Fung Hong Wang, Chau Anson Kai Chun, Lam Stanley Kam Ki, Ho Grace Wing Ka, Ross Colin A, Wong Ming Yu Claudia, Wang Edward K S, Chien Wai Tong, Wong Janet Yuen-Ha
School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
Department of Psychiatry, the University of Hong Kong, Pokfulam, Hong Kong.
Eur J Psychotraumatol. 2025 Dec;16(1):2458364. doi: 10.1080/20008066.2025.2458364. Epub 2025 Feb 17.
Although trauma-related symptoms (e.g. complex PTSD and dissociative symptoms) and psychotic symptoms often co-occur, little is known about the complex relationships among these symptoms over time. This study examined the bidirectional relationships among complex PTSD symptoms, dissociative symptoms, and positive symptoms of psychosis. This study analyzed available longitudinal data from two convenience samples (Sample 1: = 214, Chinese-speaking adults; Sample 2: = 301, English-speaking adults). Participants in both samples completed validated measures of ICD-11 complex PTSD (that included measurement of 'classical' PTSD), dissociation, and positive symptoms of psychosis at baseline and follow-up, six months (Sample 1) or 12 months (Sample 2) apart. A cross-lagged panel model was used to examine the longitudinal relationship between trauma-related symptoms and psychotic symptoms in each sample. In Sample 1, baseline dissociative symptoms significantly predicted positive symptoms of psychosis at follow-up. In Sample 2, no significant longitudinal relationships between trauma-related and psychotic symptoms were observed. In both samples, baseline disturbances in self-organization (DSO) symptoms predicted 'classical' PTSD symptoms at follow-up. This study made the first attempt to examine the longitudinal relationships among ICD-11 complex PTSD symptoms, dissociative symptoms, and psychotic symptoms. The inconsistent findings point to the importance of further research on the longitudinal relationships between trauma-related and psychotic symptoms. Moreover, our results indicate that addressing DSO symptoms may be important in the prevention and treatment of PTSD symptoms.
尽管创伤相关症状（如复杂性创伤后应激障碍和分离症状）与精神病性症状常常同时出现，但对于这些症状随时间推移的复杂关系却知之甚少。本研究考察了复杂性创伤后应激障碍症状、分离症状和精神病性阳性症状之间的双向关系。本研究分析了来自两个便利样本的现有纵向数据（样本1：n = 214，说中文的成年人；样本2：n = 301，说英语的成年人）。两个样本的参与者均在基线和随访时完成了关于ICD - 11复杂性创伤后应激障碍（包括“经典”创伤后应激障碍的测量）、分离和精神病性阳性症状的有效测量，随访分别在六个月（样本1）或十二个月（样本2）后进行。采用交叉滞后面板模型来考察每个样本中创伤相关症状与精神病性症状之间的纵向关系。在样本1中，基线分离症状显著预测了随访时的精神病性阳性症状。在样本2中，未观察到创伤相关症状与精神病性症状之间存在显著的纵向关系。在两个样本中，基线自我组织障碍（DSO）症状均预测了随访时的“经典”创伤后应激障碍症状。本研究首次尝试考察ICD - 11复杂性创伤后应激障碍症状、分离症状和精神病性症状之间的纵向关系。这些不一致的研究结果表明进一步研究创伤相关症状与精神病性症状之间纵向关系的重要性。此外，我们的结果表明，处理DSO症状可能对创伤后应激障碍症状的预防和治疗很重要。
