Gnanadesikan Mukund, Novins Douglas K, Beals Janette
American Indian and Alaska Native Programs, Department of Psychiatry, University of Colorado Health Sciences Center, Aurora, CO 80045, USA.
J Clin Psychiatry. 2005 Sep;66(9):1176-83.
Previous studies have identified a high prevalence (25%-80%) of trauma among American Indian and non-American Indian adolescents and adults. However, only a fraction of traumatized individuals develop posttraumatic stress disorder (PTSD). This article examines the relationships of gender and trauma characteristics to a diagnosis of PTSD among a community sample of traumatized American Indian adolescents and young adults.
Complete data were collected from 349 American Indians aged 15 to 24 years who participated in a cross-sectional community-based study from July 1997 to December 1999 and reported experiencing at least 1 traumatic event. Traumatic events and PTSD were assessed using a version of the Composite International Diagnostic Interview. Logistic regression determined the relationships of gender, trauma type, age at first trauma, and number of traumas to the development of PTSD.
Forty-two participants (12.0% of those who experienced a traumatic event) met criteria for lifetime PTSD. While all 4 of the independent variables noted above demonstrated univariate associations with PTSD, multivariate logistic regression analyses indicated that only experiencing a sexual trauma (odds ratio [OR] = 4.45, 95% confidence interval [CI] = 1.76 to 11.28) and having experienced 6 or more traumas (OR = 2.53, 95% CI = 1.06 to 6.04) were independent predictors of meeting criteria for PTSD.
American Indian children and adolescents who experience sexual trauma and multiple traumatic experiences may be at particularly high risk for developing PTSD.
先前的研究已确定美国印第安人和非美国印第安青少年及成年人中创伤发生率很高(25%-80%)。然而,只有一小部分受创伤个体发展为创伤后应激障碍(PTSD)。本文探讨了性别和创伤特征与受创伤的美国印第安青少年及年轻成年人社区样本中PTSD诊断之间的关系。
从349名年龄在15至24岁的美国印第安人收集完整数据,这些人参与了1997年7月至1999年12月一项基于社区的横断面研究,并报告经历过至少1次创伤事件。使用综合国际诊断访谈的一个版本评估创伤事件和PTSD。逻辑回归确定性别、创伤类型、首次创伤时的年龄以及创伤次数与PTSD发展之间的关系。
42名参与者(经历创伤事件者的12.0%)符合终生PTSD标准。虽然上述所有4个自变量均显示与PTSD存在单变量关联,但多变量逻辑回归分析表明,只有经历性创伤(优势比[OR]=4.45,95%置信区间[CI]=1.76至11.28)以及经历6次或更多创伤(OR=2.53,95%CI=1.06至6.04)是符合PTSD标准的独立预测因素。
经历性创伤和多次创伤经历的美国印第安儿童和青少年可能患PTSD的风险特别高。