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创伤后应激症状在冲突期间的轨迹:潜在类别增长分析。

Trajectories of traumatic stress symptoms during conflict: A latent class growth analysis.

机构信息

The Department of Community Mental Health, University of Haifa, 199 Aba Houshy Ave, Haifa, Israel.

The Department of Community Mental Health, University of Haifa, 199 Aba Houshy Ave, Haifa, Israel; NATAL, Israel Trauma Center for Victims of Terror and War, Tel Aviv, Israel.

出版信息

J Affect Disord. 2017 Oct 1;220:24-30. doi: 10.1016/j.jad.2017.05.036. Epub 2017 May 25.

Abstract

BACKGROUND

The ways in which traumatic stress symptoms unfold under situations of ongoing threat and trauma exposure are poorly understood. The current study aims to identify traumatic stress symptom trajectories during conflict, as well as potential risk factors.

METHODS

Experience sampling methods were used to study traumatic stress symptoms during the 2014 Israel-Gaza conflict in 100 Israeli civilians exposed to rocket fire. Summary reports of traumatic symptoms were made twice-daily for 30 days via mobile phone.

RESULTS

Latent class growth analysis revealed four distinct classes (low, reducing, moderate, and high) characterised by their trajectory of traumatic stress symptoms during the conflict. Female gender, not being in a relationship, and higher prior trauma exposure were identified as potential risk factors.

LIMITATIONS

Data were not collected in the early phase of the conflict, the sample was relatively small, and only traumatic stress symptoms were investigated as outcomes.

CONCLUSIONS

This study identified heterogeneous traumatic stress symptom trajectories among civilians during a conflict, with different subgroups showing distinct response patterns over time, associated with various risk factors. Investigating responses to ongoing trauma, and identifying predictors of different stress symptom trajectories has clinical implications for the targeted delivery of interventions. Further exploration of heterogeneous trajectories could potentially elucidate mechanisms that drive resilience and recovery, including in situations of ongoing exposure such as during conflict.

摘要

背景

在持续面临威胁和创伤暴露的情况下,创伤后应激症状的发展方式还不太清楚。本研究旨在确定冲突期间创伤后应激症状的轨迹,以及潜在的风险因素。

方法

采用经验抽样法,对 100 名在以色列遭受火箭弹袭击的以色列平民在 2014 年以色列-加沙冲突期间的创伤后应激症状进行研究。通过手机,在 30 天内每天两次报告创伤症状的总结报告。

结果

潜在类别增长分析显示,有四个不同的类别(低、减少、中等和高),其特征是在冲突期间创伤后应激症状的轨迹。女性、没有恋爱关系以及较高的先前创伤暴露被确定为潜在的风险因素。

局限性

数据不是在冲突的早期阶段收集的,样本相对较小,而且仅调查了创伤后应激症状作为结果。

结论

本研究在冲突期间确定了平民中存在不同的创伤后应激症状轨迹,不同的亚组随时间表现出不同的反应模式,与各种风险因素有关。研究对持续创伤的反应,并确定不同应激症状轨迹的预测因素,对有针对性地提供干预措施具有临床意义。进一步探讨异质轨迹可能有助于阐明在持续暴露(如冲突期间)情况下推动韧性和恢复的机制。

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