Axelrod Seth R, Morgan C Andrew, Southwick Steven M
Department of Psychiatry, Yale University School of Medicine, 425 George St., New Haven, CT 06511, USA.
Am J Psychiatry. 2005 Feb;162(2):270-5. doi: 10.1176/appi.ajp.162.2.270.
The present report is part of a follow-along investigation focusing on the evolution of trauma-related symptoms in veterans of Operation Desert Storm. The goal of the current report was to examine three hypotheses on the relationship between severity of war-related trauma, symptoms of posttraumatic stress disorder (PTSD), and symptoms of borderline personality disorder with a mixed retrospective/prospective design.
Ninety-four National Guard reservists completed self-administered measures of combat-related trauma, PTSD symptoms, and borderline personality disorder features after their Gulf War duty.
Consistent with study hypotheses, prewar features of borderline personality disorder predicted variability in postwar PTSD symptoms beyond that predicted by combat exposure, combat exposure predicted variability in postwar features of borderline personality disorder, and PTSD severity assessed shortly after combat exposure accounted for additional variability in subsequent features of borderline personality disorder.
Taken together, the present findings suggest that trauma, symptoms of PTSD, and features of borderline personality disorder are related to one another in a complex fashion that may exceed simple linear models. Clinical and research implications for the relationships among trauma, PTSD, and borderline personality disorder are discussed.
本报告是一项跟踪调查的一部分,该调查聚焦于沙漠风暴行动退伍军人创伤相关症状的演变。本报告的目的是采用回顾性与前瞻性相结合的设计,检验关于战争相关创伤的严重程度、创伤后应激障碍(PTSD)症状以及边缘型人格障碍症状之间关系的三个假设。
94名国民警卫队预备役军人在海湾战争服役结束后,完成了与战斗相关创伤、PTSD症状以及边缘型人格障碍特征的自我评估测量。
与研究假设一致,边缘型人格障碍的战前特征预测了战后PTSD症状的变异性,其超出了战斗暴露所预测的范围;战斗暴露预测了战后边缘型人格障碍特征的变异性;战斗暴露后不久评估的PTSD严重程度解释了后续边缘型人格障碍特征中的额外变异性。
总体而言,目前的研究结果表明,创伤、PTSD症状和边缘型人格障碍特征以一种复杂的方式相互关联,这种方式可能超出简单的线性模型。文中讨论了创伤、PTSD和边缘型人格障碍之间关系的临床及研究意义。