The Altshuler Center for Education & Research at Metrocare Services, Dallas, TX, USA; Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Suite NE5.102, Dallas, TX 75390-9070, USA.
The Altshuler Center for Education & Research at Metrocare Services, Dallas, TX, USA; Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Suite NE5.102, Dallas, TX 75390-9070, USA.
Psychiatry Res. 2019 Sep;279:77-82. doi: 10.1016/j.psychres.2019.07.009. Epub 2019 Jul 8.
This study examined dissociation as an outcome to disaster in dissociative data collected from 423 highly-exposed survivors of 5 different disasters using consistent methodology. Ten items selected for conceptual relevance to disaster experience were administered from the Dissociative Disorders Interview Schedule, a structured interview for lifetime dissociative disorders. Structured psychiatric interviews provided data on incident somatization symptoms, disaster-related PTSD, and lifetime predisaster psychopathology. The Temperament and Character Inventory assessed personality. Observed levels of dissociation were low and not usually postdisaster. Dissociation level was associated with female sex, number of incident somatization symptoms, personality (underdeveloped executive functioning), PTSD, and predisaster psychopathology in bivariate analyses. In multiple linear regression models, dissociation was associated with the low number of incident somatoform symptoms observed independent of the effects of PTSD, hyperarousal specifically (but not intrusion or avoidance/numbing), personality, predisaster psychopathology, and demographic variables which were not independently associated with dissociation. The low levels of dissociation found in this study and the lack of association between dissociation and indicators of psychopathology point to a largely nonpathological nature of the dissociative phenomena measured. These findings do not indicate the development of dissociative psychopathology as a prevalent mental health outcome of disasters.
本研究通过对来自 5 种不同灾难的 423 名高度暴露幸存者的分离数据进行一致性方法的研究，考察了灾难作为分离的结果。从分离障碍访谈表中选择了 10 项与灾难经历概念上相关的项目，这是一种用于终生分离障碍的结构化访谈。结构化精神病学访谈提供了关于偶发性躯体化症状、与灾难相关的 PTSD 以及终生发病前精神病理学的数据。气质和性格量表评估了人格。观察到的分离程度较低，通常不是灾后。分离程度与女性性别、偶发性躯体化症状数量、人格（执行力不足）、PTSD 和发病前精神病理学有关。在多元线性回归模型中，分离与观察到的偶发性躯体症状数量较少有关，这与 PTSD 特别是过度警觉（但不是入侵或回避/麻木）、人格、发病前精神病理学以及与分离无关的人口统计学变量无关。本研究中发现的分离程度较低，以及分离与精神病理学指标之间缺乏关联表明，所测量的分离现象在很大程度上是非病理性的。这些发现并不表明分离性精神病理学作为灾难的一种普遍心理健康后果而发展。
