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人格与创伤后精神病理学轨迹:潜在变化建模方法。

Personality and trajectories of posttraumatic psychopathology: A latent change modelling approach.

机构信息

Phoenix Australia and Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.

Phoenix Australia and Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.

出版信息

J Anxiety Disord. 2016 Aug;42:1-9. doi: 10.1016/j.janxdis.2016.05.003. Epub 2016 May 13.

Abstract

BACKGROUND

Survivors of traumatic events may develop a range of psychopathology, across the internalizing and externalizing dimensions of disorder and associated personality traits. However, research into personality-based internalizing and externalizing trauma responses has been limited to cross-sectional investigations of PTSD comorbidity. Personality typologies may present an opportunity to identify and selectively intervene with survivors at risk of posttraumatic disorder. Therefore this study examined whether personality prospectively influences the trajectory of disorder in a broader trauma-exposed sample.

METHODS

During hospitalization for a physical injury, 323 Australian adults completed the Multidimensional Personality Questionnaire-Brief Form and Structured Clinical Interview for DSM-IV, with the latter readministered 3 and 12 months later. Latent profile analysis conducted on baseline personality scores identified subgroups of participants, while latent change modelling examined differences in disorder trajectories.

RESULTS

Three classes (internalizing, externalizing, and normal personality) were identified. The internalizing class showed a high risk of developing all disorders. Unexpectedly, however, the normal personality class was not always at lowest risk of disorder. Rather, the externalizing class, while more likely than the normal personality class to develop substance use disorders, were less likely to develop PTSD and depression.

CONCLUSIONS

Results suggest that personality is an important mechanism in influencing the development and form of psychopathology after trauma, with internalizing and externalizing subtypes identifiable in the early aftermath of injury. These findings suggest that early intervention using a personality-based transdiagnostic approach may be an effective method of predicting and ultimately preventing much of the burden of posttraumatic disorder.

摘要

背景

创伤事件的幸存者可能会出现一系列精神病理学,包括内在和外在障碍以及相关的人格特质。然而,基于人格的内在和外在创伤反应的研究仅限于 PTSD 共病的横断面调查。人格类型可能为识别和选择性干预有创伤后障碍风险的幸存者提供机会。因此,本研究检验了人格是否会前瞻性地影响更广泛创伤暴露样本中障碍的轨迹。

方法

在因身体受伤住院期间,323 名澳大利亚成年人完成了多维人格问卷-简短形式和 DSM-IV 结构临床访谈,后者在 3 个月和 12 个月后重新进行。基于基线人格得分进行的潜在剖面分析确定了参与者的亚组,而潜在变化模型则检验了障碍轨迹的差异。

结果

确定了三个类别(内在、外在和正常人格)。内在类显示出所有障碍的高风险。然而,出人意料的是,正常人格类并不总是处于最低障碍风险状态。相反,外在类虽然比正常人格类更有可能发展物质使用障碍,但不太可能发展 PTSD 和抑郁。

结论

结果表明,人格是影响创伤后精神病理学发展和形式的一个重要机制,在受伤后的早期即可识别出内在和外在的亚型。这些发现表明,使用基于人格的跨诊断方法进行早期干预可能是预测和最终预防创伤后障碍大部分负担的有效方法。

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