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性别差异在创伤后应激障碍中的预测作用:暴力犯罪受害者的创伤后解离和痛苦。

Gender Differences in the Prediction of Acute Stress Disorder From Peritraumatic Dissociation and Distress Among Victims of Violent Crimes.

机构信息

Department of Psychology, Université de Montreal, Québec, Canada.

Institut Universitaire en Santé Mentale de Montreal, Montreal, Quebec, Canada.

出版信息

J Interpers Violence. 2020 Mar;35(5-6):1229-1250. doi: 10.1177/0886260517693000. Epub 2017 Feb 1.

Abstract

Peritraumatic dissociation and distress are strong predictors of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) development. However, there is limited data concerning gender differences in these relations, particularly among victims of violent crimes (VVC). The objective of this study is to examine whether peritraumatic dissociation and distress predict the number of ASD symptoms differently for men and women VVC. In all, 162 adults (97 women, age = 39.6 years), 63% of whom experienced physical assaults, completed the Acute Stress Disorder Interview, the Peritraumatic Dissociative Experience Questionnaire, and the Peritraumatic Distress Inventory. Analyses included tests and multiple hierarchical regressions models controlling for known PTSD risk factors. The regression model showed dissociation and distress to be significant predictors of ASD for both men and women (β = .349 and β =.312 respectively; all < .001). A significant three-way interaction was also observed between peritraumatic distress (PDI), past potentially traumatic experiences, and gender. In simple slopes analyses, the combination of high levels of PDI and of a high number of past potentially traumatic events were associated with greater risk of ASD in men only ( = 3.78, < .001). However, women experienced greater PDI, (157) = 5.844, = .005, than men, and elevated distress was associated with more ASD symptoms independently of past traumatic events. Gender differences were revealed as a function of past potentially traumatic experiences. There is a cumulative impact of past potential traumas and current distress that predicts ASD in men, while in women, it contributes to ASD via increased distress.

摘要

创伤后解离和痛苦是急性应激障碍(ASD)和创伤后应激障碍(PTSD)发展的强烈预测因素。然而,关于这些关系中的性别差异的数据有限,特别是在暴力犯罪(VVC)受害者中。本研究的目的是检验创伤后解离和痛苦是否能预测男性和女性 VVC 患者 ASD 症状的数量存在差异。共有 162 名成年人(97 名女性,年龄=39.6 岁),其中 63%的人经历过身体攻击,完成了急性应激障碍访谈、创伤后解离体验问卷和创伤后痛苦量表。分析包括 t 检验和多个层次回归模型,控制已知的 PTSD 风险因素。回归模型显示,解离和痛苦是男性和女性 ASD 的重要预测因素(β=.349 和β=.312;均<0.001)。还观察到创伤后痛苦(PDI)、过去潜在创伤经历和性别之间存在显著的三向交互作用。在简单斜率分析中,高水平的 PDI 和高数量的过去潜在创伤事件的组合与男性的 ASD 风险增加相关(=3.78,<0.001)。然而,女性经历的 PDI 更高,(157)=5.844,=0.005,高于男性,而痛苦的增加与 ASD 症状的增加独立于过去的创伤事件有关。性别差异是过去潜在创伤经历的函数。过去潜在创伤和当前痛苦的累积影响预测男性的 ASD,而在女性中,它通过增加痛苦导致 ASD。

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