Schuler Keke, Ruggero Camilo J, Mahaffey Brittain, Gonzalez Adam, L Callahan Jennifer, Boals Adriel, Waszczuk Monika A, Luft Benjamin J, Kotov Roman
University of North Texas, Denton, TX, USA.
Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Assessment. 2021 Jan;28(1):238-247. doi: 10.1177/1073191119869826. Epub 2019 Aug 17.
Assessment of posttraumatic stress disorder (PTSD) has relied almost exclusively on retrospective memory of symptoms, sometimes over long intervals. This approach creates potential for recall bias and obscures the extent to which symptoms fluctuate. The aim of the present study was to examine the discrepancy between retrospective self-reporting of PTSD symptoms and ecological momentary assessment (EMA), which captures symptoms closer to when they occur. The study also sought to estimate the degree to which PTSD symptoms vary or are stable in the short-term. World Trade Center responders ( = 202) oversampled for current PTSD (19.3% met criteria in past month) were assessed three times a day for 7 consecutive days. Retrospective assessment of past week symptoms at the end of the reporting period were compared with daily EMA reports. There was correspondence between two approaches, but retrospective reports most closely reflected symptom severity on the worst day of the reporting period rather than average severity across the week. Symptoms varied significantly, even within the span of hours. Findings support intervention research efforts focused on exploiting significant, short-term variability of PTSD symptoms, and suggest that traditional assessments most reflect the worst day of symptoms over a given period of recall.
创伤后应激障碍（PTSD）的评估几乎完全依赖于对症状的回顾性记忆，有时时间间隔很长。这种方法存在回忆偏差的可能性，并掩盖了症状波动的程度。本研究的目的是检验PTSD症状的回顾性自我报告与生态瞬时评估（EMA）之间的差异，生态瞬时评估能在症状出现时更接近地捕捉症状。该研究还试图估计PTSD症状在短期内变化或稳定的程度。对世贸中心的应急人员（n = 202）进行了过度抽样，这些人员目前患有PTSD（过去一个月中有19.3%符合标准），连续7天每天评估3次。在报告期结束时对过去一周症状的回顾性评估与每日EMA报告进行了比较。两种方法之间存在对应关系，但回顾性报告最能反映报告期内最糟糕一天的症状严重程度，而不是一周内的平均严重程度。即使在数小时内，症状也有显著变化。研究结果支持了专注于利用PTSD症状显著短期变异性的干预研究工作，并表明传统评估最能反映给定回忆期内症状最糟糕的一天。
