Lifetime trauma exposure in veterans with military-related posttraumatic stress disorder: Association with current symptomatology
Lifetime trauma exposure in veterans with military-related posttraumatic stress disorder: Association with current symptomatology
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DOI：
10.4088/jcp.v67n0904
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发表时间：
2006-09-01
影响因子：
5.3
通讯作者：
Beckham, Jean C.
中科院分区：
文献类型：
--
作者：
Clancy, Carolina P.;Graybeal, Anna;Beckham, Jean C.
目的：本研究调查了服兵役前、服兵役期间和/或服兵役后的创伤暴露是否对创伤后应激障碍(PTSD)和适应的当前水平有贡献。此外，我们还调查了兵役前创伤暴露对当前创伤后应激障碍的影响。方法：对2001年12月至2004年7月在退伍军人管理局医学中心创伤后应激障碍门诊就诊的422名男性退伍军人创伤后应激障碍患者的病历资料进行分析。测量包括临床医生实施的创伤后应激障碍量表访谈，以及评估创伤病史、健康问题和一般精神病理学(包括创伤后应激障碍)的自我报告措施。结果：调查结果表明，非军事相关创伤在本样本中普遍存在(90%)。对创伤后应激障碍症状严重程度的回归分析显示，年龄、更多的战斗暴露和服兵役后的身体攻击史与更严重的创伤后应激障碍症状显著相关。儿童时期的身体虐待、成人性创伤和在服兵役期间被身体侵犯的历史也与创伤后应激障碍症状的严重程度显著相关。中介分析表明，儿童创伤既与成人创伤有关，也与各种结果指标的症状增加有关。适度分析表明，成人创伤暴露降低了儿童创伤暴露对健康投诉的影响。结论：结果表明，包括年龄、更多的战斗暴露以及军事前和军事后创伤在内的几个变量与PTSD症状增加有关。这一发现强调了在诊断创伤后应激障碍时对创伤进行彻底评估的重要性。
Objective: This study examined whether trauma exposure before, during, and/or after military service contributed to current levels of posttraumatic stress disorder (PTSD) and adjustment. Further, we investigated whether trauma exposure before military service was mediated or moderated by military trauma in its effects on current PTSD and adjustment.Method: In this retrospective study, archival data from the medical records of 422 male veterans diagnosed with PTSD between December 2001 and July 2004 at a Veterans Administration Medical Center PTSD clinic were analyzed. Measures included the Clinician-Administered PTSD Scale interview as well as self-report measures assessing trauma history, health problems, and general psychopathology (including PTSD).Results: Findings indicated that nonmilitary-related trauma was prevalent in this sample (90%). Regression analyses for PTSD symptom severity revealed that age, greater combat exposure, and a history of physical assault after military service were significantly associated with more severe PTSD symptoms. Childhood physical abuse, adult sexual trauma, and a history of being physically assaulted during military service were also significantly associated with PTSD symptom severity. Mediational analyses indicated that childhood trauma was associated with both adult trauma and increased symptomatology on various outcome measures. Moderational analyses indicated that adult trauma exposure moderated the effect of childhood trauma exposure on health complaints.Conclusions: Results suggest that several variables, including age, greater combat exposure, and premilitary and postmilitary traumas, are associated with increased PTSD symptomatology. This finding underscores the importance of conducting a thorough assessment of trauma when diagnosing PTSD.