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青少年创伤后应激障碍和复杂创伤后应激障碍的流行情况及预测因素。

Prevalence and predictors of ICD-11 posttraumatic stress disorder and complex PTSD in young people.

机构信息

School of Psychology, Ulster University, Coleraine, UK.

Department of Psychology, Maynooth University, Maynooth, Ireland.

出版信息

Acta Psychiatr Scand. 2022 Aug;146(2):110-125. doi: 10.1111/acps.13442. Epub 2022 May 11.

Abstract

OBJECTIVE

The prevalence, construct validity, risk factors and psychopathological correlates associated with ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as measured by the International Trauma Questionnaire for Children and Adolescents (ITQ-CA) were assessed in a sample of young people from Northern Ireland.

METHOD

Participants were trauma-exposed 11-19-year-olds (N = 507) who participated in the Northern Ireland Youth Wellbeing Prevalence Survey (YWS-NI, 2020). Factor mixture modelling (FMM) was used to test the latent structure of the ITQ-CA. Risk-factors and psychopathological correlates associated with latent class membership, and ICD-11diagnostic status, were also investigated.

RESULTS

More participants met the ITQ-CA criteria for CPTSD (3.4%, n = 44) than PTSD (1.5%, n = 19). A second-order FMM comprising a 'partial-PTSD class', a 'CPTSD class', a 'DSO class' and a 'low symptom endorsement class' was the best-fitting model. Younger age and cumulative trauma were risk factors for all trauma classes. Female gender and two or more violent traumas were significant predictors of the 'PTSD' and 'CPTSD' classes, while single sexual trauma was a significant predictor of the 'DSO' and 'CPTSD' classes. Two or more sexual traumas was a unique predictor of 'CPTSD class', while two or more vicarious traumas was a unique predictor of 'DSO class'. The 'CPTSD' class displayed the most notable comorbidity.

CONCLUSIONS

Findings indicate that CPTSD may be more prevalent than PTSD in children and young people. Support for the ICD-11 conceptualisation of CPTSD as representing a unique diagnostic construct was supported using FMM, with findings indicating trauma symptom class-specific risk profiles.

摘要

目的

通过儿童和青少年国际创伤问卷(ITQ-CA)评估北爱尔兰青年样本中,ICD-11 创伤后应激障碍(PTSD)和复杂创伤后应激障碍(CPTSD)的流行率、结构效度、风险因素和心理病理学相关性。

方法

参与者为经历过创伤的 11-19 岁青少年(N=507),他们参加了北爱尔兰青年福利调查(YWS-NI,2020 年)。使用因子混合模型(FMM)来检验 ITQ-CA 的潜在结构。还研究了与潜在类别成员身份和 ICD-11 诊断状态相关的风险因素和心理病理学相关性。

结果

与 PTSD(1.5%,n=19)相比,更多的参与者符合 ITQ-CA 的 CPTSD 标准(3.4%,n=44)。由“部分 PTSD 类”、“CPTSD 类”、“DSO 类”和“低症状类”组成的二阶 FMM 是最佳拟合模型。年龄较小和累积创伤是所有创伤类别的风险因素。女性和两种或更多暴力创伤是“PTSD”和“CPTSD”类的显著预测因素,而单一性创伤是“DSO”和“CPTSD”类的显著预测因素。两种或更多性创伤是“CPTSD 类”的独特预测因素,而两种或更多替代性创伤是“DSO 类”的独特预测因素。“CPTSD 类”显示出最显著的共病。

结论

研究结果表明,儿童和青少年中 CPTSD 的患病率可能高于 PTSD。使用 FMM 支持 ICD-11 对 CPTSD 的概念化,即代表一种独特的诊断结构,研究结果表明,创伤症状类别具有特定的风险特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fa8/9540630/2c7249105e75/ACPS-146-110-g001.jpg

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