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分离性创伤后应激障碍亚型的证据:对创伤后应激障碍潜在类别和概况分析研究的系统文献综述

Evidence of the dissociative PTSD subtype: A systematic literature review of latent class and profile analytic studies of PTSD.

作者信息

Hansen Maj, Ross Jana, Armour Cherie

机构信息

Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.

Psychology Research Institute, Psychotraumatology, Mental Health & Suicidal Behavior Research Group, Ulster University, Cromore Road, Coleraine BT52 1SA, Northern Ireland.

出版信息

J Affect Disord. 2017 Apr 15;213:59-69. doi: 10.1016/j.jad.2017.02.004. Epub 2017 Feb 7.

Abstract

BACKGROUND

The dissociative PTSD (D-PTSD) subtype was first introduced into the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. Prior to this, studies using latent profile analysis (LPA) or latent class analysis (LCA), began to provide support for the D-PTSD construct and associated risk factors. This research is important, because dissociative symptoms in the context of PTSD may potentially interfere with treatment course or outcome. The aims of the present study were twofold: to systematically review the LCA and LPA studies investigating support for the D-PTSD construct; and to review the associated research on the risk factors or covariates of D-PTSD in the identified studies.

METHOD

Six databases (PubMed, Web of Science, Scopus, PILOTS, PsychInfo, and Embase) were systematically searched for relevant papers.

RESULTS

Eleven studies were included in the present review. The majority of the studies were supportive of the D-PTSD subtype; primarily characterized by depersonalization and derealization. Several covariates of the D-PTSD subtype have been investigated with mixed results.

LIMITATIONS

Many limitations relate to the state of the current literature, including a small number of studies, the use of self-report measurements of PTSD, and heterogeneity across the samples in investigated covariates.

CONCLUSION

The results were overall supportive of the D-PTSD construct. Future research on D-PTSD and associated risk factors is needed to shed light on the possibilities of facilitating preventive actions, screening, and implications on treatment effects.

摘要

背景

解离性创伤后应激障碍(D-PTSD)亚型于2013年首次被纳入《精神疾病诊断与统计手册》(DSM-5)第五版。在此之前,使用潜在剖面分析(LPA)或潜在类别分析(LCA)的研究开始为D-PTSD结构及相关风险因素提供支持。这项研究很重要,因为创伤后应激障碍背景下的解离症状可能会干扰治疗过程或结果。本研究的目的有两个:系统回顾调查D-PTSD结构支持情况的LCA和LPA研究;以及回顾已识别研究中关于D-PTSD风险因素或协变量的相关研究。

方法

系统检索了六个数据库(PubMed、科学网、Scopus、PILOTS、PsychInfo和Embase)中的相关论文。

结果

本综述纳入了11项研究。大多数研究支持D-PTSD亚型;其主要特征为人格解体和现实解体。对D-PTSD亚型的几个协变量进行了研究,结果不一。

局限性

许多局限性与当前文献状况有关,包括研究数量少、使用创伤后应激障碍的自我报告测量方法以及所调查协变量样本的异质性。

结论

结果总体上支持D-PTSD结构。需要对D-PTSD及其相关风险因素进行进一步研究,以阐明促进预防措施、筛查以及对治疗效果影响的可能性。

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