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不合格的合格者:评估波士顿马拉松爆炸案后修订的《精神疾病诊断与统计手册》第五版中潜在创伤性事件定义在当地青少年中的效用。

Disqualified qualifiers: evaluating the utility of the revised DSM-5 definition of potentially traumatic events among area youth following the Boston marathon bombing.

作者信息

Chou Tommy, Carpenter Aubrey L, Kerns Caroline E, Elkins R Meredith, Green Jennifer Greif, Comer Jonathan S

机构信息

Department of Psychology, Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, Miami, FL, USA.

Department of Psychological and Brain Sciences, Center for Anxiety and Related Disorders (CARD), Boston University, Boston, MA, USA.

出版信息

Depress Anxiety. 2017 Apr;34(4):367-373. doi: 10.1002/da.22543. Epub 2016 Jul 19.

Abstract

The DSM-5 includes a revised definition of the experiences that qualify as potentially traumatic events. This revised definition now offers a clearer and more exclusive definition of what qualifies as a traumatic exposure, but little is known about the revision's applicability to youth populations. The present study evaluated the predictive utility of the revised DSM definitional boundaries of traumatic exposure in a sample of youth exposed to the 2013 Boston Marathon bombing and related events METHODS: Caregivers (N = 460) completed surveys 2 to 6 months postbombing about youth experiences during the events and youth posttraumatic stress (PTS) symptoms RESULTS: Experiencing DSM-5 qualifying traumatic events (DSM-5 QTEs) significantly predicted child PTS symptoms (PTSS), whereas DSM-5 nonqualifying stressful experiences (DSM-5 non-QSEs) did not after accounting for DSM-5 QTEs. Importantly, child age moderated the relationship between DSM-5 QTEs and PTSS such that children 7 and older who experienced DSM-5 QTEs showed greater postbombing PTSS, whereas there was no such relationship in children ages 6 and below CONCLUSIONS: Data largely support the revised posttraumatic stress disorder (PTSD) definition of QTEs in older youth, and also highlight the need for further refinement of the QTE definition for children ages 6 and below.

摘要

《精神疾病诊断与统计手册》第五版(DSM - 5)对符合潜在创伤性事件的经历给出了修订后的定义。这一修订后的定义如今对符合创伤性暴露的情况给出了更清晰、更具排他性的定义,但对于该修订在青少年群体中的适用性却知之甚少。本研究评估了修订后的DSM创伤性暴露定义界限在经历2013年波士顿马拉松爆炸及相关事件的青少年样本中的预测效用。方法:照顾者(N = 460)在爆炸发生后2至6个月完成了关于青少年在事件中的经历以及青少年创伤后应激(PTS)症状的调查。结果:经历符合DSM - 5标准的创伤性事件(DSM - 5 QTEs)能显著预测儿童的PTS症状(PTSS),而在考虑了DSM - 5 QTEs之后,符合DSM - 5标准的应激性经历(DSM - 5非QSEs)则不能。重要的是,儿童年龄调节了DSM - 5 QTEs与PTSS之间的关系,即7岁及以上经历DSM - 5 QTEs 的儿童在爆炸后表现出更严重的PTSS,而6岁及以下儿童则不存在这种关系。结论:数据在很大程度上支持了对大龄青少年创伤后应激障碍(PTSD)中QTEs的修订定义,同时也凸显了进一步完善6岁及以下儿童QTEs定义的必要性。

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