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评估 DSM-5 急性应激障碍的潜在亚型:分离型或侵入型?

Assessing DSM-5 latent subtypes of acute stress disorder dissociative or intrusive?

机构信息

School of Psychology, Coleraine Campus, Ulster University, Coleraine BT52 1SA, Northern Ireland, UK.

National Centre for Psychotraumatology, Institute for Psychology, University of Southern Denmark, Denmark.

出版信息

Psychiatry Res. 2015 Feb 28;225(3):476-83. doi: 10.1016/j.psychres.2014.11.063. Epub 2014 Dec 9.

Abstract

Acute Stress Disorder (ASD) was first included in the DSM-IV in 1994. It was proposed to account for traumatic responding in the early post trauma phase and to act as an identifier for later Posttraumatic Stress Disorder (PTSD). Unlike PTSD it included a number of dissociative indicators. The revised DSM-5 PTSD criterion included a dissociative-PTSD subtype. The current study assessed if a dissociative-ASD subtype may be present for DSM-5 ASD. Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in symptomatic compared to a baseline ASD profile. We used data from 450 bank robbery victims. Latent profile analysis (LPA) was used to uncover latent profiles of ASD. Multinomial logistic regression was used to determine if female gender, age, social support, peritraumatic panic, somatization, and number of trauma exposures increased or decreased the probability of profile membership. Four latent profiles were uncovered and included an intrusion rather than dissociative subtype. Increased age and social support decreased the probability of individuals being grouped into the intrusion subtype whereas increased peritraumatic panic and somatization increased the probability of individuals being grouped into the intrusion subtype. Findings are discussed in regard to the ICD-11 and the DSM-5.

摘要

急性应激障碍(ASD)于 1994 年首次被纳入 DSM-IV。它的提出是为了说明创伤后早期的创伤反应,并作为创伤后应激障碍(PTSD)的一个标识。与 PTSD 不同,ASD 包含了一些分离症状的指标。修订后的 DSM-5 PTSD 标准包含了分离性 PTSD 亚型。本研究评估了 DSM-5 ASD 是否存在分离性 ASD 亚型。此外,我们评估了一些风险因素是否会导致症状性 ASD 比基线 ASD 更有可能出现。我们使用了 450 名银行抢劫案受害者的数据。潜在剖面分析(LPA)用于揭示 ASD 的潜在剖面。多项逻辑回归用于确定女性性别、年龄、社会支持、创伤前惊恐、躯体化和创伤暴露次数是否增加或减少了具有特定特征的个体的可能性。发现了四个潜在的剖面,包括入侵而非分离亚型。年龄和社会支持的增加降低了个体被归入入侵亚型的可能性,而创伤前惊恐和躯体化的增加则增加了个体被归入入侵亚型的可能性。研究结果结合 ICD-11 和 DSM-5 进行了讨论。

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