Lawrence-Wood Ellie, Van Hooff Miranda, Baur Jenelle, McFarlane Alexander C
Centre for Traumatic Stress Studies, University of Adelaide, Level 2/122 Frome Street, Adelaide, South Australia 5000, Australia.
Centre for Traumatic Stress Studies, University of Adelaide, Level 2/122 Frome Street, Adelaide, South Australia 5000, Australia.
J Affect Disord. 2016 Jan 15;190:278-281. doi: 10.1016/j.jad.2015.10.029. Epub 2015 Oct 27.
Contention in the literature regarding the diagnostic utility of intrusion symptoms highlights that they have high sensitivity but low specificity in predicting PTSD. They are highly prevalent following a range of traumatic events, and across a range of disorders. The prevalence of intrusion symptoms in the absence of PTSD suggests their relevance to the development of other psychopathology. Therefore, the predictive role of intrusion symptoms for other post-trauma psychopathology was examined using data from an epidemiological, longitudinal sample of adults recruited in childhood.
From 5 phases of data collection for this sample, these analyses focused on the 20 year and 28 year follow-ups (n=583). Lifetime exposure to trauma was assessed using a modified set of 10 Criterion-A events from the Composite International Diagnostic Interview (CIDI), with PTSD assessed in reference to a self-nominated worst lifetime event, and other DSM-IV disorder also assessed using the CIDI.
Results showed that the presence of intrusion symptoms without PTSD at the 20 year follow-up was predictive of increased risk at 28 years for depressive but not anxiety disorders.
There was limited psychopathology in the sample, reducing the power to examine many individual disorders. Furthermore, trauma history and psychiatric symptoms were retrospectively reported, introducing the possibility of recall bias.
Together the findings suggest that intrusion symptoms may play an aetiological role in the development and/or maintenance of disorders other than PTSD.
文献中关于侵入性症状诊断效用的争论表明,它们在预测创伤后应激障碍(PTSD)时具有高敏感性但低特异性。在一系列创伤事件后以及在一系列疾病中,它们都非常普遍。在没有PTSD的情况下,侵入性症状的普遍性表明它们与其他精神病理学的发展相关。因此,使用来自童年招募的成年人的流行病学纵向样本数据,研究了侵入性症状对其他创伤后精神病理学的预测作用。
对于该样本的5个数据收集阶段,这些分析集中在20年和28年的随访(n = 583)。使用来自综合国际诊断访谈(CIDI)的一组经过修改的10个A类标准事件评估终生创伤暴露情况,参照自我提名的最严重终生事件评估PTSD,并且也使用CIDI评估其他DSM-IV障碍。
结果显示,在20年随访时存在无PTSD的侵入性症状可预测28岁时患抑郁症而非焦虑症的风险增加。
样本中的精神病理学情况有限,降低了检查许多个体疾病的效力。此外,创伤史和精神症状是回顾性报告的,存在回忆偏差的可能性。
这些发现共同表明,侵入性症状可能在PTSD以外的疾病的发展和/或维持中起病因学作用。