Prospective study of posttraumatic stress, anxiety, and depressive reactions after earthquake and political violence
Prospective study of posttraumatic stress, anxiety, and depressive reactions after earthquake and political violence
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DOI：
10.1176/appi.ajp.157.6.911
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发表时间：
2000-06-01
影响因子：
17.7
通讯作者：
Pynoos, RS
中科院分区：
文献类型：
--
作者：
Goenjian, AK;Steinberg, AM;Pynoos, RS
目的：作者试图评估创伤后应激、焦虑和抑郁反应的严重程度和纵向过程，其中两组成年人分别暴露于严重和轻度地震创伤，另一组暴露于严重暴力。他们还检验了这些反应和预后预测因素之间的相互关系，并比较了暴露于地震和暴力暴露者之间的创伤后应激障碍(PTSD)症状类别、特征和病程。方法：对78名未寻求治疗的受试者在1988年亚美尼亚斯皮塔克地震和1988年阿塞拜疆亚美尼亚人大屠杀后大约1.5年和4.5年使用自我报告工具进行评估。结果：两组暴露于严重创伤(地震或暴力)的人在最初和后续的PTSD评分都很高，但在3年的时间间隔内没有缓解。总体而言，抑郁症状；TOM消退。创伤后应激、焦虑和抑郁反应在两个时间间隔内和跨时间段都高度相关。在严重地震创伤和严重暴力暴露的受试者之间，创伤后应激障碍的严重程度、概况和病程没有显著差异。结论：成年人在遭受严重创伤后，无论是地震还是暴力，都有很高的风险发展成与慢性焦虑和抑郁反应相关的严重和慢性创伤后应激反应。临床评估和治疗干预应包括对这些反应的特别关注。建议对其进行早期心理健康干预，防止其慢性化。
Objective: The authors sought to assess the severity and longitudinal course of posttraumatic stress, anxiety, and depressive reactions among two groups of adults differentially exposed to severe and mild earthquake trauma and a third group exposed to severe violence. They also examined interrelationships among these reactions and predictors of outcome and compared posttraumatic stress disorder (PTSD) symptom category profile and course between those exposed to earthquake and those exposed to violence.Method: Seventy-eight non-treatment-seeking subjects were assessed with self-report instruments approximately 1.5 and 4.5 years after the 1988 Spitak earthquake in Armenia and the 1988 pogroms against Armenians in Azerbaijan.Results: The two groups that had been exposed to severe trauma (earthquake or violence) had high initial and follow-up PTSD scores that did not remit over the 3-year interval. Overall, depressive symp; toms subsided. Posttraumatic stress, anxiety, and depressive reactions were highly intercorrelated within and across both time intervals. No significant differences in PTSD severity, profile, or course were seen between subjects exposed to severe earthquake trauma versus those exposed to severe violence.Conclusions: After exposure to severe trauma, either an earthquake or violence, adults are at high risk of developing severe and chronic posttraumatic stress reactions that are associated with chronic anxiety and depressive reactions. Clinical evaluation and therapeutic intervention should include specific attention to these reactions. Early mental health intervention is recommended to prevent their chronicity.