Association of trauma exposure with psychiatric morbidity in military veterans who have served since September 11, 2001
Association of trauma exposure with psychiatric morbidity in military veterans who have served since September 11, 2001
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DOI：
10.1016/j.jpsychires.2009.01.004
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发表时间：
2009-06-01
影响因子：
4.8
通讯作者：
Beckham, Jean C.
中科院分区：
文献类型：
--
作者：
Dedert, Eric A.;Green, Kimberly T.;Beckham, Jean C.
目的：本研究探讨了2001年9月11日之后在美国军队服役的退伍军人终生创伤应激与精神病学诊断状态和症状严重程度的关系。方法：分析了356名美国退伍军人的数据。措施包括精神疾病的标准化临床访谈措施，以及创伤史，人口统计学变量，智力功能，创伤后应激障碍（PTSD）症状，抑郁症，酒精滥用和全球distress.Results的纸笔评估：百分之九十四的受访者报告至少有一个创伤性应激源符合DSM-IV标准A的PTSD（即，威胁生命的事件，该人以恐惧、无助或恐怖作出反应），平均值为四个标准A创伤。71%的人报告在战区服役，50%的人报告发生了符合标准A的事件。该样本中当前精神障碍的发生率为：30% PTSD，20%重度抑郁症，6%物质滥用或依赖，10%存在其他轴I精神障碍。在考虑了人口统计学协变量和战斗暴露后，儿童身体攻击和事故/灾难与PTSD的可能性增加最相关。然而，PTSD与没有共病的重性抑郁症或物质使用障碍的预测只有战斗暴露和成人的身体攻击。医疗/意外死亡的创伤和成人的身体攻击是最一致的更严重的psychology.Conclusions：特定类别的创伤差异与精神病诊断和当前症状严重程度的风险。这些发现强调了在评估最近部署后的退伍军人时，对多重创伤暴露进行彻底评估的重要性。爱思唯尔有限公司出版
Objective: This study examined the association of lifetime traumatic stress with psychiatric diagnostic status and symptom severity in veterans serving in the US military after 9/11/01.Method: Data from 356 US military veterans were analyzed. Measures included a standardized clinical interview measure of psychiatric disorders, and paper-and-pencil assessments of trauma history, demographic variables, intellectual functioning, posttraumatic stress disorder (PTSD) symptoms, depression, alcohol misuse, and global distress.Results: Ninety-four percent of respondents reported at least one traumatic stressor meeting DSM-IV criterion A for PTSD (i.e., life threatening event to which the person responded with fear, helplessness or horror), with a mean of four criterion A traumas. Seventy-one percent reported serving in a war-zone, with 50% reporting occurrence of an event meeting criterion A. The rate of current psychiatric disorder in this sample was: 30% PTSD, 20% major depressive disorder, 6% substance abuse or dependence and 10% for the presence of other Axis I psychiatric disorders. After accounting for demographic covariates and combat exposure, childhood physical assault and accident/disasters were most consistently associated with increased likelihood of PTSD. However, PTSD with no comorbid major depressive disorder or substance use disorder was predicted only by combat exposure and adult physical assault. Medical/unexpected-death trauma and adult physical assault were most consistently associated with more severe symptomatology.Conclusions: Particular categories of trauma were differentially associated with the risk of psychiatric diagnosis and current symptom severity. These findings underscore the importance of conducting thorough assessment of multiple trauma exposures when evaluating recently post-deployed veterans. Published by Elsevier Ltd.