Latent classes of adolescent posttraumatic stress disorder predict functioning and disorder after 1 year.
Latent classes of adolescent posttraumatic stress disorder predict functioning and disorder after 1 year.
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DOI：
10.1016/j.jaac.2011.01.004
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发表时间：
2011-04
影响因子：
13.3
通讯作者：
Kilpatrick D
中科院分区：
文献类型：
--
作者：
Ayer L;Danielson CK;Amstadter AB;Ruggiero K;Saunders B;Kilpatrick D
在全国青少年样本中确定创伤后应激障碍（PTSD）症状的潜在类别，并在1年后检测其与PTSD和功能障碍的相关性。共有1,119名12至17岁的创伤暴露青少年（平均值= 14.99岁，51%女性和49%男性）参加了全国青少年复制调查。进行电话访谈，以评估创伤后应激障碍的症状和功能障碍，在波1和2。潜在类别分析显示，三个类的青少年PTSD在每个时间点：广泛的干扰，中间的干扰，没有干扰。三个麻木和两个过度觉醒症状最好区分的普遍性和中间的干扰类在波1。三个重新体验，一个回避，和一个过度觉醒症状最好区分这些类在波2。波1中间障碍类是不太可能有PTSD诊断，属于波2广泛性障碍类，并报告功能障碍1年后相比，波1广泛性障碍类。波1无干扰类是最不可能有创伤后应激障碍，属于广泛性障碍类，并报告功能障碍波2。这项研究表明，创伤后应激障碍的严重程度区分症状在青春期发生了实质性变化，并且与成人样本的研究相反，没有麻木集群的特征。这些结果可能有助于解释不一致的因素分析结果的结构和诊断的PTSD，并强调发展背景是至关重要的，考虑在研究和临床工作中的PTSD评估和诊断。
To identify latent classes of posttraumatic stress disorder (PTSD) symptoms in a national sample of adolescents, and to test their associations with PTSD and functional impairment 1 year later. A total of 1,119 trauma-exposed youth aged 12 through 17 years (mean = 14.99 years, 51% female and 49% male) participating in the National Survey of Adolescents–Replication were included in this study. Telephone interviews were conducted to assess PTSD symptoms and functional impairment at Waves 1 and 2. Latent Class Analysis revealed three classes of adolescent PTSD at each time point: pervasive disturbance, intermediate disturbance, and no disturbance. Three numbing and two hyperarousal symptoms best distinguished the pervasive and intermediate disturbance classes at Wave 1. Three re-experiencing, one avoidance, and one hyperarousal symptom best distinguished these classes at Wave 2. The Wave 1 intermediate disturbance class was less likely to have a PTSD diagnosis, belong to the Wave 2 pervasive disturbance class, and report functional impairment 1 year later compared with the Wave 1 pervasive disturbance class. The Wave 1 no disturbance class was least likely to have PTSD, belong to the pervasive disturbance class, and report functional impairment at Wave 2. This study suggests that PTSD severity– distinguishing symptoms change substantially in adolescence and are not characterized by the numbing cluster, contrary to studies in adult samples. These results may help to explain inconsistent factor analytic findings on the structure and diagnosis of PTSD, and emphasize that developmental context is critical to consider in both research and clinical work in PTSD assessment and diagnosis.
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