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使用 DSM-5 标准,在异质创伤暴露样本中检查 PTSD、重度抑郁和广泛性焦虑障碍的因素之间的相互关系。

Examination of the interrelations between the factors of PTSD, major depression, and generalized anxiety disorder in a heterogeneous trauma-exposed sample using DSM 5 criteria.

机构信息

Department of Psychological Science, University of Vermont, United States.

Department of Psychological Science, University of Vermont, United States.

出版信息

J Affect Disord. 2015 Nov 1;186:149-55. doi: 10.1016/j.jad.2015.06.012. Epub 2015 Jul 29.

DOI:10.1016/j.jad.2015.06.012
PMID:26241663
Abstract

Exposure to traumatic events places individuals at high risk for multiple psychiatric disorders, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). The high rates of comorbidity among these conditions merit evaluation in order to improve diagnosis and treatment approaches. The current study evaluated the association between PTSD, MDD, and GAD factors as presented in the DSM 5. 602 trauma-exposed individuals who experienced an event that met Criterion A for the DSM 5 PTSD diagnosis were recruited through Amazon.com, Inc.'s Mechanical Turk (MTurk) to complete an assessment of the impact of stressful events on their lives. High interrelations were detected among the 4 PTSD factors, 2 MDD factors that corresponded to somatic and affective symptoms, and the single GAD factor. The affective factor of MDD was most strongly related to the emotional numbing factor of PTSD, whereas the somatic factor of MDD was most strongly related to the hyperarousal factor of PTSD. The GAD factor was most strongly related to the hyperarousal factor of PTSD, relative to the other PTSD factors. The strength of the interrelations between factors of the three disorders is largely a function of the overlap in symptoms and calls into question the uniqueness of negative affective symptoms of PTSD, MDD and GAD. Results suggest that improved understanding of the trauma reaction requires a focus on the unique presentation of each individual and assessment of multiple disorders.

摘要

创伤性事件会使个体面临多种精神障碍的高风险,包括创伤后应激障碍(PTSD)、重性抑郁障碍(MDD)和广泛性焦虑障碍(GAD)。这些疾病的高共病率值得评估,以改善诊断和治疗方法。本研究评估了 DSM-5 中 PTSD、MDD 和 GAD 因素之间的关联。通过 Amazon.com, Inc. 的 Mechanical Turk (MTurk) 招募了 602 名经历过符合 DSM-5 PTSD 诊断标准 A 的事件的创伤暴露个体,以完成对生活中应激事件影响的评估。在 4 个 PTSD 因素、与躯体和情感症状相对应的 2 个 MDD 因素和单个 GAD 因素之间检测到高度的相互关系。MDD 的情感因素与 PTSD 的情感麻木因素关系最密切,而 MDD 的躯体因素与 PTSD 的过度警觉因素关系最密切。GAD 因素与 PTSD 的过度警觉因素关系最密切,与其他 PTSD 因素相比。三种疾病的因素之间的相互关系的强度在很大程度上是症状重叠的函数,并质疑 PTSD、MDD 和 GAD 的负性情感症状的独特性。结果表明,要更好地理解创伤反应,需要关注每个人的独特表现,并评估多种障碍。

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