial findings point to the risk of chronic pain following child maltreatment (CM). However, a coherent explanation for the mechanisms underlying pain following CM is lacking. Although peritraumatic pain may encompass a significant role in these processes, a systematic quantification of peritraumatic pain in CM has never been conducted. This study was conducted to provide an initial exploration of peritraumatic pain characteristics in CM, and its links with CM characteristics, pain expression, and later posttraumatic outcomes. Two samples of adult CM survivors (<i>N</i> = 160 and <i>N</i> = 120, respectively) filled out self-report questionnaires assessing peritraumatic pain characteristics, CM characteristics, peritraumatic dissociation, and complex posttraumatic-stress symptoms (cPTSD). Peritraumatic pain was reported by 42.2% (76 participants) and 57% (69 participants) in Samples 1 and 2, respectively. While pain was most prevalent in physical abuse (90%), it was also prevalent in sexual (63%) and emotional abuse (37.5%; <i>X</i> <sup><i>2</i></sup> (3) = 14.65, <i>p</i> = .002). Peritraumatic pain was most prevalent when the perpetrator was a family member (<i>X</i> <sup><i>2</i></sup> (3) = 14.65, <i>p</i> = .002), longer CM duration (<i>p</i> < .001), and in fight-or-flight peritraumatic responses (<i>X</i> <sup><i>2</i></sup> (2) = 7.13, <i>p</i> = .028). Peritraumatic pain expression did not differ for CM type (<i>p</i> > .083), and most participants reported that the perpetrator ignored their pain (73.9%). Explicit and concealing expressions of pain were associated with later cPTSD symptoms (<i>p</i> < .047). The findings provide an initial understanding of peritraumatic pain characteristics and phenomenology, demonstrating that pain is a substantial constituent of CM experiences and potential posttraumatic outcomes.</p>","PeriodicalId":44763,"journal":{"name":"Journal of Child & Adolescent Trauma","volume":"18 2","pages":"293-303"},"PeriodicalIF":1.7000,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130416/pdf/","citationCount":"0","resultStr":"{\"title\":\"Is Child Maltreatment Painful? An Exploration of Peritraumatic Pain in Child Maltreatment.\",\"authors\":\"Noga Tsur, Carmit Katz, Nofar Shemesh\",\"doi\":\"10.1007/s40653-024-00682-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Substantial findings point to the risk of chronic pain following child maltreatment (CM). However, a coherent explanation for the mechanisms underlying pain following CM is lacking. Although peritraumatic pain may encompass a significant role in these processes, a systematic quantification of peritraumatic pain in CM has never been conducted. This study was conducted to provide an initial exploration of peritraumatic pain characteristics in CM, and its links with CM characteristics, pain expression, and later posttraumatic outcomes. Two samples of adult CM survivors (<i>N</i> = 160 and <i>N</i> = 120, respectively) filled out self-report questionnaires assessing peritraumatic pain characteristics, CM characteristics, peritraumatic dissociation, and complex posttraumatic-stress symptoms (cPTSD). Peritraumatic pain was reported by 42.2% (76 participants) and 57% (69 participants) in Samples 1 and 2, respectively. While pain was most prevalent in physical abuse (90%), it was also prevalent in sexual (63%) and emotional abuse (37.5%; <i>X</i> <sup><i>2</i></sup> (3) = 14.65, <i>p</i> = .002). Peritraumatic pain was most prevalent when the perpetrator was a family member (<i>X</i> <sup><i>2</i></sup> (3) = 14.65, <i>p</i> = .002), longer CM duration (<i>p</i> < .001), and in fight-or-flight peritraumatic responses (<i>X</i> <sup><i>2</i></sup> (2) = 7.13, <i>p</i> = .028). Peritraumatic pain expression did not differ for CM type (<i>p</i> > .083), and most participants reported that the perpetrator ignored their pain (73.9%). Explicit and concealing expressions of pain were associated with later cPTSD symptoms (<i>p</i> < .047). The findings provide an initial understanding of peritraumatic pain characteristics and phenomenology, demonstrating that pain is a substantial constituent of CM experiences and potential posttraumatic outcomes.</p>\",\"PeriodicalId\":44763,\"journal\":{\"name\":\"Journal of Child & Adolescent Trauma\",\"volume\":\"18 2\",\"pages\":\"293-303\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-01-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130416/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Child & Adolescent Trauma\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s40653-024-00682-x\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"FAMILY STUDIES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Child & Adolescent Trauma","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s40653-024-00682-x","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"FAMILY STUDIES","Score":null,"Total":0}
