THE ROLES OF COMBAT EXPOSURE, PERSONAL VULNERABILITY, AND INVOLVEMENT IN HARM TO CIVILIANS OR PRISONERS IN VIETNAM WAR-RELATED POSTTRAUMATIC STRESS DISORDER.
THE ROLES OF COMBAT EXPOSURE, PERSONAL VULNERABILITY, AND INVOLVEMENT IN HARM TO CIVILIANS OR PRISONERS IN VIETNAM WAR-RELATED POSTTRAUMATIC STRESS DISORDER.
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DOI：
10.1177/2167702612469355
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发表时间：
2013-07-01
期刊：
影响因子：
--
通讯作者：
Adams BG
中科院分区：
文献类型：
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作者：
Dohrenwend BP;Yager TJ;Wall MM;Adams BG
创伤后应激障碍（Posttraumatic Stress Disorder）的诊断是在1980年关于越南战争精神病死亡人数的争论中提出的。然而，其核心假设存在争议，即潜在的创伤性压力源比个人脆弱性更重要。我们测试了这一假设的数据，从一个严格诊断的男性子样本（n = 260）从国家越战退伍军人重新调整研究。战斗暴露，战前的脆弱性，并参与伤害平民或囚犯进行了检查，只有战斗暴露证明是必要的疾病发作。虽然这三个因素中没有一个被证明是足够的，但估计退伍军人的发病率达到97%，对平民或囚犯的伤害显示出最大的独立贡献。战斗暴露的严重性证明更重要的比战前的脆弱性在发病;战前的脆弱性至少同样重要的长期持久性。的压力假设，进一步的研究和政策的首要影响进行了讨论。
The diagnosis, Posttraumatic Stress Disorder, was introduced in 1980 amidst debate about the psychiatric toll of the Vietnam War. There is controversy, however, about its central assumption that potentially traumatic stressors are more important than personal vulnerability in causing the disorder. We tested this assumption with data from a rigorously diagnosed male subsample (n = 260) from the National Vietnam Veterans Readjustment Study. Combat exposure, pre-war vulnerability, and involvement in harming civilians or prisoners were examined, with only combat exposure proving necessary for disorder onset. While none of the three factors proved sufficient, estimated onset reached 97% for veterans high on all three, with harm to civilians or prisoners showing the largest independent contribution. Severity of combat exposure proved more important than pre-war vulnerability in onset; pre-war vulnerability at least as important in long-term persistence. Implications for the primacy of the stressor assumption, further research, and policy are discussed.