Creamer Mark, McFarlane Alexander C, Burgess Philip
Australian Centre for Posttraumatic Mental Health, University of Melbourne, A&RMC Repat Campus, P.O. Box 5444, West Heidelberg, Victoria 3081, Australia.
J Affect Disord. 2005 Jun;86(2-3):175-82. doi: 10.1016/j.jad.2005.01.015.
The DSM-IV definition of posttraumatic stress disorder (PTSD) widened the stressor criterion to include objective (A1) and subjective (A2) components. The prevalence of Criterion A2, and its association with traumatic memory and psychopathology, was examined in a large community sample.
The presence of Criterion A2 and traumatic memories, as well as DSM-IV anxiety, affective and substance use disorders, were examined in a community sample of 6104 adults with a history of traumatic exposure.
Most individuals met Criterion A2 (76%), with higher prevalence in females (81%) than males (69%). A2 was more common following certain traumas (such as assaultive violence). Excluding those people with PTSD, prevalence of most psychiatric disorders was higher in those who met Criterion A2 than in those who only met Criterion A1. Only 3% of those who did not meet A2 went on to suffer persistent traumatic memories. The prevalence of psychiatric disorders was higher in those with A2 and traumatic memories than in those with A2 and no traumatic memories.
The retrospective nature of the data raises the potential for reporting biases. The data set allowed only one of several possible predictors of posttraumatic adjustment to be examined and only 12-month, and not lifetime, prevalence of psychiatric conditions was available.
The experience of powerful emotions at the time of traumatic exposure is common and is associated with increased prevalence not only of PTSD, but also of a range of other psychiatric conditions. Traumatic memories may mediate this association.
《精神疾病诊断与统计手册》第四版（DSM-IV）中创伤后应激障碍（PTSD）的定义拓宽了应激源标准，纳入了客观（A1）和主观（A2）成分。在一个大型社区样本中，对A2标准的患病率及其与创伤记忆和精神病理学的关联进行了研究。
在一个有创伤暴露史的6104名成年人社区样本中，调查了A2标准、创伤记忆以及DSM-IV中焦虑、情感和物质使用障碍的存在情况。
大多数个体符合A2标准（76%），女性患病率（81%）高于男性（69%）。在某些创伤（如攻击性暴力）后，A2更为常见。排除患有PTSD的个体后，符合A2标准的人比仅符合A1标准的人患大多数精神障碍的患病率更高。未符合A2标准的人中只有3%继续遭受持续性创伤记忆。有A2和创伤记忆的人比有A2但无创伤记忆的人患精神障碍的患病率更高。
数据的回顾性性质增加了报告偏倚的可能性。该数据集仅允许对创伤后适应的几种可能预测因素之一进行检查，并且仅提供了12个月而非终生的精神疾病患病率。
创伤暴露时强烈情绪的体验很常见，不仅与PTSD患病率增加有关，还与一系列其他精神疾病的患病率增加有关。创伤记忆可能介导了这种关联。
