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汶川地震后青少年创伤后应激障碍和抑郁模式的时间转变。

Temporal Transitions in Patterns of Posttraumatic Stress Disorder and Depression Among Adolescents Following the Wenchuan Earthquake.

机构信息

Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China.

Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, China.

出版信息

Child Psychiatry Hum Dev. 2019 Jun;50(3):494-504. doi: 10.1007/s10578-018-0859-8.

Abstract

Posttramatic stress disorder (PTSD) and depression are persistent disorders with heterogeneous comorbidity. Cross-sectional design limitations have prevented previous studies from examining symptom pattern transitions, which limits the understanding on the change of mental health over time since trauma. This study examined transition patterns of PTSD and depression comorbidity and assessed the role of personality. PTSD, depression, and personality scales were used to assess 619 adolescents 1 year after the Wenchuan earthquake and then to longitudinally assess 332 adolescents 2 years post-earthquake. Data were analyzed using latent transition analysis and logistic regression. Four PTSD and depression comorbidity patterns were identified at both times: moderate comorbidity, high comorbidity, no symptoms, and depression. Patterns of PTSD and depression changed in 23.4% of adolescents: 4.4% and 7.1% transitioned from no symptoms to depression and from depression to moderate comorbidity, respectively; 7.5% transitioned from moderate comorbidity to depression. Extraversion and conscientiousness were more likely and openness was less likely to be associated with moderate comorbidity symptoms transitioned to depression symptoms. These findings indicated that patterns of PTSD and depression in adolescents are heterogeneous and show temporal change.

摘要

创伤后应激障碍(PTSD)和抑郁症是持久的障碍,具有异质的共病。横断面设计的局限性使得以前的研究无法检查症状模式的转变,这限制了对创伤后心理健康随时间变化的理解。本研究检查了 PTSD 和抑郁症共病的转变模式,并评估了人格的作用。在汶川地震后 1 年,使用 PTSD、抑郁和人格量表评估了 619 名青少年,然后对 332 名青少年进行了 2 年的纵向评估。使用潜在转变分析和逻辑回归分析数据。在两个时间点都确定了 PTSD 和抑郁症共病的四种模式:中度共病、高度共病、无症状和抑郁。23.4%的青少年的 PTSD 和抑郁症模式发生了变化:分别有 4.4%和 7.1%从无症状转变为抑郁,从抑郁转变为中度共病;7.5%从中度共病转变为抑郁。外向性和尽责性更有可能,开放性更不可能与从中度共病症状转变为抑郁症状相关。这些发现表明,青少年的 PTSD 和抑郁症模式是异质的,并表现出时间上的变化。

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