Investigation On Relationship Between Childhood Traumaand Self-esteem、Resilience Among Major Depressive Disorder

Objectives:1.To compare the differences of self-esteem and resilience between depression patients with and without childhood trauma.2.Analyze the relationship between childhood trauma and self-esteem,resilience of major depressive disorder.To provide a scientific basis for exploring the psychological therapy to improve self-esteem and resilience of depressed patients with childhood trauma.Methods:Through clinical interview of childhood trauma and questionnaire survey on major depressive disorder who meeting the inclusion and exclusion criteria[Self-made general information questionnaire,Beck Depression Inventor-13 item(BDI-13),Beck Anxiety Inventory-21 item(BAI-21),Childhood Trauma Questionnaire,28 item Short Form(CTQ-SF),Self-esteem Scale(SES),Connor-Davidson Resilience Scale(CD-RISC)],according to the clinical interview of childhood trauma and the score of CTQ-SF,the patients were divided into depression group with childhood trauma and depression group without childhood trauma.Use the design of matching case-control study,after controlling the general demographic data such as gender and age,and the degree of depression and anxiety,there was no significant difference between the two groups,the differences of self-esteem and resilience between the two groups were cross sectional compared.The correlation and regression analysis between childhood trauma questionnaire and self-esteem questionnaire,resilience questionnaire of depressed patients with childhood trauma were carried out.Resuits:1.Finally,160 patients with childhood traumatic depression and 160 patients without childhood traumatic depression were included.The proportion of trauma types in depression patients with childhood trauma was: emotional abuse18.1%(29 people),physical abuse13.8%(22 people),sexual abuse18.8%(30 people),emotional neglect70.0%(112 people)and physical neglect72.5%(116 people).The constituent ratio of the number of trauma species was: 1 kinds of trauma 38.8%(62 people),2 kinds of trauma40.0%(64 people),3 kinds of trauma 11.9%(19 people),4 kinds of trauma8.8%(14 people),5 kinds of trauma 0.6%(1 people),≥2 kinds of trauma61.3%(98 people),≥3kinds of trauma 21.3%(34 people).2.the total score of self-esteem,the total score of resilience,tenacity,strength and optimism in the group with childhood trauma were lower than those in the group without childhood trauma,and the difference is statistically significant(all: P<0.05).3.The total score of CTQ was significant negatively correlated with the total score of SES,CD-RISC,tenacity,strength and optimism(r=-0.341,-0.311,-0.262,-0.311,-0.346,all: P<0.01);Emotional abuse was significant negatively correlated with the total score of SES,CD-RISC,tenacity,strength and optimism(r=-0.411,-0.347,-0.324,-0.342,-0.300,all: P<0.01);Emotional neglect was significant negatively correlated with the total score of SES,CD-RISC,tenacity,strength and optimism(r=-0.292-0.312,-0.254,-0.310,-0.377,all: P<0.01);There was no significant correlation between physical abuse,sexual abuse,physical neglect and the total score of SES,CD-RISC and its dimensions(r=-0.101,-0.035,-0.084,-0.078,-0.073,-0.058,-0.073,-0.064,-0.102,-0.018,-0.021,-0.074,-0.036,-0.084,-0.038,all P>0.05).We found that emotional abuse could negatively predict the total score of SES,CD-RISC,tenacity dimension,strength dimension 、 optimistic dimension(all: P<0.01,β=-0.350,-0.261,-0.263,-0.256,-0.170).The emotional neglect could negatively predict the total score of SES,CD-RISC,tenacity dimension,strength dimension and optimistic dimension(tenacity dimension: P=0.016,other all: P<0.01,β=-0.143,-0.200,-0.141,-0.201,0.304).Conclusions:1.Among the patients with depression in psychiatric outpatient and inpatient departments of the investigated hospitals,the self-esteem and resilience of depression patients with childhood trauma were lower than those without childhood trauma.2.Childhood trauma is significant negatively correlated with self-esteem and resilience in patients with depression.Emotional abuse and emotional neglect are risk factors for self-esteem and resilience in patients with depression.However,physical abuse,sexual abuse and physical neglect have not been found to have similar effects on depressed patients with childhood trauma.