New Mexico VA Health Care System, Albuquerque, New Mexico, USA; Department of Psychiatry, University of New Mexico, Albuquerque, New Mexico, USA.
J Trauma Stress. 2014 Feb;27(1):108-11. doi: 10.1002/jts.21886.
Subtypes of posttraumatic psychopathology were replicated and extended in 254 female veterans with posttraumatic stress disorder (PTSD). Cluster analyses on Minnesota Multiphasic Personality Inventory-2 and Personality Psychopathology Five scales (Harkness, McNulty, & Ben-Porath, ) yielded internalizing and externalizing psychopathology dimensions, with a third low psychopathology group (simple PTSD). Externalizers were higher than the internalizers and the simple PTSD groups on the antisocial, substance, and aggression scales; internalizers were higher on depression and anxiety scales. Further validation included an independent measure of psychopathology to examine anger (Buss-Durkee Hostility Inventory, [BDHI]; Buss & Durkee, ). Externalizers were higher on extreme behavioral anger scales (assault and verbal hostility); and externalizers and internalizers were higher than the simple PTSD subjects on other anger scales. Positive correlations between the BDHI scales and the PTSD symptom of "irritability and anger outbursts" were found across scales in the total sample (range: r = .19-.36), on the assault scale in externalizers (r = .59), and the verbal hostility scale in both internalizers (r = .30) and simple PTSD (r = .37) groups, suggesting the broad utility of the symptom in the diagnosis. The results demonstrate the generalizability of the internalizing/externalizing typology to the female veteran population and highlight clinically relevant distinctions in anger expression within PTSD.
创伤后精神病理学的亚型在 254 名患有创伤后应激障碍（PTSD）的女性退伍军人中得到了复制和扩展。对明尼苏达多相人格问卷-2 和人格心理病理学五量表（Harkness、McNulty 和 Ben-Porath，）的聚类分析产生了内化和外化精神病理学维度，以及第三个低精神病理学组（单纯 PTSD）。外显组在反社会、物质和攻击性量表上高于内化组和单纯 PTSD 组；内化组在抑郁和焦虑量表上得分较高。进一步的验证包括使用独立的精神病理学测量来检查愤怒（Buss-Durkee 敌意量表，[BDHI]；Buss 和 Durkee，）。外显组在极端行为愤怒量表（攻击和言语敌意）上得分较高；外显组和内化组在其他愤怒量表上的得分均高于单纯 PTSD 组。在总样本中，BDHI 量表与 PTSD 症状“易怒和愤怒爆发”之间存在正相关（范围：r =.19-.36），在外显组的攻击量表上（r =.59），以及内化组和单纯 PTSD 组的言语敌意量表上（r =.30 和 r =.37），这表明该症状在诊断中的广泛适用性。研究结果表明，内化/外化类型学在女性退伍军人群体中的普遍性，并突出了 PTSD 中愤怒表达的临床相关差异。
