分离症状预测加拿大公共安全人员疑似创伤后应激障碍（PTSD）的严重疾病表现。
Dissociative symptoms predict severe illness presentation in Canadian public safety personnel with presumptive post-traumatic stress disorder (PTSD).
机构信息
Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Canada.
Homewood Research Institute, Guelph, Canada.
出版信息
Eur J Psychotraumatol. 2021 Sep 3;12(1):1953789. doi: 10.1080/20008198.2021.1953789. eCollection 2021.
BACKGROUND
Post-traumatic stress disorder affects 9% of individuals across their lifetime and increases nearly fourfold to 35% in Canadian public safety personnel (PSP). On-the-job experiences of PSP frequently meet criteria for traumatic events, making these individuals highly vulnerable to exposures of trauma and the negative consequences of PTSD. Few studies have reported on the clinical characteristics of Canadian samples of PSP and even fewer have examined the dissociative subtype of PTSD, which is associated with more severe, chronic traumatic experiences, and worse outcomes.
OBJECTIVE
This study aimed to characterize dissociative symptoms, PTSD symptom severity, and other clinical variables among Canadian PSP with presumptive PTSD.
METHODS
We sampled current and past PSP in Canada from both inpatient and outpatient populations ( = 50) that were enrolled in a psychological intervention. Only baseline testing data (prior to any intervention) were analysed in this study, such as PTSD symptom severity, dissociative symptoms, emotion dysregulation, and functional impairment.
RESULTS
In our sample, 24.4% self-reported elevated levels of dissociation, specifically symptoms of depersonalization and derealization. Depersonalization and derealization symptoms were associated with more severe PTSD symptoms, greater emotion dysregulation, and functional impairment.
CONCLUSIONS
Nearly a quarter of this sample of Canadian PSP reported experiencing elevated levels of PTSD-related dissociation (depersonalization and derealization). These high levels of depersonalization and derealization were consistently positively associated with greater illness severity across clinical measures. It is imperative that dissociative symptoms be better recognized in patient populations that are exposed to chronic traumatic events such as PSP, so that treatment interventions can be designed to target a more severe illness presentation.
背景
创伤后应激障碍影响了 9%的个体终身，在加拿大公共安全人员（PSP）中，这一比例增加了近四倍，达到 35%。PSP 的工作经历经常符合创伤事件的标准，这使得这些人极易受到创伤暴露和创伤后应激障碍的负面影响。很少有研究报告加拿大 PSP 样本的临床特征，甚至更少研究过创伤后应激障碍的分离亚型，它与更严重、慢性的创伤经历和更糟糕的结果有关。
目的
本研究旨在描述加拿大 PSP 中假定的 PTSD 患者的分离症状、创伤后应激障碍症状严重程度和其他临床变量。
方法
我们从加拿大的住院和门诊人群中抽取了当前和过去的 PSP（n=50），这些人参加了一项心理干预。本研究仅分析了基线测试数据（任何干预之前），如创伤后应激障碍症状严重程度、分离症状、情绪调节障碍和功能障碍。
结果
在我们的样本中，24.4%的人自我报告了分离症状的升高，特别是人格解体和现实解体的症状。人格解体和现实解体症状与更严重的 PTSD 症状、更大的情绪调节障碍和功能障碍有关。
结论
几乎四分之一的加拿大 PSP 样本报告经历了 PTSD 相关的分离（人格解体和现实解体）水平升高。这些高水平的人格解体和现实解体与临床测量中更大的疾病严重程度始终呈正相关。在暴露于慢性创伤事件（如 PSP）的患者人群中，更好地识别分离症状至关重要，以便设计针对更严重疾病表现的治疗干预措施。
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