Previous exposure to trauma and PTSD effects of subsequent trauma: Results from the Detroit area survey of trauma
Previous exposure to trauma and PTSD effects of subsequent trauma: Results from the Detroit area survey of trauma
复制标题
DOI：
10.1176/ajp.156.6.902
复制
发表时间：
1999-06-01
影响因子：
17.7
通讯作者：
Davis, GC
中科院分区：
文献类型：
--
作者：
Breslau, N;Chilcoat, HD;Davis, GC
目的：除了少数报告的较高的儿童创伤率在越南退伍军人与创伤后应激障碍（PTSD），很少有人知道的影响，以前暴露于创伤对创伤后应激障碍的影响，随后的创伤。作者研究了有关先前暴露于创伤的影响的相关问题。方法：密歇根州东南部的2，181人的代表性样本通过电话采访记录了DSM-IV中规定的可能导致PTSD的创伤事件的终身史。创伤后应激障碍的评估是从每个受访者报告的事件列表中随机选择的指数创伤。结果：任何先前暴露于创伤事件的历史与索引创伤的PTSD风险更大相关。多个先前事件比单个先前事件具有更强的影响。过去的攻击性暴力的影响随着时间的推移而持续存在，几乎没有变化。当他们检查了以前暴露于创伤的几个特征时，作者发现，在童年经历过多次涉及攻击性暴力事件的受试者更有可能在成年后经历创伤后应激障碍。此外，先前涉及攻击性暴力的事件，无论是单一的还是多重的，在儿童时期还是以后，都与成年后患PTSD的风险较高有关。结论：先前暴露于创伤的信号更大的风险PTSD从随后的创伤。虽然这些结果与致敏假说一致，就像以前对创伤后应激障碍的研究结果一样，但它们并没有解决对创伤的反应性增加的机制。长期观察研究可以进一步阐明这些观察结果。
Objective: With the exception of a few reports of higher rates of childhood trauma in Vietnam veterans with posttraumatic stress disorder (PTSD), little is known about the influence of previous exposure to trauma on the PTSD effects of subsequent trauma. The authors examine interrelated questions about the effects of previous exposure to trauma. Method: A representative sample of 2,181 individuals in southeast Michigan were interviewed by telephone to record lifetime history of traumatic events specified in DSM-IV as potentially leading to PTSD. PTSD was assessed with respect to a randomly selected index trauma from the list of events reported by each respondent. Results: History of any previous exposure to traumatic events was associated with a greater risk of PTSD from the index trauma. Multiple previous events had a stronger effect than a single previous event. The effect of previous assaultive violence persisted over time with little change. When they examined several features of the previous exposure to trauma, the authors found that subjects who experienced multiple events involving assaultive violence in childhood were more likely to experience PTSD from trauma in adulthood. Furthermore, previous events involving assaultive violence-single or multiple, in childhood or later on-were associated with a higher risk of PTSD in adulthood. Conclusions: Previous exposure to trauma signals a greater risk of PTSD from subsequent trauma. Although these results are consistent with a sensitization hypothesis, like the results from previous research on PTSD, they do not address the mechanism of increased responsivity to trauma. Long-term observational studies can further elucidate these observations.