Health Program, RAND Corporation, Santa Monica, CA 90407-2138, USA.
J Consult Clin Psychol. 2009 Dec;77(6):1169-78. doi: 10.1037/a0017721.
This longitudinal study of physical injury survivors examined the degree to which Hispanic and non-Hispanic Caucasians reported similar posttraumatic stress disorder (PTSD) symptoms. Adult physical trauma survivors (N = 677) provided information regarding posttraumatic distress by completing an interview-administered version of the PTSD Symptom Checklist (Civilian version) at 3 time points: within days of trauma exposure and again at 6 and 12 months posttrauma. Structural equation modeling with propensity weights was used in analyzing data. Results replicated prior research indicating that Hispanics report greater overall PTSD symptom severity. However, the size of this effect varied significantly across the 17 individual PTSD symptoms, and several symptoms were not reported more highly by Hispanics. Relative to non-Hispanic Caucasians, Hispanics tended to report higher levels of symptoms that could be regarded as exaggerated or intensified cognitive and sensory perceptions (e.g., hypervigilance, flashbacks). In contrast, few differences were observed for symptoms characteristic of impaired psychological functioning (e.g., difficulty concentrating, sleep disturbance). Findings suggest that the pattern of PTSD symptoms experienced most prominently by Hispanics differs in kind and not merely in degree. Results have implications for theory aimed at explaining this ethnic disparity in posttraumatic psychological distress as well as for clinical intervention with trauma-exposed Hispanics.
本纵向研究调查了身体创伤幸存者中西班牙裔和非西班牙裔白种人报告的创伤后应激障碍(PTSD)症状的相似程度。677 名成年身体创伤幸存者通过在创伤暴露后的几天内和创伤后 6 个月和 12 个月完成 PTSD 症状清单(民用版)的访谈式评估版本,提供了有关创伤后痛苦的信息。使用倾向评分的结构方程模型分析数据。结果复制了先前的研究,表明西班牙裔报告的总体 PTSD 症状严重程度更高。然而,这种影响的大小在 17 个单独的 PTSD 症状中差异显著,并且一些症状并没有被西班牙裔报告为更高。与非西班牙裔白种人相比,西班牙裔更倾向于报告可能被视为夸大或加剧的认知和感官知觉的症状(例如,过度警觉、闪回)。相比之下,对于表现出心理功能受损的症状(例如,注意力集中困难、睡眠障碍),观察到的差异很少。研究结果表明,西班牙裔最明显经历的 PTSD 症状的模式在性质上有所不同,而不仅仅是程度上有所不同。这些结果对旨在解释创伤后心理困扰方面的这种种族差异的理论以及对创伤暴露的西班牙裔进行临床干预具有意义。