{"title":"创伤后应激障碍患者易怒、愤怒、敌意和攻击性的临床相关性。","authors":"Nalan Zhan, Lan Zhang, Mingliang Gong, Fulei Geng","doi":"10.1037/tra0001498","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Although irritability, anger, and aggression are diagnostic symptoms of posttraumatic stress disorder (PTSD), their clinical significance and associations with psychopathology remain unclear.</p><p><strong>Method: </strong>In a sample of community adults with probable PTSD (<i>n</i> = 151), we measured irritability, physical aggression, verbal aggression, anger, and hostility with the Brief Irritability Test and the Brief Aggression Questionnaire. Participants' psychopathology, including depression, attention deficit and hyperactivity disorder (ADHD), psychotic-like experiences, insomnia, as well as suicidal behaviors were also assessed.</p><p><strong>Results: </strong>Correlation analysis showed that irritability and anger were modestly related to all PTSD dimensions; physical aggression was related to avoidance, negative alterations in cognitions and mood (NACM), and hyperarousal; hostility was related to reexperiencing, NACM, and hyperarousal; while verbal aggression was not significantly related to any PTSD dimensions. After adjustment for trauma exposure and PTSD symptoms, irritability was associated with almost all psychopathology and suicidal behaviors, however, anger, hostility, and aggression were sparsely related to some psychopathology or suicidal behaviors. Particularly, anger was only related to ADHD and insomnia. Latent profile analysis based on PTSD, irritability, anger, hostility, and aggression indicated two discrete subgroups: the high severity group (33.8%) and the low severity group (66.2%), with high severity group reporting higher rates of comorbidity and suicidal behaviors.</p><p><strong>Conclusions: </strong>The findings support irritability, aggression, anger, and hostility as separate constructs; moreover, irritability, anger, and aggression should be independently measured in PTSD. Our findings also suggest the significance of irritability as a separate hallmark of PTSD and the need to incorporate PTSD dimensions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical correlates of irritability, anger, hostility, and aggression in posttraumatic stress disorder.\",\"authors\":\"Nalan Zhan, Lan Zhang, Mingliang Gong, Fulei Geng\",\"doi\":\"10.1037/tra0001498\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Although irritability, anger, and aggression are diagnostic symptoms of posttraumatic stress disorder (PTSD), their clinical significance and associations with psychopathology remain unclear.</p><p><strong>Method: </strong>In a sample of community adults with probable PTSD (<i>n</i> = 151), we measured irritability, physical aggression, verbal aggression, anger, and hostility with the Brief Irritability Test and the Brief Aggression Questionnaire. Participants' psychopathology, including depression, attention deficit and hyperactivity disorder (ADHD), psychotic-like experiences, insomnia, as well as suicidal behaviors were also assessed.</p><p><strong>Results: </strong>Correlation analysis showed that irritability and anger were modestly related to all PTSD dimensions; physical aggression was related to avoidance, negative alterations in cognitions and mood (NACM), and hyperarousal; hostility was related to reexperiencing, NACM, and hyperarousal; while verbal aggression was not significantly related to any PTSD dimensions. After adjustment for trauma exposure and PTSD symptoms, irritability was associated with almost all psychopathology and suicidal behaviors, however, anger, hostility, and aggression were sparsely related to some psychopathology or suicidal behaviors. Particularly, anger was only related to ADHD and insomnia. Latent profile analysis based on PTSD, irritability, anger, hostility, and aggression indicated two discrete subgroups: the high severity group (33.8%) and the low severity group (66.2%), with high severity group reporting higher rates of comorbidity and suicidal behaviors.</p><p><strong>Conclusions: </strong>The findings support irritability, aggression, anger, and hostility as separate constructs; moreover, irritability, anger, and aggression should be independently measured in PTSD. Our findings also suggest the significance of irritability as a separate hallmark of PTSD and the need to incorporate PTSD dimensions. 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引用次数: 0
