遭受创伤和意外创伤后广泛创伤症状中的性别差异：临床环境中的横断面研究。
Gender differences in a wide range of trauma symptoms after victimization and accidental traumas: a cross-sectional study in a clinical setting.
机构信息
Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
出版信息
Eur J Psychotraumatol. 2021 Sep 28;12(1):1975952. doi: 10.1080/20008198.2021.1975952. eCollection 2021.
BACKGROUND
There are large gender differences in PTSD prevalence. Gender differences in a wide range of trauma symptoms including disturbances in self-organization have not been extensively researched.
OBJECTIVE
To explore gender differences in a wide range of trauma symptoms by comparing victimization trauma (VT) with accidental trauma (AT).
METHOD
A cross-sectional study of 110 traumatized patients attending a mental health outpatient clinic in Oslo, Norway (38.2% men, Mage = 40.4, 40% ethnic Norwegians). The trauma was categorized as VT or AT based on the Life Events Checklist. The Structured Clinical Interview for DSM-IV-PTSD-module and Structured Interview for Disorders of Extreme Stress Not-Otherwise-Specified (DESNOS) assessed a wide range of trauma symptoms. First, we examined gender differences within the trauma categories, then MANCOVA for an adjusted two-by-two between-groups analysis.
RESULTS
Among VT patients, men reported more symptoms of alteration of negative self-perception ( = .02, ES = 0.50) and alteration in systems of meaning ( < .01, ES = 1.04). Within the AT group, women reported more symptoms of affect and impulses ( = .01, ES = 0.94). The VT-AT difference was significantly higher in men in intrusion ( < .01, η = 0.04), affect and impulses ( < .01, η = 0.12), negative self-perception ( < .01, η = 0.11), difficulty in relations ( = .01, η = 0.10) and alterations in systems of meaning ( = .01, η = 0.14). Conclusion: Comparing the VT-AT differences between the genders, men with VT had relatively more symptoms of intrusion, self-organization, identity, ideology/meaning, cognition, and relations difficulties. Effect sizes were moderate to large. Men may be relatively more vulnerable to VT than AT, while women may be more equally affected by VT and AT. Acknowledging possible gender differences in a wider range of trauma symptoms depending on trauma category may have clinical benefits.
背景
创伤后应激障碍（PTSD）的患病率存在较大的性别差异。性别差异在广泛的创伤症状中都有体现，包括自我组织紊乱，但这些差异并未得到广泛研究。
目的
通过比较创伤后应激障碍（PTSD）和意外创伤（AT），探讨广泛的创伤症状中的性别差异。
方法
这是一项在挪威奥斯陆的一家心理健康门诊接受治疗的 110 名创伤患者的横断面研究（38.2%为男性，Mage = 40.4，40%为挪威裔）。根据生活事件检查表，将创伤分为 VT 或 AT。DSM-IV-PTSD 模块的结构性临床访谈和未指定的极端应激障碍结构性访谈（DESNOS）评估了广泛的创伤症状。首先，我们在创伤类别内检查了性别差异，然后进行了 MANCOVA 调整后的两因素两水平组间分析。
结果
在 VT 患者中，男性报告了更多的自我认知改变（ =.02，ES = 0.50）和意义系统改变（ <.01，ES = 1.04）的症状。在 AT 组中，女性报告了更多的情感和冲动症状（ =.01，ES = 0.94）。VT-AT 差异在男性的侵入（ <.01，η = 0.04）、情感和冲动（ <.01，η = 0.12）、自我认知改变（ <.01，η = 0.11）、人际关系困难（ <.01，η = 0.10）和意义系统改变（ <.01，η = 0.14）方面明显更高。结论：比较性别之间的 VT-AT 差异，VT 男性有更多的侵入、自我组织、身份、意识形态/意义、认知和关系困难症状。效应大小为中等至较大。与 AT 相比，男性可能更容易受到 VT 的影响，而女性可能更容易受到 VT 和 AT 的同等影响。根据创伤类别承认广泛的创伤症状中可能存在的性别差异，可能具有临床意义。
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