引用次数: 0
摘要
大量的研究结果指出了儿童虐待(CM)后慢性疼痛的风险。然而,对CM后疼痛的机制缺乏一致的解释。尽管创伤周围疼痛可能在这些过程中起重要作用,但从未对CM的创伤周围疼痛进行过系统的量化。本研究旨在初步探讨CM的创伤周围疼痛特征,以及其与CM特征、疼痛表达和后来的创伤后结局的联系。两组成年CM幸存者(N = 160和N = 120)分别填写了评估创伤周围疼痛特征、CM特征、创伤周围分离和复杂创伤后应激症状(cPTSD)的自我报告问卷。在样本1和样本2中,分别有42.2%(76名参与者)和57%(69名参与者)报告了创伤周围疼痛。虽然疼痛在身体虐待(90%)中最为普遍,但在性虐待(63%)和精神虐待(37.5%)中也很普遍;x2 (3) = 14.65, p = .002)。当作案者为家庭成员时,创伤周围疼痛最为普遍(x2 (3) = 14.65, p = 0.002), CM持续时间较长(x2 (2) = 7.13, p = 0.028)。创伤周围疼痛的表达在CM类型上没有差异(p < 0.05),大多数参与者报告行凶者忽略了他们的疼痛(73.9%)。显性和隐性疼痛表达与后期cPTSD症状相关(p
Is Child Maltreatment Painful? An Exploration of Peritraumatic Pain in Child Maltreatment.
Substantial findings point to the risk of chronic pain following child maltreatment (CM). However, a coherent explanation for the mechanisms underlying pain following CM is lacking. Although peritraumatic pain may encompass a significant role in these processes, a systematic quantification of peritraumatic pain in CM has never been conducted. This study was conducted to provide an initial exploration of peritraumatic pain characteristics in CM, and its links with CM characteristics, pain expression, and later posttraumatic outcomes. Two samples of adult CM survivors (N = 160 and N = 120, respectively) filled out self-report questionnaires assessing peritraumatic pain characteristics, CM characteristics, peritraumatic dissociation, and complex posttraumatic-stress symptoms (cPTSD). Peritraumatic pain was reported by 42.2% (76 participants) and 57% (69 participants) in Samples 1 and 2, respectively. While pain was most prevalent in physical abuse (90%), it was also prevalent in sexual (63%) and emotional abuse (37.5%; X2 (3) = 14.65, p = .002). Peritraumatic pain was most prevalent when the perpetrator was a family member (X2 (3) = 14.65, p = .002), longer CM duration (p < .001), and in fight-or-flight peritraumatic responses (X2 (2) = 7.13, p = .028). Peritraumatic pain expression did not differ for CM type (p > .083), and most participants reported that the perpetrator ignored their pain (73.9%). Explicit and concealing expressions of pain were associated with later cPTSD symptoms (p < .047). The findings provide an initial understanding of peritraumatic pain characteristics and phenomenology, demonstrating that pain is a substantial constituent of CM experiences and potential posttraumatic outcomes.
期刊介绍:
Underpinned by a biopsychosocial approach, the Journal of Child & Adolescent Trauma presents original research and prevention and treatment strategies for understanding and dealing with symptoms and disorders related to the psychological effects of trauma experienced by children and adolescents during childhood and where the impact of these experiences continues into adulthood. The journal also examines intervention models directed toward the individual, family, and community, new theoretical models and approaches, and public policy proposals and innovations. In addition, the journal promotes rigorous investigation and debate on the human capacity for agency, resilience and longer-term healing in the face of child and adolescent trauma. With a multidisciplinary approach that draws input from the psychological, medical, social work, sociological, public health, legal and education fields, the journal features research, intervention approaches and evidence-based programs, theoretical articles, specific review articles, brief reports and case studies, and commentaries on current and/or controversial topics. The journal also encourages submissions from less heard voices, for example in terms of geography, minority status or service user perspectives.
Among the topics examined in the Journal of Child & Adolescent Trauma:
The effects of childhood maltreatment
Loss, natural disasters, and political conflict
Exposure to or victimization from family or community violence
Racial, ethnic, gender, sexual orientation or class discrimination
Physical injury, diseases, and painful or debilitating medical treatments
The impact of poverty, social deprivation and inequality
Barriers and facilitators on pathways to recovery
The Journal of Child & Adolescent Trauma is an important resource for practitioners, policymakers, researchers, and academics whose work is centered on children exposed to traumatic events and adults exposed to traumatic events as children.