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马来西亚海啸幸存者创伤后应激障碍的潜在结构:评估新提出的苦恼唤醒模型。

PTSD's latent structure in Malaysian tsunami victims: assessing the newly proposed Dysphoric Arousal model.

机构信息

The National Centre for Psychotraumatology, University of Southern Denmark, Odense, Denmark.

出版信息

Psychiatry Res. 2013 Mar 30;206(1):26-32. doi: 10.1016/j.psychres.2012.09.012. Epub 2012 Sep 25.

Abstract

The underlying latent structure of Posttraumatic Stress Disorder (PTSD) is widely researched. However, despite a plethora of factor analytic studies, no single model has consistently been shown as superior to alternative models. The two most often supported models are the Emotional Numbing and the Dysphoria models. However, a recently proposed five-factor Dysphoric Arousal model has been gathering support over and above existing models. Data for the current study were gathered from Malaysian Tsunami survivors (N=250). Three competing models (Emotional Numbing/Dysphoria/Dysphoric Arousal) were specified and estimated using Confirmatory Factor Analysis (CFA). The Dysphoria model provided superior fit to the data compared to the Emotional Numbing model. However, using chi-square difference tests, the Dysphoric Arousal model showed a superior fit compared to both the Emotional Numbing and Dysphoria models. In conclusion, the current results suggest that the Dysphoric Arousal model better represents PTSD's latent structure and that items measuring sleeping difficulties, irritability/anger and concentration difficulties form a separate, unique PTSD factor. These results are discussed in relation to the role of Hyperarousal in PTSD's on-going symptom maintenance and in relation to the DSM-5.

摘要

创伤后应激障碍(PTSD)的潜在潜在结构已得到广泛研究。然而,尽管有大量的因子分析研究,但没有一种单一的模型始终优于替代模型。最常支持的两种模型是情绪麻木和烦躁模型。然而,最近提出的五因素烦躁觉醒模型在现有模型之上得到了越来越多的支持。本研究的数据来自马来西亚海啸幸存者(N=250)。使用验证性因子分析(CFA)指定并估计了三个竞争模型(情绪麻木/烦躁/烦躁觉醒)。与情绪麻木模型相比,烦躁模型更适合数据。但是,通过卡方差异检验,与情绪麻木和烦躁模型相比,烦躁觉醒模型显示出更好的拟合度。总之,目前的结果表明,烦躁觉醒模型更好地代表了 PTSD 的潜在结构,并且测量睡眠困难、易怒/愤怒和注意力困难的项目形成了一个单独的、独特的 PTSD 因素。这些结果与 PTSD 持续症状维持中的过度警觉作用以及与 DSM-5 的关系进行了讨论。

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