I-Core Research Center for Mass Trauma, The Bob Shappell School of Social Work, Tel-Aviv University, Israel.
Department of community health, University of Haifa, Israel; NATAL, Israel Trauma Center for Victims of Terror and War, Israel.
J Anxiety Disord. 2017 Oct;51:94-100. doi: 10.1016/j.janxdis.2017.06.006. Epub 2017 Jun 29.
Many individuals worldwide are exposed to continuous traumatic stress (CTS). However, the psychiatric sequela of CTS and the relevance of posttraumatic stress disorder (PTSD) diagnostic criteria in this situation have yet to be determined. Filling this gap, the present study assessed psychiatric reactions to CTS and the relationship between such reactions and functional impairment among two representative samples of adults exposed to ongoing shelling over 6 (n=387) and 9 years (n=468). Assessment included PTSD symptomatology (i.e., intrusion, avoidance, hyperarousal), anxiety, somatization, and depression. Profile categorization aimed to underscore variations in symptom clustering and severity, and determine whether or not a profile is dominated by PTSD symptoms. Latent Profile analyses (LPA) of sample I revealed four distinct symptoms profiles: (1) 'symptomatically resilient'; (2) 'symptomatically low-moderate'; (3) 'symptomatically moderate-high'; and (4) 'symptomatically overall high'. LPA of sample II revealed three distinct symptoms profiles: (1) 'symptomatically resilient'; (2) 'symptomatically low-moderate'; (3) "symptomatically moderate-high". Moreover, profile variation was implicated in dysfunction. Consistent with studies focusing on single trauma exposure, the findings revealed that the most prevalent profile was the symptomatically resilient, indicating that most people exposed to CTS seem to evince a scarce number of psychiatric symptoms. Moreover, reactions to CTS proved broader than the existing PTSD symptomatology. Examining symptom dominance and severity in relation to impairment and dysfunction, and clinical considerations are discussed.
许多人在全球范围内持续遭受创伤性压力（CTS）。然而，CTS 的精神后遗症以及创伤后应激障碍（PTSD）诊断标准在这种情况下的相关性尚未确定。为了填补这一空白，本研究评估了成年人暴露于持续炮击 6 年（n=387）和 9 年（n=468）的两个代表性样本中对 CTS 的精神反应，以及这种反应与功能障碍之间的关系。评估包括 PTSD 症状（即侵入、回避、过度警觉）、焦虑、躯体化和抑郁。特征分类旨在强调症状聚类和严重程度的变化，并确定是否存在以 PTSD 症状为主的特征。样本 I 的潜在剖面分析（LPA）揭示了四个不同的症状特征：（1）“有症状的韧性”；（2）“有症状的低中度”；（3）“有症状的中高度”；和（4）“有症状的整体高度”。样本 II 的 LPA 揭示了三个不同的症状特征：（1）“有症状的韧性”；（2）“有症状的低中度”；（3）“有症状的中高度”。此外，特征的变化与功能障碍有关。与关注单一创伤暴露的研究一致，研究结果表明，最常见的特征是有症状的韧性，这表明大多数暴露于 CTS 的人似乎表现出少数精神症状。此外，对 CTS 的反应比现有的 PTSD 症状更为广泛。研究了症状的主导地位和严重程度与障碍和功能障碍的关系，并讨论了临床考虑因素。
