受虐妇女庇护所居民共病诊断对创伤后应激障碍症状病程的影响。
The impact of comorbid diagnoses on the course of posttraumatic stress disorder symptoms in residents of battered women's shelters.
机构信息
Department of Psychology, The University of Akron.
Department of Education, Lehigh University.
出版信息
Psychol Trauma. 2018 Nov;10(6):628-635. doi: 10.1037/tra0000335. Epub 2017 Nov 20.
OBJECTIVE
The current investigation sought to explore the impact of the comorbidities of substance use disorder (SUD), major depressive disorder (MDD), and borderline personality disorder (BPD) on the trajectory of intimate partner violence (IPV)-related posttraumatic stress disorder (PTSD) symptoms across a 6-month follow-up period in IPV survivors who seek shelter. Research has found significant comorbidity of SUD, MDD, and BPD with PTSD (see Green et al., 2006; Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995; Pagura et al., 2010); however, little to no research has explored these relationships in this unique population over time.
METHOD
A sample of 147 residents of battered women's shelters completed study measures at baseline, 1 week, and 3 and 6 months following shelter stay. Participants completed measures assessing for demographics, abuse, and Diagnostic and Statistical Manual of Mental Disorders (4th edition, text revision) diagnoses.
RESULTS
Results of latent growth modeling with the time-invariant covariates of SUD, MDD, and BPD yielded a significant effect of SUD (β = .002, p = .007) on the slope of IPV-related PTSD symptoms controlling for IPV victimization. Significant effects were not identified for BPD (β = .001, p > .05) or MDD (β = .002, p > .05). Results suggest IPV survivors with SUD demonstrated less improvement in PTSD symptoms over 6 months after they left shelter as compared to women without SUD.
CONCLUSION
Findings emphasize the deleterious effects of SUD, above and beyond MDD and BPD, on IPV-related PTSD and highlight the need for assessment and treatment of SUD and PTSD simultaneously in residents of battered women's shelters. Clinical Impact Statement: Findings suggest the need to go beyond standard shelter services to more effectively address and treat co-occurring SUD-PTSD in IPV survivors. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
目的
本研究旨在探讨物质使用障碍（SUD）、重性抑郁障碍（MDD）和边缘型人格障碍（BPD）共病对寻求庇护的家庭暴力幸存者中与亲密伴侣暴力（IPV）相关的创伤后应激障碍（PTSD）症状在 6 个月随访期间轨迹的影响。研究发现 SUD、MDD 和 BPD 与 PTSD 有显著的共病（见 Green 等人，2006 年；Kessler、Sonego、Bromet、Hughes 和 Nelson，1995 年；Pagura 等人，2010 年）；然而，几乎没有研究在这段时间内探讨了这一独特人群中的这些关系。
方法
147 名受虐妇女庇护所居民在入住庇护所后 1 周、3 个月和 6 个月时完成了研究测量。参与者完成了评估人口统计学、虐待和精神疾病诊断和统计手册（第 4 版，文本修订）诊断的测量。
结果
使用 SUD、MDD 和 BPD 的时不变协变量进行潜在增长模型分析，结果表明 SUD（β=0.002，p=0.007）对 IPV 相关 PTSD 症状的斜率有显著影响，控制了 IPV 受害情况。未发现 BPD（β=0.001，p＞0.05）或 MDD（β=0.002，p＞0.05）的显著影响。结果表明，与没有 SUD 的女性相比，患有 SUD 的 IPV 幸存者在离开庇护所后 6 个月内 PTSD 症状改善较少。
结论
研究结果强调了 SUD 对 IPV 相关 PTSD 的有害影响，超过了 MDD 和 BPD，并突出了在受虐妇女庇护所居民中同时评估和治疗 SUD 和 PTSD 的必要性。
临床影响陈述
研究结果表明，需要超越标准庇护服务，更有效地解决和治疗 IPV 幸存者中同时存在的 SUD-PTSD。
Zotero 插件