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对以色列人群中创伤后应激障碍和复杂型创伤后应激障碍与多种创伤经历模式之间的关联进行建模。

Modeling Patterns of Polyvictimiztion and Their Associations with Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in the Israeli Population.

机构信息

School of Psychology and Psychology Research Institute, Ulster University, Derry, United Kingdom.

The Collabortive Network for Training and Excellence in Psychotraumatology (CONTEXT), www.psychotraumanetwork.com.

出版信息

J Trauma Stress. 2019 Dec;32(6):843-854. doi: 10.1002/jts.22455. Epub 2019 Oct 29.

Abstract

Although evidence is accumulating for the conceptual validity of the ICD-11 proposal for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD), our understanding of the specificity of trauma-related predictors is still evolving. Specifically, studies utilizing advanced statistical methods to model the association between trauma exposure and ICD-11 proposals of traumatic stress and differences in profiles of trauma exposure are lacking. Additionally, time since trauma and a clear memory of the trauma are yet to be examined as predictors of PTSD and CPTSD. We analyzed trauma exposure as reported by a general population sample of Israeli adults (N = 834), using latent class analysis, and the resultant classes were used in regression models to predict PTSD and CPTSD operationalized both dimensionally and categorically. Four distinct groups were identified: child and adult interpersonal victimization, community victimization-male, community victimization-female, and adult victimization. These groups were differentially related to PTSD and CPTSD, with only child and adult interpersonal victimization consistently predicting CPTSD and disturbances in self-organization. When modeled dimensionally, PTSD was associated with the child and adult interpersonal victimization and adult victimization groups, whereas only the child and adult interpersonal victimization group was predictive of PTSD when operationalized categorically. The roles of time since trauma and a clear memory of the trauma differed across PTSD and CPTSD. These findings support the use of trauma typologies for predicting PTSD and CPTSD and provide important insight into the distribution of trauma exposure in the Israeli population.

摘要

虽然越来越多的证据支持 ICD-11 创伤后应激障碍(PTSD)和复杂性创伤后应激障碍(CPTSD)概念的有效性,但我们对创伤相关预测因素的特异性的理解仍在不断发展。具体来说,利用先进的统计方法来模拟创伤暴露与 ICD-11 提出的创伤性应激之间的关联,以及创伤暴露模式差异的研究还很少。此外,创伤后时间和对创伤的清晰记忆尚未被视为 PTSD 和 CPTSD 的预测因素。我们使用潜在类别分析分析了以色列成年人(N=834)一般人群样本中报告的创伤暴露情况,并使用回归模型将由此产生的类别用于预测 PTSD 和 CPTSD,其操作化维度和类别均有。确定了四个不同的群体:儿童和成人人际受害、社区受害男性、社区受害女性和成人受害。这些群体与 PTSD 和 CPTSD 的关系不同,只有儿童和成人人际受害一直与 CPTSD 和自我组织障碍相关。当以维度建模时,PTSD 与儿童和成人人际受害和成人受害群体有关,而当以类别操作化时,只有儿童和成人人际受害群体才具有预测 PTSD 的能力。创伤后时间和对创伤的清晰记忆在 PTSD 和 CPTSD 中的作用不同。这些发现支持使用创伤类型学来预测 PTSD 和 CPTSD,并为了解以色列人口的创伤暴露分布提供了重要的见解。

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