Trajectories of posttraumatic stress symptoms after civilian or deployment traumatic event experiences.
Trajectories of posttraumatic stress symptoms after civilian or deployment traumatic event experiences.
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DOI：
10.1037/tra0000147
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发表时间：
2017-03
影响因子：
6.3
通讯作者：
Galea, Sandro
中科院分区：
文献类型：
--
作者：
Fink, David S.;Lowe, Sarah;Cohen, Gregory H.;Sampson, Laura A.;Ursano, Robert J.;Gifford, Robert K.;Fullerton, Carol S.;Galea, Sandro
关键词：
生长混合模型研究已经观察到创伤后应激症状（PTSS）轨迹的纵向模式存在实质性差异。这种可变性可以代表一些原型轨迹的偶然迭代或由源种群或创伤性事件经历的某些方面引起的可测量的可变性。为了检验后者，我们分析了美国预备役和国民警卫队成员的全国代表性样本，以确定平民创伤与部署创伤对PTSS轨迹数量的影响，这些轨迹的性质，以及每个轨迹中受访者的比例。从2010年到2013年收集数据，并使用潜在类别增长分析来确定暴露于平民创伤和部署创伤的人的创伤后应激障碍的不同模式，并测试暴露于平民创伤的受访者是否与暴露于部署创伤的受访者产生相似或不同的反应模式。发现ptsd遵循三个轨迹，受访者主要聚集在两种创伤类型的最低症状轨迹中。除了与平民相关的创伤事件数量外，与两种创伤轨迹相关的协变量相似；具体来说，平民创伤事件的数量较多，与平民创伤的“低一致性”轨迹相比，属于“边缘稳定”轨迹，与军事创伤的“预先存在的慢性”轨迹相关。在源人口不变的情况下，创伤后应激障碍的轨迹模型对于平民和部署相关的创伤是相似的，这表明，无论经历过什么样的创伤事件，都可能存在一些普遍的轨迹模式。因此，源种群的差异可能导致了先前PTSS轨迹研究中观察到的异质性。
Growth mixture model studies have observed substantial differences in the longitudinal patterns of posttraumatic stress symptom (PTSS) trajectories. This variability could represent chance iterations of some prototypical trajectories or measurable variability induced by some aspect of the source population or traumatic event experience. Testing the latter, we analyzed a nationally representative sample of U.S. Reserve and National Guard members to identify the influence of civilian versus deployment trauma on the number of PTSS trajectories, the nature of these trajectories, and proportion of respondents in each trajectory. Data were collected from 2010 to 2013 and latent class growth analysis was used to identify different patterns of PTSS in persons exposed to both a civilian and a deployment trauma and to test whether respondents’ exposure to civilian trauma developed similar or distinct patterns of response compared to respondents exposed to deployment trauma. PTSS were found to follow three trajectories, with respondents predominantly clustered in the lowest symptom trajectory for both trauma types. Covariates associated with each trajectory were similar between the two traumas, except number of civilian-related traumatic events; specifically, a higher number of civilian traumatic events was associated with membership in the ‘borderline-stable,’ compared to ‘low-consistent,’ trajectory, for civilian traumas and associated with the ‘pre-existing chronic’ trajectory for military traumas. Holding the source population constant, PTSS trajectory models were similar for civilian and deployment-related trauma, suggesting that irrespective of traumatic event experienced there might be some universal trajectory patterns. Thus, the differences in source populations may have induced the heterogeneity observed among prior PTSS trajectory studies.
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