Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin.
German Armed Forces Hospital.
Psychol Trauma. 2018 Jan;10(1):30-35. doi: 10.1037/tra0000293.
Posttraumatic mental disorders may occur with different affect qualities. Best known is posttraumatic stress disorder (PTSD), a conditioned anxiety reaction with intrusions. Another event-related mental disorder is posttraumatic embitterment (PTED), characterized by affect of embitterment and thoughts of revenge, occurring after an event deeply hurting basic beliefs. Knowing about associated disability is important for treatment and sociomedical decisions. This is the first study to explore work-disability in patients with PTSD, PTED, and not-event-related common mental disorder (CMD).
In this observational study, 101 soldiers (85% men, 31 years, 50% experienced expedition abroad) with different mental disorders were investigated concerning common mental disorders (MINI) and accompanying work capacity impairment (Mini-ICF-APP). Interviews were conducted by a state-licensed psychotherapist with expertise in sociomedical description of (work) capacity impairment. Patients with PTSD, PTED, and other CMD were compared concerning their degrees and pattern of work capacity impairment.
PTSD patients (n = 23) were more strongly impaired in mobility as compared to patients with other CMD (n = 64) or PTED. Patients with PTED (n = 14) were more impaired in interactional capacities (contacts with others, group integration) as compared to patients with other CMD or PTSD.
PTSD patients need support to improve mobility in (work-relevant) traffic situations. Apart from this, they are not specifically more or less impaired than patients with other CMD. PTED patients should get attention concerning their interactional problems as these may disturb esprit de corps, which is an essential requirement for service in the armed forces. (PsycINFO Database Record
创伤后精神障碍可能表现出不同的情感特质。最著名的是创伤后应激障碍（PTSD），这是一种带有侵入性的条件性焦虑反应。另一种与事件相关的精神障碍是创伤后痛苦（PTED），其特征是痛苦的情感和复仇的想法，发生在严重伤害基本信仰的事件之后。了解相关的残疾情况对于治疗和社会医学决策很重要。这是第一项探索 PTSD、PTED 和非事件相关常见精神障碍（CMD）患者工作残疾的研究。
在这项观察性研究中，对 101 名患有不同精神障碍的士兵（85%为男性，31 岁，50%有国外远征经历）进行了常见精神障碍（MINI）和伴随的工作能力障碍（Mini-ICF-APP）的调查。由具有社会医学描述（工作）能力障碍专业知识的国家许可的心理治疗师进行访谈。比较了 PTSD、PTED 和其他 CMD 患者的工作能力障碍程度和模式。
与其他 CMD（n=64）或 PTED 患者相比，PTSD 患者（n=23）在移动能力方面的障碍更为严重。与其他 CMD 或 PTSD 患者相比，PTED 患者（n=14）在互动能力（与他人的接触、团队整合）方面的障碍更为严重。
PTSD 患者需要支持来改善（与工作相关的）交通情况下的移动能力。除此之外，他们与其他 CMD 患者相比，并没有特别更多或更少的受损。PTED 患者应注意他们的互动问题，因为这些问题可能会干扰团队精神，这是在武装部队服役的基本要求。
