寻求创伤后应激障碍治疗的难民中的持续性悲伤:与创伤后应激症状的共病情况及网络结构
Prolonged Grief in Refugees Seeking Treatment for PTSD: Comorbidity with Post-Traumatic Stress Symptoms and Network Structure.
作者信息
Lechner-Meichsner Franziska, Rueger Mirjam Sophie, Nehler Kai Jannik, Ehring Thomas, Preiss Hannah, Morina Nexhmedin, Churbaji Dana, Mewes Ricarda, Giesebrecht Julia, Weise Cornelia, Steil Regina
机构信息
Department of Psychology, University of Wuppertal, Wuppertal, Germany.
Department of Psychology, Utrecht University, Utrecht, The Netherlands.
出版信息
Clin Psychol Psychother. 2025 May-Jun;32(3):e70097. doi: 10.1002/cpp.70097.
Refugees often experience traumatic events and the loss of loved ones, leading to post-traumatic stress disorder (PTSD), complex PTSD (cPTSD) and prolonged grief disorder (PGD). It has been repeatedly shown that comorbidity between PGD and PTSD is frequent especially after violent losses, but only few studies have investigated the relationship between PGD and cPTSD. The network approach to psychopathology is well suited to investigate associations between different symptoms. We therefore combined a traditional investigation of the probable prevalence of PGD and its comorbidity with PTSD and cPTSD in refugees and used network analysis to identify central symptoms and bridge symptoms. A total N of 92 treatment-seeking refugees who had experienced both loss and traumatic events completed a self-report measure of PGD and clinical interviews for PTSD and cPTSD. We determined the probable prevalence of PGD and rates of comorbidity. Network centrality and associations between symptoms of PGD and cPTSD were examined using network analysis. The probable prevalence of PGD was 28.04%. Of those with probable PGD, 65.38% also met criteria for comorbid PTSD and 19.23% for comorbid cPTSD. The most central PGD symptom in the network was difficulties engaging in social or other activities, and the most central cPTSD symptom was negative self-concept. The most important PGD bridge symptom was emotional numbness. Results underscore the importance of screening for PGD in treatment-seeking traumatized refugees in order to consider it in treatment planning. The relatively small sample size and the stability indices call for cautious interpretation of the results. TRIAL REGISTRATION: DRKS-ID: DRKS00019876. SUMMARY: This is the first prolonged grief and post-traumatic stress symptom network analysis in refugees. Prolonged grief disorder is an important mental health problem in refugees. Emotional numbness and avoidance were the most important bridge symptoms. Screening for PGD is important in traumatized treatment-seeking refugees. Culturally sensitive grief-focused interventions should be offered to refugees.
难民经常经历创伤性事件和亲人离世,从而导致创伤后应激障碍(PTSD)、复杂性创伤后应激障碍(cPTSD)和持续性悲伤障碍(PGD)。反复研究表明,PGD和PTSD之间的共病情况很常见,尤其是在经历暴力丧失亲人后,但只有少数研究调查了PGD和cPTSD之间的关系。精神病理学的网络方法非常适合研究不同症状之间的关联。因此,我们将对PGD在难民中的可能患病率及其与PTSD和cPTSD共病情况的传统调查与网络分析相结合,以识别核心症状和桥梁症状。共有92名经历过丧失和创伤性事件且寻求治疗的难民完成了一份PGD自我报告量表以及PTSD和cPTSD的临床访谈。我们确定了PGD的可能患病率和共病率。使用网络分析检查了PGD症状与cPTSD症状之间的网络中心性和关联。PGD的可能患病率为28.04%。在可能患有PGD的人群中,65.38%也符合PTSD共病标准,19.23%符合cPTSD共病标准。网络中最核心的PGD症状是难以参与社交或其他活动,最核心的cPTSD症状是消极的自我概念。最重要的PGD桥梁症状是情感麻木。结果强调了在寻求治疗的受创伤难民中筛查PGD的重要性,以便在治疗计划中予以考虑。相对较小的样本量和稳定性指标要求对结果进行谨慎解读。试验注册号:DRKS-ID:DRKS00019876。总结:这是首次对难民中的持续性悲伤和创伤后应激症状进行网络分析。持续性悲伤障碍是难民中的一个重要心理健康问题。情感麻木和回避是最重要的桥梁症状。对寻求治疗的受创伤难民进行PGD筛查很重要。应为难民提供具有文化敏感性的以悲伤为重点的干预措施。