Coyne James C, Thompson Richard
Department of Psychiatry, University of Pennsylvania School of Medicine, 3400 Spruce St., 11 Gates, Philadelphia, PA 19014, USA.
J Anxiety Disord. 2007;21(2):223-9. doi: 10.1016/j.janxdis.2006.09.008. Epub 2006 Nov 2.
The articles in this special issue provide a wide range of challenges to current conceptions, nosology, and assessment procedures for posttraumatic stress disorders. At best, they overcome the negative heuristic posed by these disorders, reopening issues that have preemptively been closed about dissociation, the presumed causal connection between a life threatening event and the symptoms of posttraumatic stress disorders, and the adequacy of checklist assessments of symptoms. They note discontinuities between current thinking about these disorders and the dominant thinking of the past. We make recommendations for more studies that similarly challenge the validity of current conceptions of posttraumatic disorders and dissociation, and the adequacy of checklist assessments of symptoms. With this goal, we note the value of studying ersatz posttraumatic stress response. Finally, we call for greater transparency in this literature with author disclosure of activity as expert witnesses.
本期特刊中的文章对创伤后应激障碍的当前概念、疾病分类学和评估程序提出了广泛挑战。充其量,它们克服了这些障碍所带来的负面启发,重新开启了一些问题,这些问题此前已被预先封闭,涉及解离、危及生命事件与创伤后应激障碍症状之间假定的因果联系,以及症状清单评估的充分性。它们指出了当前对这些障碍的思考与过去的主流思考之间的不连续性。我们建议开展更多研究,同样对创伤后障碍和解离的当前概念的有效性以及症状清单评估的充分性提出挑战。出于这一目标,我们指出了研究替代性创伤后应激反应的价值。最后,我们呼吁该文献提高透明度,作者应披露作为专家证人的活动情况。