活在童年霸凌之後：探討受害者成年期的複雜性創傷後壓力症狀

Abstract

童年同儕霸凌（Childhood Peer Bullying, CPB）不僅會在發生當下對受害者造成負面影響，也與多種長期負面心理發展有關，創傷後壓力反應就是一例。本研究欲瞭解CPB與複雜性創傷症候群（Complex Post-Traumatic Stress Disorder, CPTSD）之間的關係，遂分兩階段進行，第一階段問卷不設定填答者條件，蒐集性格、依戀、創傷歷史與CPTSD症狀等量性資料，分析有CPB經驗者在各變項上的表現，再從中篩選符合第二階段訪談條件的參與者，即有CPB經驗並在萌發成年期展現CPTSD症狀者，以半結構式深度訪談探討CPB如何與CPTSD症狀的發展與存續產生關聯。第一階段問卷結果發現，有CPB經驗者的CPTSD盛行率遠高於一般樣本，且其CPTSD症狀總分可被多個變項顯著預測，包含數種CPB事件特性、多重受害經驗、外向與神經質性格、焦慮與逃避依戀型態等，另發現其CPTSD症狀分佈有特殊趨勢，受自我組織干擾（Disturbances in Self-Organization, DSO）症狀影響的比例較PTSD症狀高，而在PTSD症狀中又以受「當前威脅感」症狀困擾者為多數。第二階段訪談結果發現，CPB包含玩物化與孤立化行為，會透過強反應與弱反應情節交替發生，使受害者反覆經驗到強烈認知衝擊與各種霸凌相關刺激（Bullying-Related Stimuli, BRS）帶來的負面情緒，甚至在脫離霸凌環境後持續受BRS制約影響並產生對於再次遭受霸凌的恐懼（Fear of Bullying Recurrence, FBR）；這些衝擊促使受害者發展多種不同時序與焦點的因應策略，在取得短期適應效果的同時，也增加了CPTSD症狀產生與存續的風險。本研究做為國內首篇以CPTSD角度探討CPB主題的論文，期能揭示霸凌的長期影響、提升大眾對霸凌防治的意識，並連結霸凌與創傷兩個領域，為CPTSD文庫貢獻根基於臺灣文化的實證資料，也為霸凌受害者的創傷後生活描繪出更完整的面貌，啟發新的臨床介入之可能。

Prior research suggests that childhood peer bullying (CPB) victimization not only inflicts immediate negative consequences on victims but may be associated with various long-term adverse psychological developments, such as Complex Post-Traumatic Stress Disorder (CPTSD). This study aimed to understand the relationship between CPB and CPTSD through a two-stage approach. In the first phase of the study, an online survey was administered to participants with or without CPB. Quantitative data pertaining to participants’ personality, attachment, trauma history, and CPTSD symptoms were collected and statistically analyzed to explore their relationships with experience of CPB victimization. Subsequently in the second phase of the study, participants who exhibited CPTSD symptoms in emerging adulthood resulted from CPB were recruited for semi-structured in-depth interviews. Qualitative data were collected and analyzed to form a grounded theory for explaining both the association between CPB and CPTSD and the mechanisms underlying CPTSD symptoms that developed and persisted into emerging adulthood. Results from the first-phase study reveal a significantly higher prevalence of CPTSD among individuals with CPB experience compared to a general sample. Furthermore, CPTSD symptoms among those with CPB experience were predicted by various variables, including several CPB event characteristics, poly-victimization experiences, both extraversion and neuroticism personality traits, and both anxious and avoidant attachment styles. Victims of CPB were also found to be more distressed by disturbances in self-organization (DSO) symptoms than PTSD symptoms, and “current sense of threat” was the most prevalent symptom among PTSD. Findings from the second-phase interviews reveal that CPB involves behaviors that made victims feel “toyified” and “isolated”, which were manifested through the occurrence of bullying episodes involving both strong and weak emotional or cognitive responses. Victims have thus repeatedly experienced intense cognitive impacts and negative emotions stemming from various bullying-related stimuli (BRS). Even after surviving CPB and transitioning to a new environment, victims were still conditioned by BRS and felt a strong sense of fear for bullying recurrence (FBR). These prompt the development of coping strategies with several foci, offering short-term adaptive effects but increasing the risk of development and persistence of CPTSD symptoms. Being one of the first studies to explore CPB from a CPTSD perspective, the findings shed light on the long-term effects of earlier bullying and may help raise public awareness about bullying prevention. This study hopes to bridge research on bullying and psychological trauma and contribute with empirical data for CPTSD literature. Moreover, the findings also provide a more comprehensive picture of bullying victims’ post-trauma lives, with the hope to inspire feasible clinical intervention.