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《精神疾病诊断与统计手册第四版》和《精神疾病诊断与统计手册第五版》中作为创伤性应激源的肺癌诊断与治疗:患病率及其与心理健康结果的关系

Lung Cancer Diagnosis and Treatment as a Traumatic Stressor in DSM-IV and DSM-5: Prevalence and Relationship to Mental Health Outcomes.

作者信息

Andrykowski Michael A, Steffens Rachel F, Bush Heather M, Tucker Thomas C

机构信息

Department of Behavioral Science, University of Kentucky, Lexington, Kentucky, USA.

Department of Epidemiology and Biostatistics, University of Kentucky, Lexington, Kentucky, USA.

出版信息

J Trauma Stress. 2015 Jun;28(3):206-13. doi: 10.1002/jts.22005. Epub 2015 May 19.

DOI:10.1002/jts.22005
PMID:25990718
Abstract

Little research has examined how lung cancer survivors whose cancer experience met the Diagnostic and Statistical Manual of Mental Disorders (DSM) traumatic stressor criterion differ with regard to posttreatment mental health status from survivors whose cancer experience did not. No research of which we are aware has examined the impact of the revised DSM-5 traumatic stressor criterion on this question. Non-small-cell (NSC) lung cancer survivors (N = 189) completed a telephone interview and questionnaire assessing distress and growth/benefit-finding. Survivors were categorized into Trauma and No Trauma groups using both the DSM-IV and DSM-5 stressor criterion. Using the DSM-IV criterion, the Trauma group (n = 70) reported poorer status than the No Trauma group (n = 119) on 10 of 10 distress indices (mean ES = 0.57 SD) and better status on all 7 growth/benefit-finding indices (mean ES = 0.30 SD). Using the DSM-5 stressor criterion, differences between the Trauma (n = 108) and No Trauma (n = 81) groups for indices of distress (mean ES = 0.26 SD) and growth/benefit-finding (mean ES = 0.17 SD) were less pronounced. Those who experience cancer as a traumatic stressor show greater distress and growth/benefit-finding, particularly when the more restrictive DSM-IV stressor criterion defines trauma exposure.

摘要

很少有研究探讨过,癌症经历符合《精神疾病诊断与统计手册》(DSM)创伤应激源标准的肺癌幸存者,与癌症经历不符合该标准的幸存者相比,在治疗后的心理健康状况方面有何不同。据我们所知,尚无研究探讨修订后的DSM-5创伤应激源标准对这一问题的影响。非小细胞(NSC)肺癌幸存者(N = 189)完成了一项电话访谈和问卷调查,评估痛苦程度以及成长/益处发现情况。根据DSM-IV和DSM-5应激源标准,将幸存者分为创伤组和非创伤组。使用DSM-IV标准时,创伤组(n = 70)在10项痛苦指数中有10项的状况比非创伤组(n = 119)差(平均效应量= 0.57标准差),而在所有7项成长/益处发现指数上状况更好(平均效应量= 0.30标准差)。使用DSM-5应激源标准时,创伤组(n = 108)和非创伤组(n = 81)在痛苦指数(平均效应量= 0.26标准差)和成长/益处发现指数(平均效应量= 0.17标准差)上的差异不那么明显。将癌症视为创伤应激源的人表现出更大的痛苦以及成长/益处发现,尤其是当更严格的DSM-IV应激源标准定义了创伤暴露时。

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