Department of Psychiatry, The University of Western Ontario, London, Ontario, Canada.
Depress Anxiety. 2012 Aug;29(8):689-700. doi: 10.1002/da.21944. Epub 2012 May 11.
Dissociative symptoms are increasingly recognized in individuals with posttraumatic stress disorder (PTSD). The aim of this study was to investigate the prevalence of derealization and depersonalization symptoms via latent profile analyses (LPAs) in a civilian PTSD sample and examine the relationship between PTSD and dissociative symptoms via factor analytic methods.
A civilian sample of individuals with PTSD predominantly related to childhood abuse (n = 134) completed a diagnostic interview for PTSD and comorbid psychiatric disorders. LPAs and confirmatory factor analyses (CFAs) were performed on the severity scores for PTSD, derealization, and depersonalization symptoms.
LPAs extracted three groups, one of which was uniquely characterized by high derealization and depersonalization symptoms, and accounted for 25% of the sample. Individuals in the dissociative subgroup also showed a higher number of comorbid Axis I disorders and a more significant history of childhood abuse and neglect. CFAs suggested the acceptance of a five factor solution in which dissociative symptoms are distinct from but correlate significantly with the core PTSD symptom clusters.
The results from LPAs and CFAs are concordant with the concept of a dissociative subtype in patients with PTSD and suggest that symptoms of derealization-depersonalization and the core symptoms of PTSD are positively correlated. Thought should be given to including a dissociative subtype of PTSD in the DSM-5.
分离症状在创伤后应激障碍（PTSD）患者中越来越受到关注。本研究的目的是通过潜在剖面分析（LPAs）调查平民 PTSD 样本中去人格化和现实解体症状的患病率，并通过因子分析方法研究 PTSD 和分离症状之间的关系。
主要与儿童期虐待有关的 PTSD 平民样本（n=134）完成了 PTSD 和合并精神障碍的诊断访谈。对 PTSD、去人格化和现实解体症状的严重程度评分进行 LPAs 和验证性因子分析（CFAs）。
LPAs 提取了三个组，其中一个组的特点是去人格化和现实解体症状较高，占样本的 25%。分离亚组的个体也表现出更多的共患 Axis I 障碍，以及更显著的儿童期虐待和忽视史。CFAs 表明，接受五因素解决方案，其中分离症状与 PTSD 的核心症状簇不同但显著相关。
LPAs 和 CFAs 的结果与 PTSD 患者存在分离亚型的概念一致，并表明去人格化-现实解体症状与 PTSD 的核心症状呈正相关。应考虑在 DSM-5 中包含 PTSD 的分离亚型。
