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初级保健诊所中城市青春期女孩创伤后应激障碍的临床及功能相关因素

Clinical and functional correlates of posttraumatic stress disorder in urban adolescent girls at a primary care clinic.

作者信息

Lipschitz D S, Rasmusson A M, Anyan W, Cromwell P, Southwick S M

机构信息

National Center for PTSD, VA Connecticut, West Haven 06516, USA.

出版信息

J Am Acad Child Adolesc Psychiatry. 2000 Sep;39(9):1104-11. doi: 10.1097/00004583-200009000-00009.

Abstract

OBJECTIVE

To identify clinical and functional correlates of posttraumatic stress disorder (PTSD) in trauma-exposed urban adolescent girls.

METHOD

Ninety female adolescents aged 12 to 21 years (mean 17.3 years) who presented for routine medical care at an adolescent primary care clinic were assessed with self-report questionnaires and interviews for trauma exposure, posttraumatic stress symptoms, other psychopathology, and psychosocial, family, and school function.

RESULTS

Ninety-two percent (n = 83) endorsed at least one trauma. Witnessing community violence (85.6%) and hearing about a homicide (67.8%) were the most common traumatic events endorsed. Twelve (14.4%) and 10 (11.6%) traumatized girls met DSM-IV symptom criteria for full and partial PTSD, respectively. Compared with traumatized girls without PTSD, girls with PTSD were significantly more depressed, used more cigarettes and marijuana, and were more likely to have failed a school grade, been suspended from school, or been arrested.

CONCLUSIONS

Urban adolescent girls are exposed to multiple types of trauma. Whereas most develop at least one posttraumatic stress symptom, girls who meet full symptom criteria for PTSD show evidence of other psychopathology, increased cigarette and marijuana use, and poorer school performance. Further research is needed to identify and treat inner-city girls with PTSD.

摘要

目的

确定遭受创伤的城市青少年女性创伤后应激障碍(PTSD)的临床及功能相关因素。

方法

对在青少年初级保健诊所接受常规医疗护理的90名年龄在12至21岁(平均17.3岁)的女性青少年进行评估,采用自我报告问卷和访谈来了解创伤暴露情况、创伤后应激症状、其他精神病理学表现以及心理社会、家庭和学校功能。

结果

92%(n = 83)的人认可至少经历过一次创伤。目睹社区暴力(85.6%)和听闻杀人事件(67.8%)是认可的最常见创伤事件。分别有12名(14.4%)和10名(11.6%)受创伤女孩符合DSM-IV中PTSD完全型和部分型症状标准。与未患PTSD的受创伤女孩相比,患PTSD的女孩抑郁程度明显更高,吸烟和使用大麻更多,更有可能学业成绩不及格、被学校停学或被捕。

结论

城市青少年女性遭受多种类型的创伤。虽然大多数人至少出现一种创伤后应激症状,但符合PTSD完全症状标准的女孩存在其他精神病理学证据,吸烟和使用大麻增加,学业表现更差。需要进一步研究以识别和治疗患有PTSD的市中心女孩。

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