Departmentof Psychiatry, PTSD Research Program, New York University School of Medicine, NY 10016, USA.
J Trauma Stress. 2011 Oct;24(5):557-65. doi: 10.1002/jts.20684. Epub 2011 Sep 6.
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.
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。