Santana Márcia Rosane Moreira, Zatti Cleonice, Spader Mariana Lunardi, Malgarim Bibiana Godoi, Salle Emílio, Piltcher Renato, Ceresér Keila Maria Mendes, Bastos Andre Goettems, Freitas Lúcia Helena
Programa de Pós-Graduação em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil.
Trends Psychiatry Psychother. 2017 Oct-Dec;39(4):247-256. doi: 10.1590/2237-6089-2016-0071. Epub 2017 Dec 4.
Acute stress disorder (ASD) encompasses a set of symptoms that can arise in individuals after exposure to a traumatic event. This study assessed the defense mechanisms used by victims of physical trauma who developed ASD.
This was a controlled cross-sectional study of 146 patients who suffered physical trauma and required hospitalization. A structured questionnaire was used to evaluate ASD symptoms based on DSM-5 diagnostic criteria, in addition to the Defense Style Questionnaire (DSQ).
Ten participants (6.85%) received a positive diagnosis of ASD, and 136, (93.15%) a negative diagnosis. The majority of the sample consisted of men with median age ranging from 33.50 to 35.50. The most prevalent defense mechanisms among the 10 patients with ASD were cancellation and devaluation, which belong to the neurotic and immature factors, respectively. Positive associations between the presence of symptoms from criterion B of the DSM-5 and defense mechanisms from the DSQ were found. These included the mechanisms of undoing, projection, passive aggression, acting out, autistic fantasy, displacement, and somatization.
Patients with ASD employed different defense mechanisms such as undoing and devaluation when compared to patients not diagnosed with ASD. These results mark the importance of early detection of ASD symptoms at a preventative level, thereby creating new possibilities for avoiding exacerbations related to the trauma, which represents an important advance in terms of public health.
急性应激障碍（ASD）包括个体在经历创伤性事件后可能出现的一系列症状。本研究评估了患有ASD的身体创伤受害者所使用的防御机制。
这是一项对146名遭受身体创伤并需要住院治疗的患者进行的对照横断面研究。除了防御方式问卷（DSQ）外，还使用了一份结构化问卷根据《精神疾病诊断与统计手册》第五版（DSM-5）的诊断标准来评估ASD症状。
10名参与者（6.85%）被诊断为ASD阳性，136名（93.15%）为阴性诊断。样本中的大多数为男性，年龄中位数在33.50至35.50岁之间。在10名患有ASD的患者中，最普遍的防御机制分别是抵消和贬低，它们分别属于神经症性和不成熟因素。发现DSM-5标准B中的症状与DSQ中的防御机制之间存在正相关。这些机制包括撤销、投射、被动攻击、付诸行动、孤独症幻想、转移和躯体化。
与未被诊断为ASD的患者相比，患有ASD的患者采用了不同的防御机制，如撤销和贬低。这些结果表明在预防层面早期发现ASD症状的重要性，从而为避免与创伤相关的病情加重创造了新的可能性，这在公共卫生方面是一项重要进展。
