Shih Chia-Hao, Zhou Adrian, Grider Stephen, Xie Hong, Wang Xin, Elhai Jon D
Department of Emergency Medicine, University of Toledo, Toledo, Ohio, USA.
Department of Psychiatry, University of Toledo, Toledo, Ohio, USA.
BJPsych Open. 2023 Jan 26;9(1):e27. doi: 10.1192/bjo.2023.1.
Trauma exposure can cause post-traumatic stress symptoms (PTSS), and persistently experiencing PTSS may lead to the development of post-traumatic stress disorder (PTSD). Research has shown that PTSS that emerged within days of trauma was a robust predictor of PTSD development.
To investigate patterns of early stress responses to trauma and their associations with development of PTSD.
We recruited 247 civilian trauma survivors from a local hospital emergency department. The PTSD Checklist for DSM-5 (PCL-5) and Acute Stress Disorder Scale (ASDS) were completed within 2 weeks after the traumatic event. Additionally, 3 months post-trauma 146 of these participants completed a PTSD diagnostic interview using the Clinician Administered PTSD Scale for DSM-5.
We first used latent profile analysis on four symptom clusters of the PCL-5 and the dissociation symptom cluster of the ASDS and determined that a four-profile model ('severe symptoms', 'moderate symptoms', 'mild symptoms', 'minimal symptoms') was optimal based on multiple fit indices. Gender was found to be predictive of profile membership. We then found a significant association between subgroup membership and PTSD diagnosis ((3) = 11.85, < 0.01, Cramer's = 0.263). analysis revealed that this association was driven by participants in the 'severe symptoms' profile, who had a greater likelihood of developing PTSD.
These findings fill the knowledge gap of identifying possible subgroups of individuals based on their PTSS severity during the early post-trauma period and investigating the relationship between subgroup membership and PTSD development, which have important implications for clinical practice.
创伤暴露可导致创伤后应激症状(PTSS),持续经历PTSS可能会导致创伤后应激障碍(PTSD)的发生。研究表明,创伤后数天内出现的PTSS是PTSD发生的有力预测指标。
调查创伤后早期应激反应模式及其与PTSD发生的关联。
我们从当地医院急诊科招募了247名平民创伤幸存者。创伤事件发生后2周内完成了《精神疾病诊断与统计手册》第5版创伤后应激障碍检查表(PCL-5)和急性应激障碍量表(ASDS)。此外,创伤后3个月,其中146名参与者使用《精神疾病诊断与统计手册》第5版临床医生管理的创伤后应激障碍量表完成了创伤后应激障碍诊断访谈。
我们首先对PCL-5的四个症状簇和ASDS的解离症状簇进行了潜在剖面分析,并根据多个拟合指数确定四剖面模型(“严重症状”、“中度症状”、“轻度症状”、“最小症状”)是最佳模型。发现性别可预测剖面成员资格。然后我们发现亚组成员资格与创伤后应激障碍诊断之间存在显著关联((3)=11.85,<0.01,克莱默氏 =0.263)。分析表明,这种关联是由“严重症状”剖面的参与者驱动的,他们患创伤后应激障碍的可能性更大。
这些发现填补了在创伤后早期根据PTSS严重程度识别可能的个体亚组并研究亚组成员资格与创伤后应激障碍发生之间关系的知识空白,这对临床实践具有重要意义。