Posttraumatic Stress Disorder, Health Problems, and Depression Among African American Women in Residential Substance Use Treatment.
Posttraumatic Stress Disorder, Health Problems, and Depression Among African American Women in Residential Substance Use Treatment.
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住院药物使用治疗中非裔美国妇女的创伤后应激障碍、健康问题和抑郁症。
DOI：
10.1089/jwh.2015.5328
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Svikis,Dace
中科院分区：
文献类型：
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作者：
Meshberg-Cohen,Sarah;Presseau,Candice;Thacker,LeroyR;Hefner,Kathryn;Svikis,Dace
背景：在寻求药物滥用障碍 (SUD) 治疗的女性中，创伤后应激障碍 (PTSD) 的发病率很高。尤其是少数族裔女性，遭受创伤的几率很高，并且可能不太可能透露创伤史。本文从现有的筛查措施中找出了一些项目，这些项目可用于跨环境敏感但非侵入性地识别可能患有 PTSD 的女性。方法：以 104 名接受住院 SUD 治疗的非裔美国女性为样本，作为一项大型随机临床试验的一部分，她们提供了知情同意书，对创伤和 PTSD 的患病率以及创伤、健康、抑郁和痛苦之间的关系进行了检查。测量指标包括创伤后应激诊断量表 (PDS)、流行病学研究中心抑郁量表 (CES-D)、彭尼贝克边缘系统无力量表 (PILL) 和简短症状量表 (BSI)。我们进行了额外的分析，以确定非侵入性项目的子集是否可以用于识别可能的 PTSD 诊断。结果：大多数女性 (94.2%) 报告至少有一次终生创伤，其中超过一半 (51.0%) 符合 DSM-IV 的 PTSD 标准。创伤症状严重程度较高的女性报告了更多的健康问题以及更高程度的抑郁和痛苦。 5 项 BSI 项目和 1 项 CES-D 项目与可能的 PTSD 诊断显着相关，敏感性为 88.7%，特异性为 66.7%，阳性预测值为 73.4%，阴性预测值为 85.0%，准确度为 77.9%。结论：研究结果证实，患有 SUD 的非洲裔美国女性因共存精神和情绪状况而接受住院治疗，需要进行评估和评估。治疗。结果强调了通过常规措施进行简短筛查以及协调获得辅助精神科和医疗服务以及与物质治疗（例如住院或初级保健）相结合的潜在好处。
Background:Rates of posttraumatic stress disorder (PTSD) are high among women seeking treatment for substance use disorders (SUDs). Minority women, in particular, experience high rates of trauma and may be less likely to disclose trauma history. This article identifies items from pre-existing screening measures that can be used across settings to sensitively but noninvasively identify women with likely PTSD.Method:For a sample of 104 African American women in residential SUD treatment who provided informed consent as a part of a larger randomized clinical trial, the prevalence of trauma and PTSD, as well as the relationships between trauma, health, depression, and distress, was examined. Measures included Posttraumatic Stress Diagnostic Scale (PDS), Center for Epidemiologic Studies-Depression Scale (CES-D), Pennebaker Inventory of Limbic Languidness (PILL), and Brief Symptom Inventory (BSI). Additional analyses were undertaken to determine if a subset of noninvasive items could serve to identify the presence of a probable PTSD diagnosis.Results:Most women (94.2%) reported at least one lifetime trauma, with over half (51.0%) meeting DSM-IV criteria for PTSD. Women with greater trauma symptom severity reported more health problems and higher levels of depression and distress. Five BSI items and one CES-D item were significantly associated with a probable PTSD diagnosis with a sensitivity of 88.7%, a specificity of 66.7%, a positive predictive value of 73.4%, a negative predictive value of 85.0%, and an accuracy of 77.9%.Conclusion:Findings affirm that African American women with SUDs present for residential treatment with comorbid psychiatric and emotional conditions that warrant assessment and treatment. Results highlight potential benefits of brief screening with routine measures and coordinated access to ancillary psychiatric and medical services, in conjunction with substance treatment, such as in residential or primary care.