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测试国际疾病分类第11版中针对遭受创伤的成年人复杂创伤后应激障碍的提案:因子结构和症状概况。

Testing the ICD-11 proposal for complex PTSD in trauma-exposed adults: factor structure and symptom profiles.

作者信息

Böttche Maria, Ehring Thomas, Krüger-Gottschalk Antje, Rau Heinrich, Schäfer Ingo, Schellong Julia, Dyer Anne, Knaevelsrud Christine

机构信息

Department of Clinical Psychology and Psychotherapy, Freie University Berlin, Berlin, Germany.

Research Department, Center Überleben (formerly Berlin Center for Torture Victims), Berlin, Germany.

出版信息

Eur J Psychotraumatol. 2018 Sep 7;9(1):1512264. doi: 10.1080/20008198.2018.1512264. eCollection 2018.

Abstract

: The proposed ICD-11 criteria for trauma-related disorders define posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (cPTSD) as separate disorders. Results of previous studies support the validity of this concept. However, due to limitations of existing studies (e.g. homogeneity of the samples), the present study aimed to test the construct validity and factor structure of cPTSD and its distinction from PTSD using a heterogeneous trauma-exposed sample. : Confirmatory factor analyses (CFAs) were conducted to explore the factor structure of the proposed ICD-11 cPTSD diagnosis in a sample of 341 trauma-exposed adults ( = 191 female,  = 37.42 years,  = 12.04). In a next step, latent profile analyses (LPAs) were employed to evaluate predominant symptom profiles of cPTSD symptoms. : The results of the CFA showed that a six-factor structure (i.e. symptoms of intrusion, avoidance, hyperarousal and symptoms of affective dysregulation, negative self-concept, and interpersonal problems) fits the data best. According to LPA, a four-class solution optimally characterizes the data. Class 1 represents moderate PTSD and low symptoms in the specific cPTSD clusters (PTSD group, 30.4%). Class 2 showed low symptom severity in all six clusters (low symptoms group, 24.1%). Classes 3 and 4 both exhibited cPTSD symptoms but differed with respect to the symptom severity (Class 3: cPTSD, 34.9% and Class 4: severe cPTSD, 10.6%). : The findings replicate previous studies supporting the proposed factor structure of cPTSD in ICD-11. Additionally, the results support the validity and usefulness of conceptualizing PTSD and cPTSD as discrete mental disorders.

摘要

拟议的创伤相关障碍的国际疾病分类第11版(ICD - 11)标准将创伤后应激障碍(PTSD)和复杂创伤后应激障碍(cPTSD)定义为不同的障碍。先前研究的结果支持这一概念的有效性。然而,由于现有研究存在局限性(例如样本的同质性),本研究旨在使用异质性创伤暴露样本检验cPTSD的结构效度、因子结构及其与PTSD的区别。:进行了验证性因子分析(CFA),以探究341名创伤暴露成年人样本(= 191名女性,= 37.42岁,= 12.04)中拟议的ICD - 11 cPTSD诊断的因子结构。下一步,采用潜在类别分析(LPA)来评估cPTSD症状的主要症状特征。:CFA的结果表明,六因子结构(即闯入症状、回避症状、过度警觉症状以及情感失调症状、消极自我概念和人际关系问题症状)最适合数据。根据LPA,四类解决方案能最佳地表征数据。第1类代表中度PTSD以及特定cPTSD集群中的低症状(PTSD组,30.4%)。第2类在所有六个集群中症状严重程度较低(低症状组,24.1%)。第3类和第4类均表现出cPTSD症状,但在症状严重程度上有所不同(第3类:cPTSD,34.9%;第4类:重度cPTSD,10.6%)。:研究结果重复了先前支持ICD - 11中拟议的cPTSD因子结构的研究。此外,结果支持将PTSD和cPTSD概念化为离散精神障碍的有效性和实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c52b/6136389/52f818c03125/ZEPT_A_1512264_F0001_B.jpg

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