The development of dissociation in maltreated preschool-aged children

Abstract

Dissociation reflects disruptions in the integration of memories, perception, and identity into a coherent sense of self, and may develop following childhood maltreatment. The preschool years were identified as an important period for the development of dissociation. However, prior research has not examined the development of dissociation during this time. In order to address this gap, evidence of dissociation in 45 maltreated children, assessed for sexual abuse, physical abuse, and neglect, was compared with dissociation in 33 nonmaltreated children. Rather than depend on adult observer reports of behavior, the study sought to gain an understanding of dissociation from the child's own point of view. Because self-reports have limitations with such young children, a measure of dissociation evidenced in children's narrative story-stem completions was utilized. Maltreated children, especially physically abused children and sexually abused children, demonstrated more dissociation than did nonmaltreated children. Moreover, during the preschool period maltreated and nonmaltreated children followed different trajectories such that dissociation increased for maltreated children but did not do so for nonmaltreated children. Findings suggest that although the self is normatively integrated during the preschool period, it becomes increasingly fragmented for some maltreated children. Results are discussed in terms of cascading effects of maltreatment throughout development, and the importance of developmentally sensitive interventions.

Abuso sexual em crianças e adolescentes: revisão de 100 anos de literatura

“…Em que pese a unanimidade dos autores sobre as repercussões que o abuso sexual e outros tipos de violência determinem na saúde mental (Zavaschi et al, 2002;Arboleda-Flórez e Wade, 2001;Meyerson et al, 2002;Molnar et al, 2001;Conway et al, 2004;Hill et al, 2001;Sharma e Gupta, 2004;Steel et al, 2004;Peleikis et al, 2004;Queiroz, 2003;Grande et al, 2003;Kisiel e Lyons, 2001;Haj-Yahia e Tamish, 2001;Macfie et al, 2001;Ystgaard et al, 2004;Roelofs et al, 2002;Roberts et al, 2004), além da predisposição para um comportamento delinqüente (Gover e MacKenzie, 2003;Craissati et al, 2002;Radosh, 2002;Lindsay et al, 2001;Swanston et al, 2003;Sharma, 2003;White e Smith, 2004), seja em idade adulta (Aylwin et al, 2003) ou na juventude, não há consenso a respeito da idéia de que a criança vítima de violência será um adulto violento, capaz de práticas abusivas (Craissati et al, 2002). O abuso sexual na infância é considerado também como fator de risco para a vitimização na idade adulta (Messman-Moore e Brown, 2004; Surrat et al, 2004;Polanczyk et al, 2003).…”

“…Dificuldade nos relacionamentos sexuais também é descrita (Peleikis et al, 2004;Queiroz, 2003). Transtornos dissociativos (Grande et al, 2003;Zavaschi et al, 2002;Kisiel e Lions, 2001), fobias, ideação paranóide e transtorno obsessivo-compulsivo têm sido referidos ao abuso sexual em crianças, adolescentes e adultos, podendo variar conforme o agressor e a idade em que ocorra o abuso (Haj-Yahia e Tamish, 2001; Macfie et al, 2001). Transtorno de conversão tem sido relacionado a pacientes com história de abuso sexual de longa duração e relações incestuosas (Ystgaard et al, 2004;Roelofs et al, 2002).…”

Depression and Play in Early Childhood

“…Von Klitzing, Kelsay, Emde, Robinson, & Schmitz, 2000;Warren, Emde, & Sroufe, 2000). Substantial literature has emerged suggesting that MSSB is able to elicit information from the child that is related to both parent and teacher symptom reports ; Macfie, Cicchetti, & Toth, 2001). …”

Trauma and Dissociation in Conversion Disorder and Chronic Pelvic Pain

“…Moreover, the results of a limited amount of prospective and longitudinal studies also suggest that overwhelming events have the potential to induce dissociative phenomena [7,8]. Empirical studies of the link between trauma and dissociation in patients with somatoform disorder, however, are relatively scarce.…”