Silove D M, Tay A K, Steel Z, Tam N, Soares Z, Soares C, Dos Reis N, Alves A, Rees S
Academic Mental Health Unit and Ingham Institute,University of New South Wales and South Western Sydney Local Health District,Level 2, Mental Health Centre,Liverpool Hospital,Sydney, NSW 2170,Australia.
St John of God Richmond Hospital,School of Psychiatry,University of New South Wales,North Richmond,NSW 2754,Australia.
Psychol Med. 2017 Jan;47(1):149-159. doi: 10.1017/S0033291716002233. Epub 2016 Sep 29.
Little is known about the mental health of partners of survivors of high levels of trauma in post-conflict countries.
We studied 677 spouse dyads (n = 1354) drawn from a community survey (response 82.4%) in post-conflict Timor-Leste. We used culturally adapted measures of post-traumatic stress disorder (PTSD), psychological distress, explosive anger and grief.
Latent class analysis identified three classes of couples: class 1, comprising women with higher trauma events (TEs), men with intermediate TEs (19%); class 2, including men with higher TEs, women with lower TEs (23%); and class 3, comprising couples in which men and women had lower TE exposure (58%) (the reference group). Men and women partners of survivors of higher TE exposure (classes 1 and 2) had increased symptoms of explosive anger and grief compared with the reference class (class 3). Women partners of survivors of higher TE exposure (class 2) had a 20-fold increased rate of PTSD symptoms compared with the reference class, a pattern that was not evident for men living with women exposed to higher levels of trauma (class 1).
Men and women living with survivors of higher levels of trauma showed an increase in symptoms of grief and explosive anger. The manifold higher rate of PTSD symptoms amongst women living with men exposed to high levels of trauma requires replication. It is important to assess the mental health of partners when treating survivors of high levels of trauma in post-conflict settings.
对于冲突后国家中遭受高度创伤幸存者的伴侣的心理健康状况，人们了解甚少。
我们对来自冲突后东帝汶社区调查（回应率82.4%）的677对配偶（n = 1354）进行了研究。我们使用了经过文化调适的创伤后应激障碍（PTSD）、心理困扰、爆发性愤怒和悲伤的测量方法。
潜在类别分析确定了三类夫妻：第1类，由创伤事件（TE）较多的女性和TE中等的男性组成（19%）；第2类，包括TE较多的男性和TE较少的女性（23%）；第3类，由男性和女性TE暴露较低的夫妻组成（58%）（参照组）。与参照组（第3类）相比，TE暴露较高的幸存者（第1类和第2类）的男性和女性伴侣的爆发性愤怒和悲伤症状有所增加。与参照组相比，TE暴露较高的幸存者（第2类）的女性伴侣的PTSD症状发生率增加了20倍，而与TE暴露较高的女性生活在一起的男性（第1类）则没有这种明显模式。
与遭受较高水平创伤的幸存者生活在一起的男性和女性，悲伤和爆发性愤怒症状有所增加。与遭受高水平创伤的男性生活在一起的女性中PTSD症状发生率大幅更高这一情况需要重复验证。在冲突后环境中治疗遭受高度创伤的幸存者时，评估其伴侣的心理健康状况很重要。