摘要
目的尽管易怒、愤怒和攻击性是创伤后应激障碍(PTSD)的诊断症状,但它们的临床意义以及与精神病理学的关系仍不清楚:我们以可能患有创伤后应激障碍的社区成年人为样本(n = 151),通过简易易怒测试和简易攻击性问卷测量了易怒、肢体攻击性、言语攻击性、愤怒和敌意。我们还评估了参与者的精神病理学,包括抑郁、注意力缺陷和多动症(ADHD)、精神病样体验、失眠以及自杀行为:相关性分析表明,易怒和愤怒与创伤后应激障碍的所有方面都有一定关系;肢体攻击与回避、认知和情绪的负面改变(NACM)和过度焦虑有关;敌意与再体验、NACM和过度焦虑有关;而言语攻击与创伤后应激障碍的任何方面都没有显著关系。在对创伤暴露和创伤后应激障碍症状进行调整后,易怒几乎与所有的精神病理学和自杀行为相关,然而,愤怒、敌意和攻击性则与某些精神病理学或自杀行为关系不大。尤其是,愤怒只与多动症和失眠有关。基于创伤后应激障碍、易激惹、愤怒、敌意和攻击性的潜在特征分析显示出两个不同的亚组:严重程度高的组别(33.8%)和严重程度低的组别(66.2%),其中严重程度高的组别报告的合并症和自杀行为发生率较高:研究结果支持将易怒、攻击性、愤怒和敌意作为独立的概念;此外,应独立测量创伤后应激障碍患者的易怒、愤怒和攻击性。我们的研究结果还表明,易怒是创伤后应激障碍的一个独立特征,具有重要意义,而且有必要纳入创伤后应激障碍的维度。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
Clinical correlates of irritability, anger, hostility, and aggression in posttraumatic stress disorder.
Objective: Although irritability, anger, and aggression are diagnostic symptoms of posttraumatic stress disorder (PTSD), their clinical significance and associations with psychopathology remain unclear.
Method: In a sample of community adults with probable PTSD (n = 151), we measured irritability, physical aggression, verbal aggression, anger, and hostility with the Brief Irritability Test and the Brief Aggression Questionnaire. Participants' psychopathology, including depression, attention deficit and hyperactivity disorder (ADHD), psychotic-like experiences, insomnia, as well as suicidal behaviors were also assessed.
Results: Correlation analysis showed that irritability and anger were modestly related to all PTSD dimensions; physical aggression was related to avoidance, negative alterations in cognitions and mood (NACM), and hyperarousal; hostility was related to reexperiencing, NACM, and hyperarousal; while verbal aggression was not significantly related to any PTSD dimensions. After adjustment for trauma exposure and PTSD symptoms, irritability was associated with almost all psychopathology and suicidal behaviors, however, anger, hostility, and aggression were sparsely related to some psychopathology or suicidal behaviors. Particularly, anger was only related to ADHD and insomnia. Latent profile analysis based on PTSD, irritability, anger, hostility, and aggression indicated two discrete subgroups: the high severity group (33.8%) and the low severity group (66.2%), with high severity group reporting higher rates of comorbidity and suicidal behaviors.
Conclusions: The findings support irritability, aggression, anger, and hostility as separate constructs; moreover, irritability, anger, and aggression should be independently measured in PTSD. Our findings also suggest the significance of irritability as a separate hallmark of PTSD and the need to incorporate PTSD dimensions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
期刊介绍:
Psychological Trauma: Theory, Research, Practice, and Policy publishes empirical research on the psychological effects of trauma. The journal is intended to be a forum for an interdisciplinary discussion on trauma, blending science, theory, practice, and policy.
The journal publishes empirical research on a wide range of trauma-related topics, including:
-Psychological treatments and effects
-Promotion of education about effects of and treatment for trauma
-Assessment and diagnosis of trauma
-Pathophysiology of trauma reactions
-Health services (delivery of services to trauma populations)
-Epidemiological studies and risk factor studies
-Neuroimaging studies
-Trauma and cultural competence