Lewis-Fernández Roberto, Turner J Blake, Marshall Randall, Turse Nicholas, Neria Yuval, Dohrenwend Bruce P
Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY 10032, USA.
J Trauma Stress. 2008 Apr;21(2):123-32. doi: 10.1002/jts.20329.
The elevated rate of current posttraumatic stress disorder (PTSD) among Hispanic Vietnam veterans has been attributed to culturally based expressiveness that inflates symptom self-reports. To investigate this possibility, the authors conducted three hypothesis-driven analyses with National Vietnam Veterans Readjustment Study (NVVRS) data from the Structured Clinical Interview for DSM-III-R (SCID-) diagnosed subsample of male Vietnam Theater veterans (N = 260). First, persistence of the Hispanic elevation after adjusting for war-zone stress exposure initially suggested the effect of greater expressiveness. Second, symptom-based analyses isolated this effect to the self-report Mississippi Scale for Combat-Related PTSD and not to the clinician-rated SCID interview. Third, objective measures of functioning did not reveal a unique Hispanic pattern of lower impairment associated with current PTSD. These tests suggest that greater Hispanic expressiveness does not account for the Hispanic elevation in current PTSD in the NVVRS SCID-diagnosed subsample.
西班牙裔越战退伍军人中当前创伤后应激障碍（PTSD）的高发病率被归因于基于文化的表达性，这种表达性夸大了症状的自我报告。为了研究这种可能性，作者对来自越南战区男性退伍军人结构化临床访谈（SCID-）诊断子样本（N = 260）的越战退伍军人重新适应全国研究（NVVRS）数据进行了三项假设驱动的分析。首先，在调整战区应激暴露后，西班牙裔发病率的持续升高最初表明了更强表达性的影响。其次，基于症状的分析将这种影响隔离到自我报告的与战斗相关的PTSD密西西比量表，而不是临床医生评定的SCID访谈。第三，功能的客观测量没有揭示与当前PTSD相关的西班牙裔独特的较低损伤模式。这些测试表明，更强的西班牙裔表达性并不能解释NVVRS SCID诊断子样本中西班牙裔当前PTSD发病率的升高。
