Department of Clinical Health and Neuropsychology, Leiden University, PO Box 9555, 2300 RB Leiden, The Netherlands.
J Affect Disord. 2011 Jul;132(1-2):192-9. doi: 10.1016/j.jad.2011.02.017. Epub 2011 Mar 13.
BACKGROUND: Different trauma characteristics have been suggested to lead to distinct symptom profiles. This study investigates the effect of two trauma characteristics, age of onset and frequency, on PTSD symptom profiles. METHODS: Trauma characteristics (childhood versus adulthood trauma and single versus multiple trauma), psychiatric diagnosis, PTSD severity, depressive symptoms, dissociation, guilt, shame, anger, and interpersonal sensitivity were assessed in 110 PTSD outpatients. RESULTS: Single versus multiple trauma and childhood versus adulthood trauma groups did not differ in depressive symptom and co-morbidity. Multiple trauma patients reported more dissociation, guilt, shame, and interpersonal sensitivity than those that experienced single trauma. Anger of multiple trauma patients was more often directed towards themselves, whereas anger in single trauma patients was more often directed towards others. Childhood trauma patients reported more dissociation and state anger than adulthood trauma patients. However, with the exception of multiple trauma patients having more dissociation and shame than those with single trauma, all differences disappeared after controlling for PTSD severity. LIMITATIONS: This study is a first step in unraveling the impact of different trauma characteristics. Causal inferences are limited, though, because of the cross-sectional design. CONCLUSIONS: The results suggest that experiencing trauma at young age or multiple times may lead to different symptom profiles but these are, with the exception of dissociation and shame, dependent on PTSD severity. These results support the proposed DSM-V criteria in which these symptoms appear as part of the disorder, and stress the importance of early treatment.
背景:不同的创伤特征被认为会导致不同的症状模式。本研究探讨了两个创伤特征,发病年龄和频率,对 PTSD 症状模式的影响。
方法:在 110 名 PTSD 门诊患者中评估了创伤特征(儿童期与成年期创伤以及单次与多次创伤)、精神诊断、PTSD 严重程度、抑郁症状、分离、内疚、羞耻、愤怒和人际关系敏感。
结果:单次与多次创伤以及儿童期与成年期创伤组在抑郁症状和合并症方面没有差异。与经历单次创伤的患者相比,多次创伤患者报告了更多的分离、内疚、羞耻和人际关系敏感。多次创伤患者的愤怒更多地指向自己,而单次创伤患者的愤怒更多地指向他人。与成年期创伤患者相比,儿童期创伤患者报告了更多的分离和状态愤怒。然而,除了多次创伤患者的分离和羞耻感比单次创伤患者更多之外,所有差异在控制 PTSD 严重程度后都消失了。
局限性:本研究是揭示不同创伤特征影响的第一步。然而,由于横断面设计,因果推论受到限制。
结论:结果表明,在年轻时或多次经历创伤可能会导致不同的症状模式,但除了分离和羞耻之外,这些模式取决于 PTSD 严重程度。这些结果支持了 DSM-V 标准中提出的这些症状作为该疾病的一部分出现的观点,并强调了早期治疗的重要性。
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