创伤后应激障碍症状表现的亚群差异:潜类分析

Sarah E. Whiteman , Daniel J. Lee , Lindsay B. Kramer , Jessica M. Petri , Frank W. Weathers
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摘要

创伤后应激障碍(PTSD)是一种高度异质性的疾病(Galatzer-Levy & Bryant, 2013)。根据创伤后应激障碍症状的表达模式,混合建模被用来识别同质的个体亚群。然而,这些研究大多基于 DSM-IV 而非 DSM-5 PTSD 标准。此外,这些研究采用了不同的潜类成员指标,这导致了所识别的潜类在数量和性质上的差异。此外,已识别潜类的构建有效性证据也相对有限。为了解决这些局限性,我们对符合创伤后应激障碍亚阈值诊断标准的本科生样本(N = 322)进行了 DSM-5 PTSD 症状的潜类分析(LCA)。目前的研究旨在复制和扩展数量有限的 DSM-5 PTSD 标准 LCA 的研究结果,并研究由此产生的类别在外部相关因素方面有何意义。研究结果显示了三类解决方案:创伤后应激障碍的低度失调/外化行为(EB)、中度症状和高度症状。与其他类别相比,高症状类别的特点是人格评估量表(PAI;Morey,1991 年)上的焦虑和躯体症状升高。相对于 "低度失乐症/EB","中度症状 "的特点是有许多精神病理学领域,包括抑郁和边缘型人格特征。本研究的结果表明,除了创伤后应激障碍症状严重程度相似的症状类别外,一些总体创伤后应激障碍症状严重程度相似的个体在抑郁症状特征上也存在差异。本文讨论了研究的意义和未来发展方向。
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Subgroup differences in PTSD symptom presentations: A latent class analysis

Posttraumatic stress disorder (PTSD) is a highly heterogeneous disorder (Galatzer-Levy & Bryant, 2013). Mixture modeling has been used to identify homogeneous subgroups of individuals based on patterns of PTSD symptom expression. However, most of these studies are based on DSM-IV rather than DSM-5 PTSD criteria. In addition, these studies employ different indicators of latent class membership, which contributes to variability in the number and nature of latent classes identified. Additionally, there is relatively limited construct validity evidence of identified latent classes. To address these limitations, a latent class analysis (LCA) of DSM-5 PTSD symptoms was conducted in a sample of undergraduate students (N = 322) who met criteria for a subthreshold diagnosis of PTSD. The current study aimed to replicate and extend findings from the limited number of LCAs of DSM-5 PTSD criteria and examine how resulting classes meaningfully differ in external correlates. Findings revealed a three-class solution: Low Anhedonia/Externalizing Behaviors (EB), Moderate Symptoms, and High Symptoms of PTSD. Relative to the other classes, the High Symptoms class was characterized by elevated anxiety and somatic symptoms on the Personality Assessment Inventory (PAI; Morey, 1991). Relative to the Low Anhedonia/EB, the Moderate Symptoms class was characterized by numerous psychopathology domains, including depression and borderline personality traits. Results from this study suggest that, beyond classes characterized by similar PTSD symptom severity across symptoms, some individuals with similar overall PTSD symptom severity differed based on depressive symptom characteristics. Implications and future directions are discussed.

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来源期刊
CiteScore
2.40
自引率
4.80%
发文量
60
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