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创伤性事件的记忆会增加创伤性脑损伤患者患创伤后应激障碍的风险吗?一项前瞻性研究。

Does memory of a traumatic event increase the risk for posttraumatic stress disorder in patients with traumatic brain injury? A prospective study.

作者信息

Gil Sharon, Caspi Yael, Ben-Ari Irit Zilberman, Koren Danny, Klein Ehud

机构信息

Department of Psychiatry, Rambam Medical Center, Rappaport Faculty of Medicine, Technion Israel Institute of Technology, P.O. Box 9602, Haifa 31096, Israel.

出版信息

Am J Psychiatry. 2005 May;162(5):963-9. doi: 10.1176/appi.ajp.162.5.963.

Abstract

OBJECTIVE

The present study examined prospectively the relationship between memory of the traumatic event and subsequent development of posttraumatic stress disorder (PTSD). More specifically, the aims of this study were to 1) investigate the possibility that lack of memory of the traumatic event might be a protective factor; 2) assess whether memory of the traumatic event equally affects the three symptom clusters of PTSD: reexperiencing, avoidance, and hyperarousal; and 3) explore the predictive value of memory of the traumatic event for the development of subsequent PTSD in the immediate aftermath of the event.

METHOD

One hundred twenty subjects with mild traumatic brain injury who were hospitalized for observation were assessed immediately after the trauma and followed up 1 week, 3 months, and 6 months later. All participants underwent psychiatric evaluation and self-assessment of their memory of the traumatic event.

RESULTS

Overall, 17 (14%) of the participants met full criteria for PTSD at 6 months. Subjects with memory of the traumatic event were significantly more likely to develop PTSD than those without memory of the traumatic event; the difference between the groups resulted primarily from the reexperiencing cluster. Logistic regression analysis revealed that memory of the traumatic event within the first 24 hours is a strong predictor of PTSD 6 months after the event.

CONCLUSIONS

Our study indicated that memory of a traumatic event is a strong predictor and a potential risk factor for subsequent development of PTSD. Future studies are needed to show whether these findings can be generalized to other traumatic conditions.

摘要

目的

本研究前瞻性地考察了创伤事件记忆与创伤后应激障碍(PTSD)后续发展之间的关系。更具体地说,本研究的目的是:1)调查创伤事件记忆缺失可能是一种保护因素的可能性;2)评估创伤事件记忆是否对PTSD的三个症状群(重新体验、回避和过度警觉)有同等影响;3)探讨创伤事件记忆对事件刚发生后后续PTSD发展的预测价值。

方法

120名因轻度创伤性脑损伤住院观察的受试者在创伤后立即接受评估,并在1周、3个月和6个月后进行随访。所有参与者均接受了精神病学评估以及对其创伤事件记忆的自我评估。

结果

总体而言,17名(14%)参与者在6个月时符合PTSD的全部标准。有创伤事件记忆的受试者比没有创伤事件记忆的受试者更易患PTSD;两组之间的差异主要源于重新体验症状群。逻辑回归分析显示,创伤后24小时内的创伤事件记忆是事件发生6个月后PTSD的有力预测指标。

结论

我们的研究表明,创伤事件记忆是PTSD后续发展的有力预测指标和潜在风险因素。需要进一步的研究来表明这些发现是否可以推广到其他创伤情况。

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