Badour Christal L, Resnick Heidi S, Kilpatrick Dean G
1 Medical University of South Carolina, Charleston, SC, USA.
2 Ralph H. Johnson VA Medical Center, Charleston, SC, USA.
J Interpers Violence. 2017 Jun;32(11):1620-1641. doi: 10.1177/0886260515589930. Epub 2015 Jun 18.
The diagnosis of posttraumatic stress disorder (PTSD) has undergone several significant changes corresponding with the recent implementation of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5). Many of these changes reflect a growing recognition that PTSD is characterized by a wide range of negative affective experiences that were underrepresented in prior conceptualizations of the disorder. The present study examined the prevalence and correlates of a new Criterion D symptom (D4-Negative Affect), which is aimed at assessing subjective problems with persistent negative emotion states (e.g., fear, anger, shame, guilt, horror) among a sample of 1,522 U.S. adults with a history of interpersonal trauma recruited from a national online panel. The prevalence of D4-Negative Affect was very high among individuals with assault-related PTSD (AR-PTSD) and in particular, was significantly higher than among PTSD negative individuals. Moreover, specific problems with anger, shame, and fear were significantly and uniquely associated with AR-PTSD. Important differences also emerged as a function of gender and interpersonal trauma history. These findings provide initial empirical support for the expanded emphasis on assessing a wide range of negative affective experiences that may be associated with PTSD in DSM-5.
创伤后应激障碍（PTSD）的诊断随着《精神疾病诊断与统计手册》第五版（DSM-5）的近期实施经历了若干重大变化。其中许多变化反映出人们越来越认识到，PTSD的特征是广泛的负面情感体验，而这些体验在该障碍先前的概念化中未得到充分体现。本研究调查了一项新的D标准症状（D4-负面情感）的患病率及其相关因素，该症状旨在评估从全国在线样本中招募的1522名有人际创伤史的美国成年人中持续负面情绪状态（如恐惧、愤怒、羞耻、内疚、恐惧）的主观问题。D4-负面情感在与攻击相关的PTSD（AR-PTSD）个体中的患病率非常高，尤其是显著高于无PTSD的个体。此外，愤怒、羞耻和恐惧的特定问题与AR-PTSD显著且独特相关。根据性别和人际创伤史也出现了重要差异。这些发现为DSM-5中扩大对可能与PTSD相关的广泛负面情感体验评估的强调提供了初步实证支持。
