Trauma, Resilience, and Recovery in a High-Risk African-American Population
Trauma, Resilience, and Recovery in a High-Risk African-American Population
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DOI：
10.1176/appi.ajp.2008.07121939
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发表时间：
2008-12-01
影响因子：
17.7
通讯作者：
Charney, Dennis S.
中科院分区：
文献类型：
--
作者：
Alim, Tanya N.;Feder, Adriana;Charney, Dennis S.
目的：尽管创伤暴露后精神障碍的风险增加，但许多人能够以最小的生活中断适应，其他人最终在症状期后康复。本研究探讨了心理社会因素与弹性和恢复精神障碍的高风险样本的非洲裔美国成年人暴露于一系列严重的创伤，谁参加了结构化的诊断访谈。方法：样本包括259名至少经历过一次严重创伤事件的患者，从霍华德大学的初级保健办公室招募，并对DSM-IV轴I障碍进行结构化临床访谈。多项逻辑回归被用来确定潜在的心理社会因素与弹性和恢复，包括生活的目的，掌握，应对strategies.Results：47例患者没有终身精神疾病（弹性），85符合标准，至少有一个过去的DSM-IV障碍，但没有目前的疾病（恢复），和127符合标准，至少有一个目前的DSM-IV障碍（目前生病）。弹性组的特点是一生的创伤负荷明显较低。女性是目前患病状态的预测因素。在最后的模型中，在生活中的目的出现了一个关键因素与弹性和恢复，掌握也显着与recovery.Conclusions：识别与抵抗严重创伤相关的心理社会因素，可以为今后的研究提供信息的预防和治疗干预高危人群。需要进一步的研究来确定哪些社会心理因素与恢复力相关，以及通过临床干预可以在多大程度上改变这些因素。
Objective: Despite increased risk for psychiatric disorders after trauma exposure, many people are able to adapt with minimal life disruption, and others eventually recover after a symptomatic period. This study examined psychosocial factors associated with resilience and recovery from psychiatric disorders in a high-risk sample of African American adults exposed to a range of severe traumas, who participated in structured diagnostic interviews.Method: The sample included 259 patients exposed to at least one severe traumatic event, recruited from primary care offices at Howard University and administered the Structured Clinical Interview for DSM-IV Axis I disorders. Multinomial logistic regression was used to identify potential psychosocial factors associated with resilience and recovery, including purpose in life, mastery, and coping strategies.Results: Forty-seven patients had no lifetime psychiatric disorders (resilient), 85 met criteria for at least one past DSM-IV disorder but no current disorders (recovered), and 127 met criteria for at least one current DSM-IV disorder (currently ill). The resilient group was characterized by a significantly lower lifetime trauma load. Female gender was predictive of currently ill status. In the final model, purpose in life emerged as a key factor associated with both resilience and recovery, and mastery was also significantly associated with recovery.Conclusions: The identification of psychosocial factors associated with resistance to severe trauma can inform future studies of preventive and treatment interventions for high-risk populations. Further study is needed to determine which psychosocial factors are consistently associated with resilience and to what extent they can be modified through clinical intervention.