Li Gen, Wang Li, Cao Chengqi, Fang Ruojiao, Chen Chen, Qiao Xue, Yang Haibo, Forbes David, Elhai Jon D
Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
J Anxiety Disord. 2020 Dec;76:102319. doi: 10.1016/j.janxdis.2020.102319. Epub 2020 Sep 28.
Revealing the dynamic interplay between posttraumatic stress disorder (PTSD) symptom clusters has always been an important topic in traumatic stress studies. Based on longitudinal studies, different hypotheses have been proposed to explain PTSD symptom dynamics. But currently, no study have been conducted to test these hypotheses in children and adolescents.
Data were derived from a longitudinal study of child and adolescent traumatic event survivors of an explosion accident (N = 659). DSM-5 PTSD symptoms was measured by the PTSD Checklist-5 (PCL-5) at 4, 8, and 13 months after the disaster. Latent difference score (LDS) modeling was used to evaluate the dynamic interplay between clusters.
The results of LDS model indicated that intrusion level positively predicted subsequent rate of increase for hyperarousal (p = .008) and negative changes in cognitions and mood symptoms (p = .036). Also, intrusion level trended to positively predict subsequent increase rate of avoidance symptoms (p = .059).
This study expands previous knowledge of dynamic relations between symptom clusters during the maintenance and fluctuation of child and adolescent PTSD symptoms. By using new methodology, this study provided novel evidence for the hypothesis that intrusion symptom plays an important role in maintaining other PTSD symptoms.
揭示创伤后应激障碍（PTSD）症状群之间的动态相互作用一直是创伤应激研究中的一个重要课题。基于纵向研究，人们提出了不同的假设来解释PTSD症状动态。但目前，尚未有研究在儿童和青少年中检验这些假设。
数据来自一项对爆炸事故中儿童和青少年创伤事件幸存者的纵向研究（N = 659）。在灾难发生后的4个月、8个月和13个月，通过创伤后应激障碍检查表-5（PCL-5）测量DSM-5 PTSD症状。使用潜在差异分数（LDS）模型来评估症状群之间的动态相互作用。
LDS模型的结果表明，侵入水平正向预测随后的过度警觉增加率（p = .008）以及认知和情绪症状的负向变化（p = .036）。此外，侵入水平有正向预测随后回避症状增加率的趋势（p = .059）。
本研究扩展了之前关于儿童和青少年PTSD症状维持和波动期间症状群之间动态关系的认识。通过使用新方法，本研究为侵入症状在维持其他PTSD症状中起重要作用这一假设提供了新证据。
