School of Psychology, Jiangxi Normal University, Nanchang, China.
Department of Social Work, Hong Kong Baptist University, Hong Kong.
J Affect Disord. 2024 Dec 15;367:606-616. doi: 10.1016/j.jad.2024.08.213. Epub 2024 Sep 3.
Although irritability is a prominent clinical manifestation among traumatized populations, its relationships with other psychopathologies are rarely studied. Adopting a symptom-level perspective, this study aimed to explore how symptoms of irritability, posttraumatic stress disorder (PTSD), and depression are associated.
The Brief Irritability Test, the PTSD Checklist for DSM-5, and the Patient Health Questionnaire-9 were used to measure irritability, PTSD, and depression, respectively, in a large sample of trauma-exposed children and adolescents (n = 5454), trauma-exposed adults (n = 4718), and children and adolescents with probable PTSD (n = 556). Exploratory graph analysis (EGA) and network analysis were conducted to examine potential communities and significant relations.
Although irritability, PTSD, and depression were highly correlated at the disorder level, EGA results indicated that, at the symptom level, they formed highly stable and dense communities, respectively. Relations across disorders mainly emerged at symptoms related to negative cognition, dysphoria, and suicidal thoughts. Especially, strong transdiagnostic relations across all samples were "negative beliefs" and "suicidal thoughts", "numbing" and "suicidal thoughts", "startle" and "moving slowly or restless", "bothering" and "moving slowly or restless". Furthermore, irritability symptoms seem more central than PTSD and depression symptoms, with "snap" being the most central node across all networks, especially in the child and adolescent sample.
Irritability, PTSD, and depression are relatively independent constructs when analyzed at the symptom level. Irritability symptoms emerged as core symptoms in trauma-exposed populations. Our findings highlight the importance of independent assessment of irritability in the diagnosis and treatment of PTSD.
尽管易激惹是创伤人群中突出的临床表现之一，但它与其他精神病理学的关系很少被研究。本研究采用症状层面的视角，旨在探讨易激惹、创伤后应激障碍（PTSD）和抑郁症状之间的关系。
采用Brief Irritability Test、DSM-5 PTSD 清单和 PHQ-9 分别对大量创伤暴露的儿童和青少年（n=5454）、创伤暴露的成年人（n=4718）和可能患有 PTSD 的儿童和青少年（n=556）进行易激惹、PTSD 和抑郁的测量。采用探索性图形分析（EGA）和网络分析来检查潜在的社区和显著关系。
尽管在疾病层面上，易激惹、PTSD 和抑郁高度相关，但 EGA 结果表明，在症状层面上，它们分别形成了高度稳定和密集的社区。跨疾病的关系主要出现在与负性认知、心境恶劣和自杀意念相关的症状上。特别是，所有样本中都存在强烈的跨诊断关系，包括“消极信念”和“自杀意念”、“麻木”和“自杀意念”、“惊跳”和“动作缓慢或不安”、“困扰”和“动作缓慢或不安”。此外，易激惹症状似乎比 PTSD 和抑郁症状更为核心，在所有网络中，“Snap”都是最核心的节点，尤其是在儿童和青少年样本中。
当在症状层面进行分析时，易激惹、PTSD 和抑郁是相对独立的结构。易激惹症状在创伤暴露人群中是核心症状。我们的研究结果强调了在 PTSD 的诊断和治疗中对易激惹症状进行独立评估的重要性。
