Straud Casey L, Moring John C, Hale Willie J, McMahon Chelsea, Moore Brian A, Baker Monty T, Bryant Richard A, Young-McCaughan Stacey, Isler William C, Lara-Ruiz Jose, Lancaster Cynthia L, Mintz Jim, Peterson Alan L
Department of Psychiatry and Behavioral Sciences.
Department of Psychological Science.
Psychol Trauma. 2023 Feb;15(2):255-264. doi: 10.1037/tra0001150. Epub 2021 Oct 25.
The primary aims of this study were to identify latent profiles of acute stress disorder (ASD) symptoms and to evaluate postconcussive symptom differences across the identified profiles as measured by the Acute Stress Disorder Scale and the Military Acute Concussion Evaluation, respectively.
Participants (N = 315) in the current study were predominantly active-duty (75.0%), enlisted (97.8%) males (97.4%) serving in the U.S. Army (87.8%). Approximately, half of the sample reported being married or engaged (51.1%) and was on average 25.94 ( = 6.31) years old. Participants were referred to the Air Force Theater Hospital, 332nd Air Expeditionary Wing, Joint Base Balad, Iraq, to be evaluated as part of routine clinical assessment for neurocognitive and psychological symptoms following exposure to a blast.
A 3-profile solution was identified as the most parsimonious and best-fitting model based on statistical model fit indices. Blast injured service members in Profile 3 had greater ASD total and subscale severity compared to the other 2 subgroups, with effect size estimates largely differing by hyperarousal and reexperiencing symptoms. Furthermore, Profiles 2 and 3 were more likely to demonstrate postconcussive symptoms compared to Profile 1.
Findings provide novel information on heterogenous ASD symptom profiles during the acute phase following a blast injury and highlight the relationship between psychological and physical symptoms. Classification of blast-injured service members may help identify at-risk individuals who would benefit from further clinical care and mitigate long-term psychological and neurocognitive issues. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
本研究的主要目的是识别急性应激障碍（ASD）症状的潜在概况，并分别通过急性应激障碍量表和军事急性脑震荡评估来评估所识别概况之间的脑震荡后症状差异。
本研究的参与者（N = 315）主要是现役军人（75.0%）、应征入伍者（97.8%）、男性（97.4%），在美国陆军服役（87.8%）。大约一半的样本报告已婚或订婚（51.1%），平均年龄为25.94岁（标准差 = 6.31）。参与者被转介到伊拉克巴拉德联合基地第332空中远征联队的空军战区医院，作为爆炸暴露后神经认知和心理症状常规临床评估的一部分进行评估。
基于统计模型拟合指数，一个三概况解决方案被确定为最简约且拟合最佳的模型。与其他两个亚组相比，概况3中的爆炸受伤军人的ASD总分及分量表严重程度更高，效应量估计在很大程度上因过度唤醒和重新体验症状而有所不同。此外，与概况1相比，概况2和概况3更有可能表现出脑震荡后症状。
研究结果提供了关于爆炸伤急性期ASD症状异质性概况的新信息，并突出了心理和身体症状之间的关系。对爆炸伤军人进行分类可能有助于识别那些将从进一步临床护理中受益的高危个体，并减轻长期的心理和神经认知问题。（PsycInfo数据库记录（c）2023美国心理学会，保留所有权利）
