Emotions and emotion regulation in survivors of childhood sexual abuse: the importance of “disgust” in traumatic stress and psychopathology

Childhood sexual abuse (CSA) has the potential to compromise socio-emotional development of the survivor resulting in increased vulnerability to difficulties regulating emotions. In turn, emotion regulation is thought to play a key part in a number of psychological disorders which CSA survivors are at increased risk of developing. A better understanding of the basic emotions experienced in this population and emotion regulation strategies will inform current treatment. This paper examines the relationships between type of emotions experienced, emotion regulation strategies, and psychological trauma symptoms in a sample of survivors of CSA. A consecutive case series of CSA survivors (n=109) completed the Basic Emotions Scale (BES)—Weekly, General, and Coping versions; the Regulation of Emotions Questionnaire; the Post-traumatic Stress Checklist—Civilian Version (PCL-C); and the Clinical Outcomes in Routine Evaluation Outcome Measure. Significantly higher levels of disgust than other levels of emotions were reported on the weekly version of the BES. In addition, significantly higher levels of disgust and lower levels of happiness were reported on the BES—General subscale. Regression analyses revealed that sadness, fear, disgust, and external dysfunctional coping strategies predicted global post-traumatic stress disorder and re-experiencing symptomatology measured by the PCL-C. Global distress, as measured by CORE, was predicted by the emotions of sadness, disgust, and low happiness, as well as dysfunctional regulatory strategies. In addition, preliminary exploratory factor analyses supported the structure of all three versions of the BES, with disgust explaining the largest percentage of variance, followed by happiness. The findings highlight the utility of profiling basic emotions in understanding the strong associations between emotional phenomena, particularly the emotion of disgust and psychopathology in CSA survivors.

儿童性虐待（Childhood Sexual Abuse, CSA）可损害幸存者的社会情感发展，使其更易出现情绪调节困难。反之，情绪调节被认为在多种心理障碍中发挥关键作用，而CSA幸存者罹患此类障碍的风险显著升高。对该群体所体验的基本情绪及情绪调节策略进行更深入的认识，可为当前的临床治疗提供参考依据。本研究针对一组CSA幸存者样本，探讨了其所体验的情绪类型、情绪调节策略与心理创伤症状之间的关联。研究纳入109名连续入组的CSA幸存者，要求其完成以下量表的填写：基本情绪量表（Basic Emotions Scale, BES）的周度版、总体版与应对版；情绪调节问卷；平民版创伤后应激障碍检查表（Post-traumatic Stress Checklist—Civilian Version, PCL-C）；以及临床结局常规评估结局量表（Clinical Outcomes in Routine Evaluation Outcome Measure, CORE）。分析结果显示，在BES周度量表中，受试者报告的厌恶情绪水平显著高于其他各类情绪；在BES总体分量表中，受试者报告的厌恶情绪水平显著更高，而快乐情绪水平则显著更低。回归分析结果表明，悲伤、恐惧、厌恶情绪以及外部功能失调性应对策略，可预测由PCL-C评估的整体创伤后应激障碍症状及闯入症状。通过CORE测量的总体心理痛苦，则可由悲伤、厌恶、低快乐情绪以及功能失调性情绪调节策略来预测。此外，初步探索性因素分析验证了BES三个版本的因子结构，其中厌恶情绪对变异的解释率最高，其次为快乐情绪。本研究结果凸显了通过剖析基本情绪，以理解情绪相关现象（尤其是厌恶情绪）与CSA幸存者精神病理之间紧密关联的实用价值。