Center on Autobiographical Memory Research, Department of Psychology and Behavioral Sciences, Aarhus University, Denmark.
Psychol Sci. 2012 Dec;23(12):1557-65. doi: 10.1177/0956797612457389. Epub 2012 Nov 5.
In the study reported here, we examined posttraumatic stress disorder (PTSD) symptoms in 746 Danish soldiers measured on five occasions before, during, and after deployment to Afghanistan. Using latent class growth analysis, we identified six trajectories of change in PTSD symptoms. Two resilient trajectories had low levels across all five times, and a new-onset trajectory started low and showed a marked increase of PTSD symptoms. Three temporary-benefit trajectories, not previously described in the literature, showed decreases in PTSD symptoms during (or immediately after) deployment, followed by increases after return from deployment. Predeployment emotional problems and predeployment traumas, especially childhood adversities, were predictors for inclusion in the nonresilient trajectories, whereas deployment-related stress was not. These findings challenge standard views of PTSD in two ways. First, they show that factors other than immediately preceding stressors are critical for PTSD development, with childhood adversities being central. Second, they demonstrate that the development of PTSD symptoms shows heterogeneity, which indicates the need for multiple measurements to understand PTSD and identify people in need of treatment.
在本研究中，我们在丹麦对 746 名士兵进行了 PTSD 症状的调查，这些士兵在部署到阿富汗之前、期间和之后分别进行了五次测量。通过潜在类别增长分析，我们确定了 PTSD 症状的六种变化轨迹。两个恢复轨迹在所有五次测量中均处于低水平，新发病例轨迹开始时水平较低，但 PTSD 症状明显增加。三个暂时获益轨迹，以前在文献中未描述过，在部署期间（或部署后立即）显示 PTSD 症状下降，然后在返回部署后增加。部署前的情绪问题和部署前的创伤，尤其是儿童期逆境，是纳入非恢复性轨迹的预测因素，而与部署相关的压力则不是。这些发现从两个方面挑战了 PTSD 的标准观点。首先，它们表明，除了直接的压力源外，其他因素对 PTSD 的发展至关重要，其中儿童期逆境是关键因素。其次，它们表明 PTSD 症状的发展具有异质性，这表明需要进行多次测量才能了解 PTSD 并确定需要治疗的人。
