受过创伤的中国青少年的复杂创伤后应激障碍和解离:潜类分析。

IF 4.2 2区 医学 Q1 PSYCHIATRY European Journal of Psychotraumatology Pub Date : 2024-01-01 Epub Date: 2024-05-29 DOI:10.1080/20008066.2024.2351292
Li Wang, Haibo Fu, Hengjia Guo, Ping Liu, Yajie Bi, Shu Luo, Yuwei Han, Yuxuan Wang, Chengqi Cao
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引用次数: 0

摘要

背景:初步证据表明,复杂创伤后应激障碍(CPTSD)存在解离亚型。对这一命题的研究将扩展我们对 CPTSD 与解离之间关联的认识,指导当代关于将解离置于 CPTSD 分类学中的思考,并为临床有用的评估和干预提供信息:本研究旨在调查中国受创伤青少年中CPTSD和解离症状的共存模式,并明确这种模式的临床特征协变量,包括童年创伤、合并重性抑郁障碍(MDD)和广泛性焦虑障碍(GAD)以及功能障碍:研究对象包括57984名受到2019年冠状病毒病(COVID-19)大流行影响的高中生。通过全球青少年精神创伤筛查(GPS-T)测量了 CPTSD 和分离症状、童年创伤经历和功能障碍。重度抑郁症(MDD)和广泛性焦虑症(GAD)症状分别通过患者健康问卷-9(PHQ-9)和广泛性焦虑症-7(GAD-7)进行测量。采用潜类分析(LCA)来检验 CPTSD 和分离症状的共存模式。方差分析(ANCOVA)和卡方检验分别用于检验连续和分类临床协变量的类间差异:结果:一个五类模型成为最佳拟合模型,包括复原力、以创伤后应激障碍症状为主、以自我组织紊乱(DSO)症状为主、以 CPTSD 症状为主和 CPTSD 解离亚型类。CPTSD 解离亚型类别的功能水平最低,而 MDD、GAD 和童年创伤的发病率最高:我们的研究结果为支持 CPTSD 解离亚型的存在提供了初步的实证证据,并为针对创伤个体的进一步研究和临床实践提供了参考。
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Complex posttraumatic stress disorder and dissociation in trauma-exposed Chinese adolescents: a latent class analysis.

Background: Preliminary evidence provides support for the proposition that there is a dissociative subtype of Complex posttraumatic stress disorder (CPTSD). Research on this proposition would extend our knowledge on the association between CPTSD and dissociation, guide contemporary thinking regarding placement of dissociation in the nosology of CPTSD, and inform clinically useful assessment and intervention.Objectives: The present study aimed to investigate the co-occurring patterns of CPTSD and dissociative symptoms in a large sample of trauma exposed adolescents from China, and specify clinical features covariates of such patterns including childhood trauma, comorbidities with major depressive disorder (MDD) and generalized anxiety disorder (GAD), and functional impairment.Methods: Participants included 57,984 high school students exposed to the coronavirus disease 2019 (COVID-19) pandemic. CPTSD and dissociative symptoms, childhood traumatic experience, and functional impairment were measured with the Global Psychotrauma Screen for Teenagers (GPS-T). Major depressive disorder (MDD) and generalized anxiety disorder (GAD) symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7), respectively. Latent class analysis (LCA) was employed to test the co-occurring patterns of CPTSD and dissociative symptoms. Analysis of covariance (ANCOVA) and chi-square tests were respectively used to examine between-class differences in continuous and categorical clinical covariates.Results: A 5-class model emerged as the best-fitting model, including resilience, predominantly PTSD symptoms, predominantly disturbances in self-organization (DSO)symptoms, predominantly CPTSD symptoms, and CPTSD dissociative subtype classes. The CPTSD dissociative subtype class showed the lowest level of functioning and the highest rates of MDD, GAD and childhood trauma.Conclusions: Our findings provide initial empirical evidence supporting the existence of a dissociative subtype of CPTSD, and inform for further research and clinical practice on traumatized individuals.

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来源期刊
CiteScore
7.60
自引率
12.00%
发文量
153
审稿时长
18 weeks
期刊介绍: The European Journal of Psychotraumatology (EJPT) is a peer-reviewed open access interdisciplinary journal owned by the European Society of Traumatic Stress Studies (ESTSS). The European Journal of Psychotraumatology (EJPT) aims to engage scholars, clinicians and researchers in the vital issues of how to understand, prevent and treat the consequences of stress and trauma, including but not limited to, posttraumatic stress disorder (PTSD), depressive disorders, substance abuse, burnout, and neurobiological or physical consequences, using the latest research or clinical experience in these areas. The journal shares ESTSS’ mission to advance and disseminate scientific knowledge about traumatic stress. Papers may address individual events, repeated or chronic (complex) trauma, large scale disasters, or violence. Being open access, the European Journal of Psychotraumatology is also evidence of ESTSS’ stand on free accessibility of research publications to a wider community via the web. The European Journal of Psychotraumatology seeks to attract contributions from academics and practitioners from diverse professional backgrounds, including, but not restricted to, those in mental health, social sciences, and health and welfare services. Contributions from outside Europe are welcome. The journal welcomes original basic and clinical research articles that consolidate and expand the theoretical and professional basis of the field of traumatic stress; Review articles including meta-analyses; short communications presenting new ideas or early-stage promising research; study protocols that describe proposed or ongoing research; case reports examining a single individual or event in a real‑life context; clinical practice papers sharing experience from the clinic; letters to the Editor debating articles already published in the Journal; inaugural Lectures; conference abstracts and book reviews. Both quantitative and qualitative research is welcome.
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