Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton. Hamilton, Ontario, Canada; St. Joseph's Healthcare Hamilton, Hamilton Ontario, Canada; Department of Psychology Neuroscience, and Behaviour, McMaster University, Hamilton, Ontario, Canada.
Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton. Hamilton, Ontario, Canada; St. Joseph's Healthcare Hamilton, Hamilton Ontario, Canada.
Psychiatry Res. 2023 Nov;329:115496. doi: 10.1016/j.psychres.2023.115496. Epub 2023 Sep 23.
Few studies have examined changes in posttraumatic-stress disorder (PTSD) symptomatology across an extended time period during the COVID-19 pandemic. This study used a longitudinal cohort design to examine: (1) changes in overall PTSD symptoms and symptom clusters; (2) moderators of change; (3) the clinical significance of observed changes; and (4) correlates of clinically meaningful changes. Community adults (N = 1412) were assessed using the PTSD Checklist for DSM-5 (PCL-5) at 10 timepoints (October 2018 - April 2022). Changes in overall PCL-5 score and symptom clusters were substantially moderated by pre-pandemic clinical severity (i.e., above/below PCL-5 cut-off). Pre-pandemic non-clinical participants exhibited increases in overall scores, Cluster D (negative cognitions), and Cluster E (arousal), while clinically elevated participants exhibited decreases overall and in all clusters. Regarding clinical significance, 12% of pre-pandemic non-clinical participants exhibited clinically meaningful increases, and 4% exhibited decreases. Conversely, 42% of the pre-pandemic elevated group exhibited clinically meaningful decreases, while 6% exhibited increases. Pandemic impacts in numerous psychosocial domains were associated with clinically meaningful change. Collectively, these findings reveal substantively divergent trajectories by pre-pandemic severity and PTSD symptom cluster. The large proportion of pre-pandemic high-severity participants exhibiting sizable decreases was an unexpected notable observation.
很少有研究在 COVID-19 大流行期间的延长时间段内检查创伤后应激障碍 (PTSD) 症状的变化。本研究使用纵向队列设计来检查：(1) 总体 PTSD 症状和症状群的变化；(2) 变化的调节因素；(3) 观察到的变化的临床意义；和 (4) 临床有意义变化的相关因素。社区成年人 (N = 1412) 使用 DSM-5 创伤后应激障碍检查表 (PCL-5) 在 10 个时间点 (2018 年 10 月至 2022 年 4 月) 进行评估。总体 PCL-5 评分和症状群的变化主要受到大流行前临床严重程度的调节 (即，高于/低于 PCL-5 截止值)。大流行前非临床参与者的总分、D 组 (负性认知) 和 E 组 (唤醒) 均有所增加，而临床升高的参与者总分和所有组均有所下降。关于临床意义，12%的大流行前非临床参与者表现出有临床意义的增加，4%表现出减少。相反，42%的大流行前升高组表现出有临床意义的减少，而 6%表现出增加。众多社会心理领域的大流行影响与有临床意义的变化有关。总的来说，这些发现揭示了大流行前严重程度和 PTSD 症状群的实质性不同轨迹。大流行前高严重程度参与者中表现出大量减少的比例很高，这是一个出乎意料的显著观察结果。
