Henigsberg N, Folnegović-Smalc V, Moro L
Vrapce Psychiatric Hospital and Croatian Institute for Brain Research, Zagreb, Croatia.
Croat Med J. 2001 Oct;42(5):543-50.
To evaluate how the type of trauma is related to specific symptom patterns in patients with post-traumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) criteria.
A total of 136 PTSD patients exposed to war-related traumatic experiences were divided in four groups: 79 veterans, 18 former prisoners (who witnessed or were subject to torture or frequent assaults), 15 victims of rape, and 24 refugees from Bosnia and Herzegovina. Each group was homogenous in regard to traumatic experiences.
Significant inter-group differences were found in symptoms listed in the DSM-IV criteria, and under criteria C (avoidance) and D (arousal). No such differences were observed in symptoms listed under criterion B (intrusive symptoms). The results indicate that stressor characteristics may play a role not only in the variety of symptoms exhibited, but particularly in the number of avoidance and arousal symptoms. Victims of rape tended to present with more avoidance symptoms and fewer hyperarousal symptoms, whereas former prisoners and veterans tended to report more hyperarousal symptoms. Rape victims and former prisoners also reported more symptoms than the other groups.
There is a strong indication that stressor characteristics influence the variety and number of exhibited intrusive, avoidance, and arousal symptoms. More research is needed to precisely define individual symptom dimensions possibly relating to particular stressor characteristics. Additional studies are needed to determine whether PTSD, as it is currently defined in the DSM-IV, is really a homogenous diagnostic category.
根据《精神疾病诊断与统计手册》第四版（DSM-IV）标准，评估创伤类型与创伤后应激障碍（PTSD）患者特定症状模式之间的关系。
总共136名经历过与战争相关创伤经历的PTSD患者被分为四组：79名退伍军人、18名 former prisoners（目睹或遭受过酷刑或频繁袭击者）、15名强奸受害者以及24名来自波斯尼亚和黑塞哥维那的难民。每组在创伤经历方面具有同质性。
在DSM-IV标准列出的症状以及标准C（回避）和D（唤醒）下发现了显著的组间差异。在标准B（侵入性症状）下列出的症状中未观察到此类差异。结果表明，应激源特征可能不仅在表现出的症状种类中起作用，而且尤其在回避和唤醒症状的数量中起作用。强奸受害者往往表现出更多的回避症状和更少的过度唤醒症状，而former prisoners和退伍军人往往报告更多的过度唤醒症状。强奸受害者和former prisoners报告的症状也比其他组更多。
有强烈迹象表明应激源特征会影响所表现出的侵入性、回避和唤醒症状的种类和数量。需要更多研究来精确界定可能与特定应激源特征相关的个体症状维度。还需要进行更多研究以确定DSM-IV中目前定义的PTSD是否真的是一个同质的诊断类别。
