Breslau N, Davis G C
Am J Psychiatry. 1987 May;144(5):578-83. doi: 10.1176/ajp.144.5.578.
The authors examined the effects of wartime stressors in a sample of 69 Vietnam veterans who were psychiatric inpatients in a Veterans Administration hospital. Participation in atrocities and the cumulative exposure to combat stressors, each independently of the other, conferred a significant risk for posttraumatic stress disorder. In contrast, the effect of these war experiences on the onset of panic, major depression, and mania was not significant. The results indicate that extreme stressors are uniquely linked with posttraumatic stress disorder's characteristic cluster of symptoms but challenge DSM-III's implicit assumption that the reexperienced trauma is the stressor responsible for posttraumatic stress disorder.
作者对69名越战老兵进行了研究，这些老兵是退伍军人管理局医院的精神科住院患者，以此来检验战时应激源的影响。参与暴行以及累积暴露于战斗应激源，二者相互独立，均会带来患创伤后应激障碍的显著风险。相比之下，这些战争经历对惊恐障碍、重度抑郁症和躁狂症发作的影响并不显著。结果表明，极端应激源与创伤后应激障碍的典型症状群存在独特关联，但对《精神疾病诊断与统计手册》第三版（DSM-III）隐含的假设提出了挑战，该假设认为再次体验到的创伤是导致创伤后应激障碍的应激源。
