National Center for PTSD, VA Boston Healthcare System, United States.
National Center for PTSD, VA Boston Healthcare System, United States; Department of Psychiatry, Boston University School of Medicine, United States.
J Anxiety Disord. 2014 Jun;28(5):488-94. doi: 10.1016/j.janxdis.2014.05.001. Epub 2014 May 20.
This study examined the prevalence of intermittent explosive disorder (IED) and its associations with trauma exposure, posttraumatic stress disorder (PTSD), and other psychiatric diagnoses in a sample of trauma-exposed veterans (n=232) with a high prevalence of PTSD. Structural associations between IED and latent dimensions of internalizing and externalizing psychopathology were also modeled to examine the location of IED within this influential structure. Twenty-four percent of the sample met criteria for a lifetime IED diagnosis and those with the diagnosis were more likely to meet criteria for lifetime PTSD than those without (30.3% vs. 14.3% respectively). Furthermore, regression analyses revealed lifetime PTSD severity to be a significant predictor of IED severity after controlling for combat, trauma exposure, and age. Finally, confirmatory factor analysis revealed significant cross-loadings of IED on both the externalizing and distress dimensions of psychopathology, suggesting that the association between IED and other psychiatric disorders may reflect underlying tendencies toward impulsivity and aggression and generalized distress and negative emotionality, respectively.
本研究调查了创伤后应激障碍(PTSD)患者中间歇性爆发障碍(IED)的患病率及其与创伤暴露、PTSD 和其他精神疾病诊断的关联,这些患者是创伤暴露的退伍军人(n=232),其中 PTSD 的患病率很高。还对 IED 与内化和外化精神病理学潜在维度之间的结构关联进行建模,以检查 IED 在这一有影响力的结构中的位置。该样本中有 24%符合终身 IED 诊断标准,而患有该诊断的人比没有该诊断的人更有可能符合终身 PTSD 标准(分别为 30.3%和 14.3%)。此外,回归分析显示,在控制战斗、创伤暴露和年龄后,终身 PTSD 严重程度是 IED 严重程度的一个显著预测因素。最后,验证性因素分析显示 IED 在精神病理学的外化和痛苦维度上均有显著的交叉负荷,这表明 IED 与其他精神疾病之间的关联可能反映了冲动和攻击性以及普遍的痛苦和负性情绪的潜在倾向。