Turk J, Robbins I, Woodhead M
Department of Clinical Developmental Sciences, St. George's Hospital Medical School, University of London, Cranmer Terrace, London, UK.
J Intellect Disabil Res. 2005 Nov;49(Pt 11):872-5. doi: 10.1111/j.1365-2788.2005.00764.x.
Post-traumatic stress disorder (PTSD) is common and treatable. There is extensive research on people of average intelligence yet little on individuals with developmental disabilities.
We report two people with intellectual disability (ID) who experienced PTSD. The relevance of their developmental difficulties, social and communication profiles, attentional skills, and causes of these, to their presentations is discussed.
Both individuals have fragile X syndrome and severe ID. One has Diagnostic and Statistical Manual - 4th Edition (DSM-IV) autistic disorder; the other DSM-IV attention deficit-hyperactivity disorder. They experienced developmental and psychological regressions, new challenging behaviours and exacerbations of existing ones coincident with emotional trauma. PTSD symptoms and phenomena were identifiable despite intellectual and communicatory impairments.
Presentation of PTSD is influenced by degree and cause of ID, social circumstances, social and communicatory skills, nature and timing of traumatic experience and subsequent management. The paucity of literature suggests it is missed frequently in individuals with ID who risk having problems misattributed to other causes with potential for inappropriate interventions.
创伤后应激障碍（PTSD）很常见且可治疗。针对智力正常人群已有广泛研究，但针对发育障碍个体的研究较少。
我们报告了两名患有创伤后应激障碍的智力残疾（ID）患者。讨论了他们的发育困难、社交和沟通状况、注意力技能及其成因与临床表现之间的相关性。
两名患者均患有脆性X综合征和严重智力残疾。其中一名患有《精神疾病诊断与统计手册》第四版（DSM-IV）中的孤独症谱系障碍；另一名患有DSM-IV中的注意力缺陷多动障碍。他们经历了发育和心理倒退、新的具有挑战性的行为以及与情感创伤同时出现的现有行为的恶化。尽管存在智力和沟通障碍，但仍可识别出创伤后应激障碍的症状和现象。
创伤后应激障碍的表现受智力残疾的程度和成因、社会环境、社交和沟通技能、创伤经历的性质和时机以及后续管理的影响。文献匮乏表明，在智力残疾个体中，创伤后应激障碍经常被漏诊，这些个体存在问题被错误归因于其他原因并可能导致不适当干预的风险。
