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创伤后应激障碍和极端应激障碍中的分离症状学

Dissociative symptomatology in posttraumatic stress disorder and disorders of extreme stress.

作者信息

Zucker Marla, Spinazzola Joseph, Blaustein Margaret, van der Kolk Bessel A

机构信息

The Trauma Center at Justice Resource Institute, Brookline, MA, USA.

出版信息

J Trauma Dissociation. 2006;7(1):19-31. doi: 10.1300/J229v07n01_03.

Abstract

The present study was designed to assess differences in dissociative symptoms in adults with Posttraumatic Stress Disorder (PTSD) vs. PTSD plus Disorders of Extreme Stress Not Otherwise Specified (DESNOS). This study was done for two reasons: (1) to better understand the clinical profile of DESNOS clients in order to inform more effective treatment, and (2) to further empirical research on the validity of the DESNOS construct. To assess severity of dissociative symptoms, the authors administered the Dissociative Experiences Scale (DES) to 155 participants with PTSD. Using the Structured Interview for Disorders of Extreme Stress (SIDES), participants were divided into two groups: those who also met criteria for DESNOS and those who did not. DES means are provided for the two groups. Participants with PTSD plus DESNOS scored higher than participants with only PTSD on the measure of dissociative symptomatology, particularly on the DES scales that tap absorption/fantasy and depersonalization/derealization. The two groups did not differ on the amnesia subscale of the DES. Findings support the construct validity of the DESNOS concept and further delineate the clinical profiles of community-based PTSD with and without DESNOS, thus contributing to the knowledge base on the assessment of complex adaptations to trauma.

摘要

本研究旨在评估患有创伤后应激障碍(PTSD)的成年人与患有PTSD加未另行规定的极端应激障碍(DESNOS)的成年人在分离症状上的差异。进行这项研究有两个原因:(1)更好地了解DESNOS患者的临床特征,以便提供更有效的治疗方法;(2)进一步对DESNOS概念的有效性进行实证研究。为了评估分离症状的严重程度,作者对155名患有PTSD的参与者进行了分离体验量表(DES)测试。使用极端应激障碍结构化访谈(SIDES),参与者被分为两组:符合DESNOS标准的参与者和不符合标准的参与者。文中给出了两组的DES平均值。患有PTSD加DESNOS的参与者在分离症状测量上的得分高于仅患有PTSD的参与者,特别是在涉及专注/幻想以及人格解体/现实解体的DES量表上。两组在DES的失忆分量表上没有差异。研究结果支持了DESNOS概念的结构效度,并进一步描绘了伴有和不伴有DESNOS的社区PTSD的临床特征,从而为评估创伤复杂适应情况的知识库做出了贡献。

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