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社区火灾暴露者创伤性应激反应及与创伤后应激症状的关系网络分析

A Network Analysis of Peritraumatic Distress Reactions and Their Relation to Posttraumatic Stress Symptoms in People Exposed to Community Fires.

出版信息

Psychiatry. 2020 Winter;83(4):375-389. doi: 10.1080/00332747.2020.1762393. Epub 2020 Aug 3.

Abstract

: Research indicates that people who experience more intense peritraumatic reactions are at higher risk of subsequently developing PTSD. The study used network analysis to: 1) explore the network structure of peritraumatic distress reactions; 2) identify clusters of peritraumatic distress reactions; and 3) assess whether central items in the peritraumatic network have stronger network associations with subsequent posttraumatic stress symptoms (PTS). : A convenience sample of adults living in communities affected by large-scale community fires in Israel (November 2016) were recruited. Participants completed the 13-item peritraumatic distress inventory (PDI) within one month of the fires (n = 372), and the PTSD checklist for DSM-5 (PCL-5) four months after the fires (n = 199). Network analyses and exploratory graph analysis were conducted. : The PDI items were positively connected to each other in a network structure, which divided into two clusters: emotional reactions; and physical/somatic reactions along with guilt and shame. Loss of emotional control was the most central peritraumatic distress symptom. Highly central peritraumatic distress symptoms were not strongly associated with subsequent PTS; rather, physical reactions were most associated with PTS levels four months after the fires. : Future studies should investigate targeting peritraumatic physical reactions as an early secondary prevention strategy for PTSD.

摘要

研究表明,经历更强烈创伤前反应的人随后患创伤后应激障碍(PTSD)的风险更高。该研究使用网络分析来:1)探讨创伤前困扰反应的网络结构;2)识别创伤前困扰反应的集群;3)评估创伤前网络中的中心项目是否与随后的创伤后应激症状(PTS)有更强的网络关联。研究对象为居住在以色列受大规模社区火灾影响的社区的成年人(2016 年 11 月),采用便利抽样法招募。参与者在火灾发生后一个月内完成了 13 项创伤前困扰量表(PDI)(n=372),并在火灾发生四个月后完成了 DSM-5 创伤后应激障碍检查表(PCL-5)(n=199)。进行了网络分析和探索性图形分析。在网络结构中,PDI 项目彼此呈正相关,分为两个集群:情绪反应;以及内疚和羞耻感的身体/躯体反应。情绪失控是最主要的创伤前困扰症状。高度中心的创伤前困扰症状与随后的 PTS 相关性不强;相反,身体反应与火灾发生四个月后的 PTS 水平最相关。未来的研究应该调查针对创伤前身体反应的策略,作为 PTSD 的早期二级预防策略。

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