Clarifying Heterogeneity of Daytime and Nighttime Symptoms of Post-traumatic Stress in Combat Veterans with Insomnia.
Clarifying Heterogeneity of Daytime and Nighttime Symptoms of Post-traumatic Stress in Combat Veterans with Insomnia.
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DOI：
10.1037/mil0000077
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发表时间：
2015-07
期刊：
影响因子：
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通讯作者：
Germain A
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文献类型：
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作者：
Wallace ML;Iyengar S;Bramoweth AD;Frank E;Germain A
创伤后应激障碍 (PTSD) 的白天和夜间症状在退伍军人和军人中很常见。然而，症状的表达方式存在很大的异质性。通过探索性聚类澄清白天和夜间 PTSD 症状的异质性，可能会产生关于如何将基于证据的治疗与 PTSD 症状特征最佳匹配的假设。我们使用混合模型根据 154 名患有失眠症和不同程度 PTSD 症状的退伍军人的 6 种白天和夜间症状来揭示聚类。确定了症状严重程度增加的三个集群（N1=50、N2=70、N3=34）。这些结果表明，在患有失眠症的退伍军人中，PTSD 症状往往存在严重程度的连续性，而不是作为明确的 PTSD 诊断。讨论了关于每个确定的集群内退伍军人可能的有针对性的治疗策略的假设，以及将这些方法推广到军队内其他群体的方法。
Daytime and nighttime symptoms of posttraumatic stress disorder (PTSD) are common among combat veterans and military service members. However, there is a great deal of heterogeneity in how symptoms are expressed. Clarifying the heterogeneity of daytime and nighttime PTSD symptoms through exploratory clustering may generate hypotheses regarding ways to optimally match evidence-based treatments to PTSD symptom profiles. We used mixture modeling to reveal clusters based on six daytime and nighttime symptoms of 154 combat veterans with insomnia and varying levels of PTSD symptoms. Three clusters with increasing symptom severity were identified (N1=50, N2=70, N3=34). These results suggest that, among veterans with insomnia, PTSD symptoms tend to exist on a continuum of severity, rather than as a categorical PTSD diagnosis. Hypotheses regarding possible targeted treatment strategies for veterans within each identified cluster, as well as ways to generalize these methods to other groups within the military, are discussed.