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丧失和创伤后的症状表现:在寻求治疗的创伤暴露样本中,对延长哀伤障碍、创伤后应激障碍和抑郁进行潜在类别和网络分析。

Symptomatology following loss and trauma: Latent class and network analyses of prolonged grief disorder, posttraumatic stress disorder, and depression in a treatment-seeking trauma-exposed sample.

机构信息

Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.

Arq Psychotrauma Expert Group, Diemen, The Netherlands.

出版信息

Depress Anxiety. 2020 Jan;37(1):26-34. doi: 10.1002/da.22880. Epub 2019 Feb 6.

Abstract

BACKGROUND

Although bereavement is likely a common stressor among patients referred to a psychotrauma clinic, no study has yet examined the co-occurrence and relationships between symptoms of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and major depressive disorder symptoms in this population.

METHOD

In a sample of patients seeking treatment following psychological trauma (n = 458), we used latent class analysis to identify classes of patients sharing the same profile of PGD, PTSD, and depression symptoms. We then used network analysis to investigate the relationships among these symptoms and with loss-related variables.

RESULTS

Most participants (65%) were members of a class that exhibited elevated endorsement of PGD symptoms. PGD, PTSD, and depression symptoms hung together as highly overlapping but distinguishable communities of symptoms. Symptoms related to social isolation and diminished sense of self bridged these communities. Violent loss was associated with more difficulty accepting the loss. The loss of close kin was most strongly associated with difficulty moving on in life.

CONCLUSIONS

PGD symptoms are common in trauma-exposed bereaved adults and closely associated with symptoms of PTSD and depression, illustrating the importance of assessing bereavement and PGD symptoms in those seeking treatment following trauma.

摘要

背景

尽管丧亲之痛可能是被转诊到心理创伤诊所的患者的常见应激源,但尚无研究在该人群中检查延长哀伤障碍(PGD)、创伤后应激障碍(PTSD)和重度抑郁障碍症状之间的共同发生和关系。

方法

在接受心理创伤治疗的患者样本中(n=458),我们使用潜在类别分析来确定具有相同 PGD、PTSD 和抑郁症状特征的患者类别。然后,我们使用网络分析来研究这些症状之间的关系以及与丧失相关的变量。

结果

大多数参与者(65%)属于一个表现出 PGD 症状升高的类别。PGD、PTSD 和抑郁症状交织在一起,形成高度重叠但可区分的症状群。与社会隔离和自我意识减弱相关的症状连接了这些社区。暴力性丧失与更难接受丧失有关。失去近亲与更难继续生活最密切相关。

结论

创伤后丧亲的成年患者中常见 PGD 症状,且与 PTSD 和抑郁症状密切相关,这表明在创伤后寻求治疗的患者中评估丧亲和 PGD 症状很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c0c/7004006/b162c691a42d/DA-37-26-g001.jpg

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