Lonigan C J, Anthony J L, Shannon M P
Department of Psychology, Florida State University, Tallahassee 32306-1270, USA.
J Clin Child Psychol. 1998 Oct;27(3):255-67. doi: 10.1207/s15374424jccp2703_3.
Examined 5 conditional probability indices to determine the diagnostic efficacy of 48 symptoms associated with posttraumatic stress disorder (PTSD) in 5,687 children exposed to Hurricane Hugo, of whom 5.5% had a diagnosis of posttraumatic stress syndrome (PTSS). Moderate levels of sensitivity and high levels of specificity were obtained for most symptoms. Odds ratios more precisely demonstrated that some Diagnostic and Statistical Manual of Mental Disorders (DSM) symptoms of PTSD, especially when combined, were useful for identifying children with PTSS but that anxiety symptoms and some DSM symptoms of PTSD had poor diagnostic utility. Satisfying criteria for the DSM-III-R numbing/avoidance cluster and symptoms from the numbing/avoidance cluster had the highest diagnostic efficacy, suggesting that avoidance may be the hallmark of severe posttraumatic reactions. These results suggest which symptoms should be conceptualized as central versus peripheral to the disorder and which symptoms and symptom combinations clinicians should attend to most when diagnosing or screening PTSD in children.
研究了5个条件概率指数，以确定与创伤后应激障碍（PTSD）相关的48种症状对5687名遭受雨果飓风影响儿童的诊断效力，其中5.5%被诊断为创伤后应激综合征（PTSS）。大多数症状获得了中等水平的敏感性和高水平的特异性。优势比更精确地表明，《精神疾病诊断与统计手册》（DSM）中PTSD的一些症状，尤其是合并时，对识别患有PTSS的儿童有用，但焦虑症状和PTSD的一些DSM症状诊断效用较差。满足DSM-III-R麻木/回避集群标准以及来自麻木/回避集群的症状具有最高的诊断效力，这表明回避可能是严重创伤后反应的标志。这些结果表明哪些症状应被视为该障碍的核心症状与外周症状，以及临床医生在诊断或筛查儿童PTSD时应最关注哪些症状和症状组合。
