Boscarino J A
Department of Epidemiology and Biostatistics, University of California, San Francisco 94105, USA.
J Trauma Stress. 1995 Apr;8(2):317-36. doi: 10.1007/BF02109567.
The hypothesis is tested that individuals exposed to traumatic stress who currently have lower social support have higher rates of post-traumatic stress and associated disorders. To test this, the current prevalence of five psychiatric disorders, including post-traumatic stress, generalized anxiety, depression, alcohol abuse, and drug abuse, were studied among a random sample of veterans who served in Vietnam (N = 2,490) and a random sample of "era" veterans who did not (N = 1,972). Logistic regression was used to analyze each disorder, controlling for past combat exposure, current social status, childhood delinquency, military adjustment, and current social support. Combat exposure was the best predictor of post-traumatic stress and was also associated with anxiety and depression, but not alcohol or drug abuse. Substance abuse was associated with childhood delinquency, and the best predictor of drug abuse was illicit Army drug use. Lower social support was associated with all disorders, except drug abuse. Although the causal nexus is not clear in this case, this study suggests that future research and clinical interventions should not overlook the significance of social support among victims of traumatic stress.
当前社会支持较低的遭受创伤性应激的个体，患创伤后应激障碍及相关疾病的几率更高。为验证此假设，在曾赴越南服役的退伍军人随机样本（N = 2490）和未赴越南服役的“同期”退伍军人随机样本（N = 1972）中，对包括创伤后应激障碍、广泛性焦虑症、抑郁症、酒精滥用和药物滥用在内的五种精神疾病的当前患病率进行了研究。采用逻辑回归分析每种疾病，并对过去的战斗经历、当前社会地位、童年犯罪、军事适应情况和当前社会支持进行了控制。战斗经历是创伤后应激障碍的最佳预测因素，也与焦虑症和抑郁症相关，但与酒精或药物滥用无关。物质滥用与童年犯罪有关，药物滥用的最佳预测因素是军队中的非法药物使用。除药物滥用外，较低的社会支持与所有疾病均相关。尽管在这种情况下因果关系尚不清楚，但本研究表明，未来的研究和临床干预不应忽视创伤性应激受害者中社会支持的重要性。
