Department of Educational and Psychological Studies, University of Miami, Coral Gables, FL, USA.
Int J Psychiatry Clin Pract. 2013 Aug;17(3):232-7. doi: 10.3109/13651501.2012.667113. Epub 2012 Apr 26.
The study examined the long-term course of posttraumatic stress disorder (PTSD) by analyzing rates of recurrence and the predictive value of comorbid psychiatric disorders and psychosocial functioning.
This study is based on diagnostic assessments administered at intake and subsequent follow-up interviews over a period of 15 years in a sample of 90 anxiety-disordered patients with comorbid PTSD who participated in the Harvard Brown Anxiety Research project (HARP). Kaplan-Meier life table analysis revealed a 0.20 probability of full remission during the 15 years of follow-up.
Latent growth model (LGM) analysis revealed that the number of trauma exposures was a predictor of a worse course of PTSD but only during some intervals of the 15-year follow-up. Subjects with full social phobia were more likely to experience worsening of PTSD over time in comparison with subjects with less severe social phobia. Role functioning in the areas of household and employment was a significant predictor of a declining course of PTSD.
These findings revealed the dynamic nature of the predictive value of traumatic experiences, the deleterious effect of social phobia and the long term effect of psychosocial functioning on the course of PTSD. Implications for treatment planning and development of interventions for PTSD are discussed.
通过分析复发率以及合并精神障碍和心理社会功能的预测价值，研究了创伤后应激障碍（PTSD）的长期病程。
本研究基于在哈佛布朗焦虑研究项目（HARP）中，90 名患有 PTSD 共病的焦虑障碍患者在入组时和随后的 15 年随访中进行的诊断评估。Kaplan-Meier 生命表分析显示，在 15 年的随访期间，完全缓解的概率为 0.20。
潜在增长模型（LGM）分析显示，创伤暴露次数是 PTSD 病程恶化的预测因素，但仅在 15 年随访的某些时间段内如此。与社交恐惧症较轻的患者相比，患有完全社交恐惧症的患者随着时间的推移，PTSD 恶化的可能性更大。家庭和就业领域的角色功能是 PTSD 病程下降的一个重要预测因素。
这些发现揭示了创伤经历预测价值的动态性质、社交恐惧症的有害影响以及心理社会功能对 PTSD 病程的长期影响。讨论了对治疗计划和 PTSD 干预措施发展的影响。
