Veterans Affairs North Texas Health Care System, Dallas, USA.
Am J Public Health. 2012 Oct;102(10):e40-8. doi: 10.2105/AJPH.2012.300689. Epub 2012 Aug 16.
Using a comprehensive disaster model, we examined predictors of posttraumatic stress disorder (PTSD) in combined data from 10 different disasters.
The combined sample included data from 811 directly exposed survivors of 10 disasters between 1987 and 1995. We used consistent methods across all 10 disaster samples, including full diagnostic assessment.
In multivariate analyses, predictors of PTSD were female gender, younger age, Hispanic ethnicity, less education, ever-married status, predisaster psychopathology, disaster injury, and witnessing injury or death; exposure through death or injury to friends or family members and witnessing the disaster aftermath did not confer additional PTSD risk. Intentionally caused disasters associated with PTSD in bivariate analysis did not independently predict PTSD in multivariate analysis. Avoidance and numbing symptoms represented a PTSD marker.
Despite confirming some previous research findings, we found no associations between PTSD and disaster typology. Prospective research is needed to determine whether early avoidance and numbing symptoms identify individuals likely to develop PTSD later. Our findings may help identify at-risk populations for treatment research.
利用一个综合的灾难模型，我们研究了来自 10 种不同灾难的合并数据中创伤后应激障碍（PTSD）的预测因素。
合并样本包括 1987 年至 1995 年间 10 种灾难中 811 名直接暴露幸存者的数据。我们在所有 10 个灾难样本中使用了一致的方法，包括全面的诊断评估。
在多变量分析中，PTSD 的预测因素为女性、年龄较小、西班牙裔、受教育程度较低、已婚状态、发病前精神病理学、灾难伤害以及目睹伤害或死亡；通过朋友或家庭成员的死亡或受伤以及目睹灾难后果的暴露并没有增加 PTSD 的风险。在双变量分析中与 PTSD 相关的故意引发的灾难在多变量分析中并未独立预测 PTSD。回避和麻木症状是 PTSD 的一个标志。
尽管证实了一些先前的研究结果，但我们没有发现 PTSD 与灾难类型之间的关联。需要进行前瞻性研究，以确定早期的回避和麻木症状是否能识别出以后可能发展为 PTSD 的个体。我们的研究结果可能有助于确定治疗研究的高危人群。
