Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China.
Department of Psychology, University of Chinese Academy of Sciences, Beijing, People's Republic of China.
Eur J Psychotraumatol. 2024;15(1):2351292. doi: 10.1080/20008066.2024.2351292. Epub 2024 May 29.
Preliminary evidence provides support for the proposition that there is a dissociative subtype of Complex posttraumatic stress disorder (CPTSD). Research on this proposition would extend our knowledge on the association between CPTSD and dissociation, guide contemporary thinking regarding placement of dissociation in the nosology of CPTSD, and inform clinically useful assessment and intervention. The present study aimed to investigate the co-occurring patterns of CPTSD and dissociative symptoms in a large sample of trauma exposed adolescents from China, and specify clinical features covariates of such patterns including childhood trauma, comorbidities with major depressive disorder (MDD) and generalized anxiety disorder (GAD), and functional impairment. Participants included 57,984 high school students exposed to the coronavirus disease 2019 (COVID-19) pandemic. CPTSD and dissociative symptoms, childhood traumatic experience, and functional impairment were measured with the Global Psychotrauma Screen for Teenagers (GPS-T). Major depressive disorder (MDD) and generalized anxiety disorder (GAD) symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7), respectively. Latent class analysis (LCA) was employed to test the co-occurring patterns of CPTSD and dissociative symptoms. Analysis of covariance (ANCOVA) and chi-square tests were respectively used to examine between-class differences in continuous and categorical clinical covariates. A 5-class model emerged as the best-fitting model, including resilience, predominantly PTSD symptoms, predominantly disturbances in self-organization (DSO)symptoms, predominantly CPTSD symptoms, and CPTSD dissociative subtype classes. The CPTSD dissociative subtype class showed the lowest level of functioning and the highest rates of MDD, GAD and childhood trauma. Our findings provide initial empirical evidence supporting the existence of a dissociative subtype of CPTSD, and inform for further research and clinical practice on traumatized individuals.
初步证据支持这样一种观点，即创伤后应激障碍（CPTSD）存在一种分离亚型。对这一观点的研究将扩展我们对 CPTSD 与分离之间关联的认识，指导我们对 CPTSD 分类中分离位置的当代思考，并为临床有用的评估和干预提供信息。本研究旨在调查中国大样本创伤暴露青少年中 CPTSD 和分离症状的共同发生模式，并确定此类模式的临床特征协变量，包括儿童期创伤、与重度抑郁症（MDD）和广泛性焦虑症（GAD）的共病以及功能障碍。参与者包括 57984 名暴露于 2019 年冠状病毒病（COVID-19）大流行的高中生。CPTSD 和分离症状、儿童期创伤经历以及功能障碍采用青少年全球心理创伤筛查（GPS-T）进行测量。使用患者健康问卷-9（PHQ-9）和广泛性焦虑症-7（GAD-7）分别测量 MDD 和 GAD 症状。采用潜在类别分析（LCA）检验 CPTSD 和分离症状的共同发生模式。协方差分析（ANCOVA）和卡方检验分别用于检验连续和分类临床协变量的类间差异。5 类模型是最佳拟合模型，包括韧性、主要 PTSD 症状、主要自我组织障碍（DSO）症状、主要 CPTSD 症状和 CPTSD 分离亚型。CPTSD 分离亚型表现出最低的功能水平和最高的 MDD、GAD 和儿童期创伤发生率。我们的研究结果为创伤后个体的进一步研究和临床实践提供了支持 CPTSD 存在分离亚型的初步经验证据。
