a Division of General Internal Medicine & Health Services Research , University of California Los Angeles , Los Angeles , California , USA.
b University of Connecticut , Farmington , Connecticut , USA.
J Trauma Dissociation. 2019 Mar-Apr;20(2):212-227. doi: 10.1080/15299732.2019.1572043. Epub 2019 Feb 4.
The purpose of this study was to explore relationships between maltreatment, posttraumatic stress disorder, and the dissociative subtype of posttraumatic stress disorder among adolescents. This descriptive study used secondary data from the National Child Traumatic Stress Network Core Data Set. A clinical sample of adolescents exposed to potentially traumatizing events ages 12 to 16 was selected (N = 3081) to explore associations between trauma history characteristics, sociodemographic factors, posttraumatic stress disorder, and the dissociative subtype of PTSD which includes depersonalization and derealization. More than half of adolescents who met criteria for posttraumatic stress disorder also met criteria for the posttraumatic stress disorder dissociative subtype with significant depersonalization/derealization symptoms. No particular maltreatment type was associated with increased odds of posttraumatic stress disorder, with or without the dissociative subtype. All posttraumatic stress disorder-affected adolescents, with or without the dissociative subtype, experienced more overall potentially traumatizing events and maltreatment events than those without a posttraumatic stress disorder diagnosis. Girls and adolescents in residential treatment were more likely to have posttraumatic stress disorder with the dissociative subtype. This study provides evidence about the dissociative subtype of posttraumatic stress disorder among adolescents and provides new directions for research on trauma and dissociation. Future research studies should explore the co-occurrence of posttraumatic stress disorder and dissociation with broader range of dissociative symptoms than only depersonalization/derealization to further understand how to diagnose and treat traumatic stress disorders among adolescents.
本研究旨在探讨虐待、创伤后应激障碍（PTSD）与 PTSD 解离亚型之间的关系。本描述性研究使用了国家儿童创伤应激网络核心数据集的二级数据。从 12 至 16 岁经历过潜在创伤事件的青少年临床样本中（n=3081）选择了具有创伤史特征、社会人口统计学因素、PTSD 及其包括人格解体和现实解体的解离亚型之间的关联。超过一半符合 PTSD 标准的青少年也符合 PTSD 解离亚型的标准，且存在明显的人格解体/现实解体症状。无论是否存在解离亚型，没有特定的虐待类型与 PTSD 的发病几率增加有关。所有患有 PTSD 的青少年，无论是否存在解离亚型，经历的总体潜在创伤事件和虐待事件都比没有 PTSD 诊断的青少年多。接受住院治疗的女孩和青少年更有可能患有 PTSD 解离亚型。本研究为青少年 PTSD 解离亚型提供了证据，并为创伤和解离研究提供了新的方向。未来的研究应探讨 PTSD 和解离的共病，以及比人格解体/现实解体更广泛的解离症状，以进一步了解如何诊断和治疗青少年的创伤后应激障碍。
