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创伤史对归国老兵惊恐障碍和创伤后应激障碍的影响。

Influence of trauma history on panic and posttraumatic stress disorder in returning veterans.

机构信息

Michael E. DeBakey VA Medical Center.

出版信息

Psychol Serv. 2013 May;10(2):168-176. doi: 10.1037/a0031178.

Abstract

The current study examined the role of predeployment sexual and physical abuse, combat exposure, and postdeployment social support in predicting panic disorder and PTSD diagnoses in a large sample of returning veterans. A chart review was conducted for 1740 OEF/OIF veterans who received mental health screenings at a large VA hospital between May 24, 2004 and March 26, 2008. Assessments included psychosocial evaluations conducted by psychiatrists, psychologists, and social workers in addition to self-report measures. Results suggested that the prevalence of panic disorder (6.1%) and PTSD (28.7%) are elevated among OEF/OIF veterans. Veterans reporting higher levels of combat experience were likely to be diagnosed with PTSD (odds ration [OR], 1.17; 95% confidence interval [CI], 1.10-1.25; p < .001) or comorbid panic disorder and PTSD (OR, 1.18; 95% CI, 1.04-1.33; p < .001). Veterans endorsing predeployment sexual abuse were likely to be diagnosed with comorbid panic disorder and PTSD (OR, 3.05; 95% CI, 1.15-8.08; p < .05), as were veterans endorsing predeployment physical abuse (OR, 0.47; 95% CI, 0.22-1.00; p < .05). Panic disorder was also found to be associated with greater risk for suicide attempts than PTSD (χ² = 16.38, p = .001). These findings indicate a high prevalence of panic disorder among returning veterans and highlight the importance for clinicians to assess returning veterans routinely for panic disorder in addition to PTSD.

摘要

本研究考察了 Deployment 前性虐待和身体虐待、战斗暴露以及 Deployment 后社会支持在预测大量回归老兵中惊恐障碍和 PTSD 诊断中的作用。对 1740 名在 2004 年 5 月 24 日至 2008 年 3 月 26 日期间在一家大型退伍军人事务部医院接受心理健康筛查的 OEF/OIF 退伍军人进行了病历回顾。评估包括精神病医生、心理学家和社会工作者进行的心理社会评估,以及自我报告措施。结果表明,OEF/OIF 退伍军人中惊恐障碍(6.1%)和 PTSD(28.7%)的患病率较高。报告战斗经历较高的退伍军人更有可能被诊断出患有 PTSD(优势比[OR],1.17;95%置信区间[CI],1.10-1.25;p<.001)或并发惊恐障碍和 PTSD(OR,1.18;95% CI,1.04-1.33;p<.001)。报告 Deployment 前性虐待的退伍军人更有可能被诊断出并发惊恐障碍和 PTSD(OR,3.05;95% CI,1.15-8.08;p<.05),报告 Deployment 前身体虐待的退伍军人也是如此(OR,0.47;95% CI,0.22-1.00;p<.05)。惊恐障碍也与自杀企图的风险高于 PTSD 相关(χ²=16.38,p=.001)。这些发现表明,惊恐障碍在回归老兵中患病率较高,突出了临床医生在评估 PTSD 之外,常规评估回归老兵惊恐障碍的重要性。

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