Perry S, Difede J, Musngi G, Frances A J, Jacobsberg L
Department of Psychiatry, Cornell University Medical College, New York, NY.
Am J Psychiatry. 1992 Jul;149(7):931-5. doi: 10.1176/ajp.149.7.931.
The authors' goal was to examine subjective and objective predictors of posttraumatic stress disorder (PTSD).
Hospitalized burn patients were assessed 1 week after injury with both objective predictors (percent of burned area and facial disfigurement) and subjective predictors (emotional distress and perceived social support). The patients were then assessed 2, 6, and 12 months later for development of PTSD.
Among 51 patients, 18 (35.3%) met PTSD criteria at 2 months. High rates of PTSD were also found at 6 months (N = 16, 40.0% of the 40 available patients) and 12 months (N = 14, 45.2% of the 31 available patients). PTSD was predicted by subjective variables assessed at baseline, but patients with more severe burns were not more likely to develop PTSD.
The DSM-III-R diagnosis of PTSD relies on an objective evaluation of the stressor's severity. The prospective data in this study support those who argue that evaluations of the severity of the stressor might also take into account subjective factors.
作者的目标是研究创伤后应激障碍（PTSD）的主观和客观预测因素。
对住院烧伤患者在受伤1周后进行评估，评估内容包括客观预测因素（烧伤面积百分比和面部毁容情况）和主观预测因素（情绪困扰和感知到的社会支持）。然后在2个月、6个月和12个月后对患者进行PTSD发展情况的评估。
在51名患者中，18名（35.3%）在2个月时符合PTSD标准。在6个月时（N = 16，占40名可评估患者的40.0%）和12个月时（N = 14，占31名可评估患者的45.2%）也发现了较高的PTSD发生率。PTSD可由基线时评估的主观变量预测，但烧伤更严重的患者发生PTSD的可能性并不更高。
DSM-III-R对PTSD的诊断依赖于对应激源严重程度的客观评估。本研究中的前瞻性数据支持了那些认为对应激源严重程度的评估也可能需要考虑主观因素的观点。
