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创伤综合化类型的特征分析:一项在城市人群中检验内化和外化精神病理学的重复与扩展研究。

Characterizing Typologies of Polytraumatization: A Replication and Extension Study Examining Internalizing and Externalizing Psychopathology in an Urban Population.

作者信息

Mekawi Yara, Kuzyk Eva, Dixon H Drew, McKenna Brooke, Camacho Luisa, de Andino Ana Martinez, Stevens Jennifer, Michopolous Vasiliki, Powers Abigail

机构信息

Department of Psychiatry and Brain Science, Emory School of Medicine.

Department of Psychology, Emory University.

出版信息

Clin Psychol Sci. 2021 Nov;9(6):1144-1163. doi: 10.1177/21677026211000723. Epub 2021 May 19.

Abstract

A person-centered approach to examining trauma has uncovered typologies of polytraumatization that are differentially associated with psychopathology. However, previous research is limited by narrow conceptualizations of trauma, limited distal outcomes, and underrepresentation of minorities. To address these gaps, we used latent profile analyses to uncover distinct polytraumatization typologies and examine four symptom-based (PTSD, depression, aggression, and substance abuse) and two behavior-based (self-harm, jail counts) outcomes in a sample of low-income adults ( = 7,426, 94% African American). The models were indicated by 19 traumatic experiences (e.g., accident, sexual assault, witnessing/experiencing violence). The best fitting model uncovered five classes: minimal trauma, physical abuse, violence exposure, sexual abuse, and polytrauma. Classes characterized by significant and varied trauma were higher on both internalizing and externalizing psychopathology, while those characterized by specific types of trauma were only higher on one type of psychopathology. Implications for the assessment and treatment of trauma-related disorders are discussed.

摘要

一种以患者为中心的创伤研究方法揭示了多种创伤类型,这些类型与精神病理学存在不同程度的关联。然而,以往的研究存在创伤概念狭窄、远端结果有限以及少数群体代表性不足等局限性。为了填补这些空白,我们采用潜在剖面分析来揭示不同的多种创伤类型,并在一个低收入成年人样本(N = 7426,94%为非裔美国人)中检验四种基于症状的结果(创伤后应激障碍、抑郁、攻击行为和药物滥用)以及两种基于行为的结果(自我伤害、入狱次数)。模型由19种创伤经历(如事故、性侵犯、目睹/经历暴力)表示。最佳拟合模型揭示了五类:轻度创伤、身体虐待、暴力暴露、性虐待和多重创伤。以严重且多样的创伤为特征的类别在内化和外化精神病理学方面得分更高,而以特定类型创伤为特征的类别仅在一种精神病理学类型上得分更高。本文还讨论了对创伤相关障碍评估和治疗的启示。

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