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精神病的阳性症状与《国际疾病分类第11版》(ICD - 11)复杂性创伤后应激障碍:来自蒙特利尔的加拿大样本的网络分析:精神病阳性症状与复杂性创伤后应激障碍(ICD - 11):蒙特利尔加拿大样本的网络分析

Positive Symptoms of Psychosis and International Classification of Diseases 11th Revision (ICD-11) Complex Post-traumatic Stress Disorder: A Network Analysis in a Canadian Sample from Montreal: Symptômes positifs de psychose et trouble de stress post-traumatique complexe (CIM-11): Une analyse de réseau dans un échantillon canadien de Montréal.

作者信息

Levin Yafit, Mazza Amelie, Hyland Philip, Karatzias Thanos, Shevlin Mark, McGinty Grainne, Hoffman Yaakov, Lis Eric, Ben-Ezra Menachem, Rahel Bachem

机构信息

School of Social Work, Ariel University, Ariel, Israel.

Department of Psychology, University of Zurich, Zurich, Switzerland.

出版信息

Can J Psychiatry. 2025 May 15:7067437251337645. doi: 10.1177/07067437251337645.

Abstract

ObjectivesTraumatic experiences constitute a risk factor for developing different psychopathologies, such as post-traumatic stress disorder (PTSD), complex PTSD (CPTSD), and positive symptoms of psychosis. However, on the symptom level, it is still unclear how CPTSD and positive symptoms of psychosis associate with each other. The present study aimed to shed light on these dynamics by investigating the symptoms network of CPTSD and positive symptoms of psychosis.MethodsA network analysis was performed on CPTSD and psychosis symptoms among a Canadian community sample with a history of traumatic life events ( = 747). Measures included the international trauma questionnaire and the mPRIME screen.ResultsIn total, 4.8% of the sample reached the criteria of probable PTSD and 7% fulfilled the criteria of probable CPTSD. PTSD and CPTSD groups had a significantly higher severity of positive symptoms of psychosis compared to the no-disorder group. Network analysis revealed 3 distinct communities of symptoms of PTSD, disturbances in self-organization, and psychosis. Affective dysregulation served as the bridging symptom between the communities. Hearing one's own thoughts aloud was the most central symptom in the network.ConclusionsFindings show that positive symptoms of psychosis can be considered trauma-related responses. Furthermore, interventions targeting affective dysregulation as well as the experience and distress associated with hearing one's own thoughts aloud may contribute to symptom reduction and improved functioning.

摘要

目标

创伤经历是引发不同精神疾病的风险因素,如创伤后应激障碍(PTSD)、复杂性创伤后应激障碍(CPTSD)以及精神病性阳性症状。然而,在症状层面,CPTSD与精神病性阳性症状之间如何相互关联仍不明确。本研究旨在通过调查CPTSD和精神病性阳性症状的症状网络来阐明这些动态关系。

方法

对加拿大一个有创伤性生活事件史的社区样本(n = 747)中的CPTSD和精神病症状进行网络分析。测量工具包括国际创伤问卷和mPRIME筛查。

结果

总体而言,4.8%的样本达到可能的PTSD标准,7%符合可能的CPTSD标准。与无疾病组相比,PTSD组和CPTSD组的精神病性阳性症状严重程度显著更高。网络分析揭示了PTSD、自我组织障碍和精神病症状的3个不同群落。情感失调是这些群落之间的桥梁症状。幻听是网络中最核心的症状。

结论

研究结果表明,精神病性阳性症状可被视为与创伤相关的反应。此外,针对情感失调以及与幻听相关的体验和痛苦的干预措施可能有助于减轻症状并改善功能。

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本文引用的文献

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Complex post-traumatic stress disorder.复杂性创伤后应激障碍。
Lancet. 2022 Jul 2;400(10345):60-72. doi: 10.1016/S0140-6736(22)00821-2.
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A network analysis of post-traumatic stress and psychosis symptoms.创伤后应激与精神病症状的网络分析。
Psychol Med. 2021 Oct;51(14):2485-2492. doi: 10.1017/S0033291720001300. Epub 2020 May 18.

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