Bomyea J, Lang A J, Golinelli D, Craske M G, Chavira D A, Sherbourne C D, Rose R D, Campbell-Sills L, Welch S S, Sullivan G, Bystritsky A, Roy-Byrne P, Stein M B
SDSU/UCSD Joint Doctoral Program in Clinical Psychology, University of California, San Diego.
J Psychopathol Behav Assess. 2013 Jun 1;35(2):254-263. doi: 10.1007/s10862-012-9327-0.
The present study examined rates of trauma exposure, clinical characteristics associated with trauma exposure, and the effect of trauma exposure on treatment outcome in a large sample of primary care patients without posttraumatic stress disorder (PTSD). Individuals without PTSD (N = 1263) treated as part of the CALM program (Roy-Byrne et al., 2010) were assessed for presence of trauma exposure. Those with and without trauma exposure were compared on baseline demographic and diagnostic information, symptom severity, and responder status six months after beginning treatment. Trauma-exposed individuals (N = 662, 53%) were more likely to meet diagnostic criteria for Obsessive Compulsive Disorder and had higher levels of somatic symptoms at baseline. Individuals with and without trauma exposure did not differ significantly on severity of anxiety, depression, or mental health functioning at baseline. Trauma exposure did not significantly impact treatment response. Findings suggest that adverse effects of trauma exposure in those without PTSD may include OCD and somatic anxiety symptoms. Treatment did not appear to be adversely impacted by trauma exposure. Thus, although trauma exposure is prevalent in primary care samples, results suggest that treatment of the presenting anxiety disorder is effective irrespective of trauma history.
本研究调查了大量无创伤后应激障碍（PTSD）的初级保健患者的创伤暴露率、与创伤暴露相关的临床特征，以及创伤暴露对治疗结果的影响。作为CALM项目（Roy-Byrne等人，2010年）一部分接受治疗的无PTSD个体（N = 1263）被评估是否存在创伤暴露。对有和没有创伤暴露的个体在基线人口统计学和诊断信息、症状严重程度以及开始治疗六个月后的缓解者状态方面进行了比较。有创伤暴露的个体（N = 662，53%）更有可能符合强迫症的诊断标准，并且在基线时躯体症状水平更高。有和没有创伤暴露的个体在基线时焦虑、抑郁或心理健康功能的严重程度上没有显著差异。创伤暴露对治疗反应没有显著影响。研究结果表明，无PTSD个体中创伤暴露的不良影响可能包括强迫症和躯体焦虑症状。治疗似乎没有受到创伤暴露的不利影响。因此，尽管创伤暴露在初级保健样本中很普遍，但结果表明，无论创伤史如何，对当前焦虑障碍的治疗都是有效的。
