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创伤后和特质性分离可区分具有创伤后应激症状弹性轨迹和症状轨迹的警察。

Peritraumatic and trait dissociation differentiate police officers with resilient versus symptomatic trajectories of posttraumatic stress symptoms.

机构信息

Departmentof Psychiatry, PTSD Research Program, New York University School of Medicine, NY 10016, USA.

出版信息

J Trauma Stress. 2011 Oct;24(5):557-65. doi: 10.1002/jts.20684. Epub 2011 Sep 6.

Abstract

Research has consistently demonstrated that stress reactions to potentially traumatic events do not represent a unified phenomenon. Instead, individuals tend to cluster into prototypical response patterns over time including chronic symptoms, recovery, and resilience. We examined heterogeneity in a posttraumatic stress disorder (PTSD) symptom course in a sample of 178 active-duty police officers following exposure to a life-threatening event using latent growth mixture modeling (LGMM). This analysis revealed 3 discrete PTSD symptom trajectories: resilient (88%), distressed-improving (10%), and distressed-worsening (2%). We further examined whether trait and peritraumatic dissociation distinguished these symptom trajectories. Findings indicate that trait and peritraumatic dissociation differentiated the resilient from the distressed-improving trajectory (trait, p < .05; peritraumatic, p < .001), but only peritraumatic dissociation differentiated the resilient from the distressed-worsening trajectory (p < .001). It is essential to explore heterogeneity in symptom course and its predictors among active-duty police officers, a repeatedly exposed group. These findings suggest that police officers may be a highly resilient group overall. Furthermore, though there is abundant evidence that dissociation has a positive linear relationship with PTSD symptoms, this study demonstrates that degree of dissociation can distinguish between resilient and symptomatic groups of individuals.

摘要

研究一致表明,对潜在创伤性事件的应激反应并不代表一个统一的现象。相反,个体往往会随着时间的推移聚集到典型的反应模式中,包括慢性症状、恢复和韧性。我们使用潜在增长混合建模(LGMM)检查了 178 名现役警察在经历危及生命的事件后的创伤后应激障碍(PTSD)症状过程中的异质性。这项分析显示 PTSD 症状轨迹有 3 个离散:有韧性(88%)、苦恼改善(10%)和苦恼恶化(2%)。我们进一步研究了特质和创伤前解离是否能区分这些症状轨迹。研究结果表明,特质和创伤前解离区分了有韧性和苦恼改善的轨迹(特质,p <.05;创伤前,p <.001),但只有创伤前解离区分了有韧性和苦恼恶化的轨迹(p <.001)。探索现役警察中症状过程及其预测因素的异质性至关重要,因为现役警察是一个反复暴露于创伤的群体。这些发现表明,警察总体上可能是一个非常有韧性的群体。此外,尽管有大量证据表明解离与 PTSD 症状呈正线性关系,但这项研究表明,解离程度可以区分有韧性和有症状的个体群体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e357/3974926/011eec6d6d72/nihms495461f1.jpg

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