Department of Psychiatry, University of Texas Health Science Center at San Antonio.
Department of Psychiatry, University of Pennsylvania.
Psychol Trauma. 2017 Nov;9(6):741-745. doi: 10.1037/tra0000242. Epub 2017 Jan 9.
It is uncertain whether ethnoracial factors should be considered by clinicians assessing and treating posttraumatic stress disorder (PTSD) among service members. The purpose of this study was to shed light on ethnoracial variation in the presentation of PTSD symptoms, trauma-related cognitions, and emotions among treatment-seeking active duty military personnel.
Participants were 303 male active duty military members with PTSD participating in a clinical trial (60% were self-identified as White, 19% as African American, and 21% as Hispanic/Latino). In the parent study, participants completed a baseline assessment that included clinician-administered and self-report measures of PTSD, trauma-related cognitions, and emotions.
Multivariate hierarchical regression models were used to examine ethnoracial differences in these variables, covarying age, education, military grade, combat exposure, and exposure to other potentially traumatic events. Hispanic/Latino and African American participants reported more reexperiencing symptoms, more fear, and more guilt and numbing than White participants. All effect sizes were in the small to medium range.
These findings suggest ethnoracial variation in PTSD symptom burden and posttraumatic cognitions among treatment-seeking service members with PTSD. Attending to cultural factors related to differences in PTSD presentation and cognitive coping strategies during the assessment and treatment process could increase rapport and lead to more comprehensive trauma processing. (PsycINFO Database Record
临床医生在评估和治疗创伤后应激障碍（PTSD）时是否应考虑种族因素，这一点尚不确定。本研究的目的是阐明寻求治疗的现役军人 PTSD 症状、与创伤相关的认知和情绪表现中的种族差异。
303 名患有 PTSD 的现役男性军人参加了一项临床试验（60%自认为是白人，19%是非裔美国人，21%是西班牙裔/拉丁裔）。在母研究中，参与者完成了基线评估，包括临床医生管理的和自我报告的 PTSD、与创伤相关的认知和情绪的测量。
使用多变量分层回归模型，在控制年龄、教育程度、军阶、战斗暴露和其他潜在创伤事件暴露的情况下，检验了这些变量的种族差异。西班牙裔/拉丁裔和非裔美国参与者比白人参与者报告更多的再体验症状、更多的恐惧、更多的内疚和麻木。所有效应大小均处于小到中等范围。
这些发现表明，寻求治疗的 PTSD 服务成员中，PTSD 症状负担和创伤后认知存在种族差异。在评估和治疗过程中，关注与 PTSD 表现和认知应对策略差异相关的文化因素，可能会增加医患关系，并导致更全面的创伤处理。
