Giaconia R M, Reinherz H Z, Silverman A B, Pakiz B, Frost A K, Cohen E
Early Adulthood Research Project, Simmons College School of Social Work, Boston, MA 02116, USA.
J Am Acad Child Adolesc Psychiatry. 1995 Oct;34(10):1369-80. doi: 10.1097/00004583-199510000-00023.
The prevalence of DSM-III-R traumas and posttraumatic stress disorder (PTSD) and their impact on psychosocial functioning were examined in a community population of older adolescents.
Subjects were 384 adolescents participating in an ongoing longitudinal study. When subjects were aged 18 years, the NIMH Diagnostic Interview Schedule, Version IIIR, was used to identify lifetime traumatic events and diagnoses of PTSD, major depression, phobias, and substance dependence. Behavioral, emotional, and academic functioning in later adolescence was evaluated through self-report measures and school records.
More than two fifths of adolescents experienced at least one DSM-III-R trauma by age 18 years; PTSD developed in 14.5% of these affected youths or 6.3% of the total sample. Youths with PTSD demonstrated widespread impairment at age 18, including more overall behavioral-emotional problems, interpersonal problems, academic failure, suicidal behavior, and health problems, as well as an increased risk for additional disorders. An equally striking finding was that youths who experienced traumas but did not develop PTSD also showed deficits in many of these areas when compared with their peers who had not experienced traumas.
The substantial risk faced by youths in community settings for experiencing traumas and PTSD, along with associated impairments in later adolescence, underscores the need for programs of prompt intervention.
在一群年龄较大的青少年社区人群中，研究《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）所定义的创伤及创伤后应激障碍（PTSD）的患病率及其对心理社会功能的影响。
研究对象为384名参与一项正在进行的纵向研究的青少年。当研究对象年满18岁时，使用美国国立精神卫生研究所诊断访谈表第三版修订本（NIMH DIS-III-R）来确定终生创伤事件以及PTSD、重度抑郁症、恐惧症和物质依赖的诊断。通过自我报告测量和学校记录来评估青少年后期的行为、情绪和学业功能。
超过五分之二的青少年在18岁前经历过至少一次DSM-III-R所定义的创伤；在这些受影响的青少年中，14.5%患上了PTSD，占总样本的6.3%。患有PTSD的青少年在18岁时表现出广泛的功能损害，包括更多的整体行为-情绪问题、人际问题、学业失败、自杀行为和健康问题，以及患其他疾病的风险增加。一个同样显著的发现是，与未经历过创伤的同龄人相比，经历过创伤但未患上PTSD的青少年在许多这些方面也存在缺陷。
社区环境中的青少年面临着遭受创伤和患PTSD的重大风险，以及在青少年后期出现的相关功能损害，这突出了及时干预项目的必要性。
