Department of Psychology, Neuroscience, and Behaviour, McMaster University.
Homewood Research Institute.
Psychol Trauma. 2020 Oct;12(7):739-749. doi: 10.1037/tra0000576. Epub 2020 Mar 23.
Functional impairment among individuals with posttraumatic stress disorder (PTSD) represents a significant factor in recovery. Critically, functional impairment appears to persist following remission of PTSD symptoms. To date, work investigating functional impairment among individuals with PTSD has focused on PTSD symptom clusters, excluding other relevant symptoms, including emotion regulation difficulties and dissociative symptoms. Emerging work suggests that these symptoms may serve as important predictors of functional impairment among individuals with PTSD.
The present study investigated the contributions of difficulties with emotion regulation, dissociative symptoms, and individual PTSD symptom clusters to functional impairment among an inpatient civilian sample who completed self-report assessments of PTSD symptoms, functional impairment, emotion regulation difficulties, and dissociative symptoms, upon admission to the program. Participants met criteria for probable PTSD as per the PTSD checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and reported high rates of exposure to childhood abuse and neglect.
Emotion regulation difficulties contributed significantly, while dissociative symptoms and PTSD arousal and reactivity symptoms showed a signal toward contributing significantly to a model accounting for variance in functional impairment among individuals with probable PTSD. Differential patterns of contributors emerged for the various domains of functional impairment measured.
These findings add to a growing body of literature highlighting the importance of emotion regulation difficulties, dissociative symptoms, and arousal and reactivity symptoms in contributing to functional impairment in this disorder. Recovery to premorbid functional status in PTSD may require interventions that target directly these symptoms. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
创伤后应激障碍（PTSD）患者的功能障碍是康复的一个重要因素。至关重要的是，在 PTSD 症状缓解后，功能障碍似乎仍然存在。迄今为止，研究 PTSD 患者功能障碍的工作主要集中在 PTSD 症状群上，而忽略了其他相关症状，包括情绪调节困难和分离症状。新出现的工作表明，这些症状可能是 PTSD 患者功能障碍的重要预测因素。
本研究调查了情绪调节困难、分离症状以及个体 PTSD 症状群对住院平民样本功能障碍的贡献，这些患者在进入项目时完成了 PTSD 症状、功能障碍、情绪调节困难和分离症状的自我报告评估，符合 PTSD 检查表的 PTSD 诊断和统计手册，第五版（DSM-5）标准，并报告了较高比例的儿童期虐待和忽视。
情绪调节困难有显著贡献，而分离症状和 PTSD 唤醒和反应性症状显示出对个体 PTSD 功能障碍模型有显著贡献的信号。在测量的各种功能障碍领域，出现了不同的贡献模式。
这些发现增加了越来越多的文献，强调了情绪调节困难、分离症状和唤醒反应性症状在该疾病功能障碍中的重要性。PTSD 恢复到发病前的功能状态可能需要直接针对这些症状的干预措施。（PsycInfo 数据库记录（c）2020 APA，保留所有权利）。
