Sack W H, Clarke G N, Seeley J
Division of Child and Adolescent Psychiatry, Oregon Health Sciences University, Portland 97201, USA.
J Am Acad Child Adolesc Psychiatry. 1995 Sep;34(9):1160-6. doi: 10.1097/00004583-199509000-00013.
To examine the expression of war-related trauma as manifested by DSM-III-R rates of posttraumatic stress disorder (PTSD) and major depressive disorder in two generations of Cambodian refugees living in the western United States.
A probability sample of 209 Khmer adolescents and one of their parents were interviewed using portions of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version and the PTSD section of the Diagnostic Interview for Children and Adolescents. Interviews were conducted in English by a master's-level clinician with a Khmer interpreter.
PTSD was found to be significantly related across parent-child generations. A nonsignificant generational trend was also found for depressive disorders. A number of environmental variables measured in the study (amount of reported war trauma, loss, living arrangements, treatment received, socioeconomic status) were not related to these findings. Parents were more likely to report an earlier onset of PTSD symptoms.
This study suggests that PTSD in refugees may cluster in families. Whether this phenomenon is caused by a genetic susceptibility to trauma awaits further research. PTSD and depressive disorders in refugee populations, while often comorbid, appear to follow different courses over time.
通过美国西部两代柬埔寨难民中创伤后应激障碍(PTSD)和重度抑郁症的《精神疾病诊断与统计手册》第三版修订本(DSM-III-R)发病率,研究战争相关创伤的表现。
使用儿童情感障碍和精神分裂症量表-流行病学版本的部分内容以及儿童和青少年诊断访谈中的PTSD部分,对209名高棉青少年及其父母中的一方进行概率抽样访谈。访谈由一名拥有硕士学位的临床医生用英语进行,并配有高棉语口译员。
发现PTSD在亲子代际间存在显著关联。抑郁症也存在不显著的代际趋势。研究中测量了一些环境变量(报告的战争创伤量、损失、生活安排、接受的治疗、社会经济地位),这些变量与这些发现无关。父母更有可能报告PTSD症状的发病时间更早。
本研究表明,难民中的PTSD可能在家庭中聚集。这种现象是否由对创伤的遗传易感性引起有待进一步研究。难民群体中的PTSD和抑郁症虽然常常共病,但随着时间推移似乎遵循不同的病程。