Examining a Comprehensive Model of Disaster-Related Posttraumatic Stress Disorder in Systematically Studied Survivors of 10 Disasters
Examining a Comprehensive Model of Disaster-Related Posttraumatic Stress Disorder in Systematically Studied Survivors of 10 Disasters
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DOI：
10.2105/ajph.2012.300689
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发表时间：
2012-10-01
影响因子：
12.7
通讯作者：
Pandya, Anand
中科院分区：
文献类型：
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作者：
North, Carol S.;Oliver, Julianne;Pandya, Anand
目标.使用一个综合的灾难模型，我们研究了创伤后应激障碍（PTSD）的预测因素，从10个不同的灾难的组合数据。合并样本包括1987年至1995年期间10次灾害的811名直接暴露幸存者的数据。我们在所有10个灾难样本中使用了一致的方法，包括完整的诊断评估。在多变量分析中，PTSD的预测因素是女性性别，年龄较小，西班牙裔，受教育程度较低，已婚状态，灾前精神病理学，灾难伤害和目睹伤害或死亡;通过死亡或伤害暴露于朋友或家人和目睹灾难后果并没有增加PTSD的风险。在双变量分析中，与PTSD相关的故意造成的灾难在多变量分析中不能独立预测PTSD。回避和麻木症状是PTSD的标志。尽管证实了一些以前的研究结果，我们没有发现PTSD和灾难类型之间的联系。需要进行前瞻性研究，以确定早期的回避和麻木症状是否会识别出日后可能发展为PTSD的个体。我们的研究结果可能有助于识别治疗研究的高危人群。
Objectives. Using a comprehensive disaster model, we examined predictors of posttraumatic stress disorder (PTSD) in combined data from 10 different disasters.Methods. The combined sample included data from 811 directly exposed survivors of 10 disasters between 1987 and 1995. We used consistent methods across all 10 disaster samples, including full diagnostic assessment.Results. In multivariate analyses, predictors of PTSD were female gender, younger age, Hispanic ethnicity, less education, ever-married status, predisaster psychopathology, disaster injury, and witnessing injury or death; exposure through death or injury to friends or family members and witnessing the disaster aftermath did not confer additional PTSD risk. Intentionally caused disasters associated with PTSD in bivariate analysis did not independently predict PTSD in multivariate analysis. Avoidance and numbing symptoms represented a PTSD marker.Conclusions. Despite confirming some previous research findings, we found no associations between PTSD and disaster typology. Prospective research is needed to determine whether early avoidance and numbing symptoms identify individuals likely to develop PTSD later. Our findings may help identify at-risk populations for treatment research.