在一个文化多元化的难民样本中,创伤后应激障碍和复杂创伤后应激障碍症状与创伤经历以及移民后困难之间的差异关联。

Differential Associations Among PTSD and Complex PTSD Symptoms and Traumatic Experiences and Postmigration Difficulties in a Culturally Diverse Refugee Sample.

机构信息

Department of Psychology, University of Zurich, Zurich, Switzerland.

Department of Psychology, Bielefeld University, Bielefeld, Germany.

出版信息

J Trauma Stress. 2018 Dec;31(6):795-804. doi: 10.1002/jts.22342. Epub 2018 Nov 15.

Abstract

Forced migration is one of the major challenges currently facing the international community. Many refugees have been affected by traumatic experiences at home and during their flight, putting them at a heightened risk of developing trauma-related disorders. The new version of the International Classification of Diseases (ICD-11) introduced two sibling disorders, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). So far, little is known about risk and protective factors in refugees that are specifically associated with the disturbances in self-organization (DSO) characteristic of CPTSD. In this study, we aimed to investigate the association between PTSD and DSO symptoms and traumatic experiences, postmigration difficulties, and social support in a culturally diverse sample of refugees who resettled in Switzerland. A total of 94 refugees (85.1% male; M age = 31.60 years, SD = 10.14, range: 18-61 years) participated in this study. Trained assessors performed either guided questionnaire assessments or structured interviews. In our advice- and help-seeking sample, 32.9% of individuals suffered from PTSD and 21.3% from CPTSD. After controlling for potential gender differences, we found positive associations between PTSD symptoms and trauma exposure, β = .22, as well as between DSO symptoms and postmigration living difficulties, β = .42, and lack of social support, β = .22. Our findings support the notion that it is highly important to consider differential associations among PTSD and DSO symptoms and risk and protective factors to gain a deeper understanding of the trauma-related problems refugees face.

摘要

被迫迁移是国际社会目前面临的主要挑战之一。许多难民在国内和逃亡期间经历了创伤性事件,使他们面临更高的创伤相关障碍发病风险。国际疾病分类(ICD-11)的新版本引入了两种兄弟姐妹障碍,创伤后应激障碍(PTSD)和复杂性创伤后应激障碍(CPTSD)。到目前为止,对于与 CPTSD 特征性的自我组织障碍(DSO)具体相关的难民的风险和保护因素知之甚少。在这项研究中,我们旨在调查 PTSD 和 DSO 症状与创伤经历、后移民困难和社会支持之间的关联,这些因素在在瑞士重新安置的文化多样化的难民样本中具有特征性。共有 94 名难民(85.1%为男性;M 年龄=31.60 岁,SD=10.14,范围:18-61 岁)参与了这项研究。受过培训的评估员进行了指导问卷评估或结构化访谈。在我们的咨询和求助样本中,32.9%的人患有 PTSD,21.3%的人患有 CPTSD。在控制潜在的性别差异后,我们发现 PTSD 症状与创伤暴露之间存在正相关,β=0.22,以及 DSO 症状与后移民生活困难之间存在正相关,β=0.42,以及缺乏社会支持,β=0.22。我们的研究结果支持这样一种观点,即考虑 PTSD 和 DSO 症状与风险和保护因素之间的差异关联对于深入了解难民面临的与创伤相关的问题非常重要。

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