Department of Surgery/Trauma & Critical Care, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI 53226, USA.
Rehabil Psychol. 2010 Feb;55(1):1-11. doi: 10.1037/a0018601.
To investigate trajectories of PTSD and depression following traumatic injury using latent class growth curve modeling.
A longitudinal study of 330 injured trauma survivors was conducted and participants were assessed during hospitalization, and at 1, 3, and 6 months follow-up. Acute Stress Disorder (ASD) was assessed during hospitalization using the Acute Stress Disorder Interview (ASD-I), PTSD was measured at all follow-up with the Post-Traumatic Stress Diagnostic Scale (PDS) and depression was measured at hospitalization with the (BSI) and at follow-up with the Center for Epidemiologic Studies Depression Scale (CESDS). Covariates were explored, including coping self-efficacy, anger, education level, and mechanism of injury.
Four latent classes were identified for PTSD and Depression symptoms: chronic distress, delayed distress, recovered, and resilience. When compared to the resilient group, individuals with chronic distress were more likely to have been assaulted, had higher levels of anger, and had less coping self-efficacy. The delayed distress group had lower education levels, higher levels of coping self-efficacy, and higher levels of anger. Individuals in the recovered group had fewer years of education, and higher levels of anger.
The majority of the injured trauma sample demonstrated resiliency, with those exhibiting distress doing so as a delayed, chronic, or recovered trajectory. Coping self efficacy, education, assaultive trauma type, and anger were important covariates of depression and PTSD trajectories. These results are similar to studies of individuals who experienced a major health threat and with survivors from the World Trade Center attacks in the U.S.
使用潜在类别增长曲线模型研究创伤后 PTSD 和抑郁的轨迹。
对 330 名创伤后幸存者进行了一项纵向研究,在住院期间以及随访 1、3 和 6 个月时对参与者进行评估。使用急性应激障碍访谈 (ASD-I) 在住院期间评估急性应激障碍 (ASD),使用创伤后应激障碍诊断量表 (PDS) 在所有随访时评估 PTSD,使用症状自评量表 (BSI) 在住院时和使用流行病学研究中心抑郁量表 (CESDS) 在随访时评估抑郁。探讨了协变量,包括应对自我效能、愤怒、教育水平和损伤机制。
确定了 PTSD 和抑郁症状的四个潜在类别:慢性困扰、延迟困扰、恢复和韧性。与有韧性的组相比,慢性困扰的个体更有可能遭受过攻击,愤怒程度更高,应对自我效能感更低。延迟困扰组的教育水平较低,应对自我效能感和愤怒水平较高。恢复组的个体受教育程度较低,愤怒程度较高。
大多数创伤后样本表现出韧性,而表现出困扰的个体则表现为延迟、慢性或恢复轨迹。应对自我效能、教育、攻击性行为创伤类型和愤怒是抑郁和 PTSD 轨迹的重要协变量。这些结果与经历重大健康威胁的个体的研究以及美国世界贸易中心袭击事件的幸存者的研究相似。