RAND Corporation, Santa Monica, CA 90407-2138, USA.
J Abnorm Psychol. 2010 Feb;119(1):126-35. doi: 10.1037/a0018477.
This study used longitudinal data collected from two trauma-exposed samples, survivors of community violence (N = 294) and wildfire evacuees (N = 234), to examine a key claim underlying a proposed reformulation of the symptom structure of posttraumatic stress disorder (PTSD). This theory, which we term the PTSD-dysphoria model, posits that 8 of 17 symptoms of PTSD reflect dysphoria or general psychological distress and might be deemphasized to improve the utility of the PTSD construct (Simms, Watson, & Doebbeling, 2002). For each sample, we analyzed PTSD symptoms and measures of general distress administered at 2 time points. A consistent pattern of findings was observed across assessments for each sample: All 17 PTSD symptoms were highly associated with measures of general distress. Moreover, we found no evidence that dysphoria symptoms were more highly correlated than PTSD-specific symptoms with general distress. Results call into question both the conceptual basis and the clinical utility of differentiating between symptoms that appear to be relatively specific to PTSD and those that seem more broadly characteristic of general psychological distress.
本研究使用了来自两个创伤暴露样本的纵向数据，分别是社区暴力幸存者（N=294）和野火疏散人员（N=234），以检验一个拟议的创伤后应激障碍（PTSD）症状结构重新表述的核心主张。我们将这个理论称为 PTSD-抑郁模型，它假设 PTSD 的 17 种症状中有 8 种反映了抑郁或一般心理困扰，可能需要被淡化，以提高 PTSD 结构的实用性（Simms、Watson 和 Doebbeling，2002）。对于每个样本，我们分析了 PTSD 症状和两次评估时的一般困扰测量值。每个样本的评估结果都呈现出一致的模式：所有 17 种 PTSD 症状都与一般困扰的测量值高度相关。此外，我们没有发现抑郁症状与一般困扰的相关性高于 PTSD 特异性症状的证据。研究结果对区分似乎相对特定于 PTSD 的症状和那些似乎更广泛地具有一般心理困扰特征的症状的概念基础和临床实用性提出了质疑。
