Dr. Southwick and Colleagues Reply
Dr. Southwick and Colleagues Reply
复制标题
DOI：
10.1176/ajp.154.11.1629
复制
发表时间：
1997-11
影响因子：
17.7
通讯作者：
S. Southwick;C. A. Morgan;D. Charney
中科院分区：
文献类型：
--
作者：
S. Southwick;C. A. Morgan;D. Charney
致编辑：我们饶有兴趣地阅读了罗默及其同事的信，信中描述了对索马里退伍军人中与战斗相关的事件的回顾描述中的系统性不一致，这与我们在沙漠风暴退伍军人中的发现相似。我们同意罗默等人S的观点，即两项研究中的发现都没有直接涉及恢复记忆的问题。正如我们在文章中指出的，对于观察到的记忆不一致，有多种可能的解释。此外，由于这项研究涉及回溯性记述，因此不可能知道1个月时回忆的事件比2年后回忆的事件更准确还是更不准确。然而，在我们的研究和Roemer等人的研究中，很明显，记忆随着时间的推移而改变或不一致。这种不一致表明，在任何一个时间点回忆都可能是不准确的。弗兰奇的评论也令人感兴趣。在几个不同的退伍军人群体中，我们也发现困惑、羞愧、孤立和内疚是患有创伤后应激障碍的退伍军人的主要担忧。然而，我们不同意创伤后应激障碍的出现是对这些担忧的回应，而不是对创伤、疼痛和虐待的回应。此外，我们不认为创伤事件的记忆对创伤后应激障碍的发展无关紧要。相反，我们同意Roemer等人的观点。世卫组织指出，创伤经历和症状之间关系的简单剂量-反应模型是不够的。似乎包括创伤暴露程度在内的多个因素与创伤后应激障碍症状的程度有关。
TO THE EDITOR: We read with interest the letter by Dr. Roemer and colleagues that described systematic inconsistency in retrospective accounts of combat-related events among Somalia veterans that resembled our findings among Desert Storm veterans. We agree with Roemer et al.'s observation that the findings in both studies do not directly address the issue of recovered memories. As we noted in our article, there were multiple possible explanations for the observed inconsistencies in memory. Further, because the study involved retrospective accounts, it was not possible to know whether events recalled at 1 month were more or less accurate than events recalled at 2 years. However, in both our study and in the study by Roemer et al., it is clear that memory changed or was inconsistent over time. Such inconsistencies suggest that recall at any one time point may be inaccurate.Dr. French's comments also were of interest. In several different veteran populations we too have found confusion, shame, isolation, and guilt to be major concerns for combat veterans with PTSD. However, we do not agree that PTSD arises in response to these concerns “rather than” in response to trauma, pain, and abuse. Further, we do not believe that memories of a traumatic incident are immaterial to the development of PTSD. Instead, we agree with Roemer et al. who note that a simple dose-response model of the relationship between trauma experiences and symptoms is insufficient. It appears that multiple factors, including degree of traumatic exposure, are related to level of PTSD symptoms.