Do different traumatic events invoke different kinds of post-traumatic stress symptoms?
Do different traumatic events invoke different kinds of post-traumatic stress symptoms?
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DOI：
10.1080/20008198.2020.1866399
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发表时间：
2021-02-01
影响因子：
5
通讯作者：
Jensen TK
中科院分区：
文献类型：
--
作者：
Birkeland MS;Skar AM;Jensen TK
背景资料：创伤事件的特征可能会影响创伤后应激的特定症状的水平和具体表现（Grimm，Hulse，Preiss，&施密特，2012）。例如，性创伤与创伤后应激症状（PTSS）的相关程度高于机动车事故和突然损失（Kelley，Weathers，McDevitt-Murphy，Eakin和Flood，2009）。机动车事故与高水平的警觉性和生理反应比突然损失。一个有限的范围内的影响/无法爱亲密的人，避免的想法/感觉，和分离/疏远更严重的性虐待和突然的损失比机动车事故。这可能反映了一些创伤性事件的方面（例如突然，快速，危及生命）可能会诱发恐惧条件反射，而其他创伤性事件持续较长时间（例如重复性虐待，欺凌）可能会引发其他PTSS，例如世界通常不是一个善良或安全的地方的想法（威尔金森，道奇森和米尔斯，2017）。为了进一步了解PTSS的病因学，在更多类型的创伤暴露中识别PTSS的相似性和差异性可能是有帮助的。目的：评估性创伤、家庭暴力、事故/医疗创伤、亲人突然失去/严重疾病和欺凌/威胁后PTSS的差异特征。方法：我们研究了创伤后应激症状的严重程度和配置文件，根据最严重的创伤报告，在4873名儿童和青少年（6-18岁，M = 14.0，SD = 2.7，63.7%的女孩）的临床样本中，以任何理由提到的一般儿童和青少年心理健康服务在挪威。我们比较了每种创伤类型中每种症状的95%置信区间（CI）与总体PTSS的95% CI。结果：PTSS的总体严重程度高于性创伤（n = 353）比所有其他评估的创伤。此外，家庭暴力（n = 407）和欺凌/威胁（n = 648）的严重程度显著高于事故/医疗创伤（n = 213）和亲人突然失去/严重疾病（n = 654）。在所有评估的最严重创伤经历中，最常见的症状是心理暗示反应、回避以及睡眠和注意力集中困难。此外，性创伤、家庭暴力和欺凌/威胁与相对较高的消极信念和情绪有关。突然的损失/严重的疾病与相对较高水平的负面情绪有关。事故/医疗创伤与其他相对较高的症状相比，回避和睡眠和集中困难。结论：创伤后应激综合征的表现可能因创伤暴露类型而异。这可能对治疗干预的反应性产生影响。例如，针对消极信念的干预措施（如认知重建）可能对经历过性创伤，家庭暴力或欺凌/威胁的青少年特别有效。
Background: Characteristics of the traumatic event may influence the levels of and specific manifestation of particular symptoms of post-traumatic stress (Grimm, Hulse, Preiss, & Schmidt, 2012). For example, sexual trauma has been found to be associated with higher levels of post-traumatic stress symptoms (PTSS) than both motor vehicle accidents and sudden loss (Kelley, Weathers, McDevitt-Murphy, Eakin, & Flood, 2009). Motor vehicle accidents were associated with higher levels of hypervigilance and physiological reactivity than sudden loss. A restricted range of affect/inability to love close others, avoidance of thoughts/feelings, and detachment/estrangement were more severe in sexual abuse and sudden loss than in motor vehicle accidents. This may reflect that aspects of some traumatic events (e.g. sudden, fast, life-threatening) may induce fear conditioning, whereas other traumatic events lasting over an extended time (e.g. repeated sexual abuse, bullying) may elicit other PTSS such as thoughts that the world is generally not a kind or safe place (Wilkinson, Dodgson, & Meares, 2017). To further understand the aetiology of PTSS, it may be helpful to identify similarities and differences in PTSS across more types of trauma exposure. Objective: To assess differential profiles of PTSS after sexual trauma, domestic violence, accidents/medical trauma, sudden loss/serious illness of a loved one, and bullying/threats. Method: We examined the severity and profiles of symptoms of post-traumatic stress according to worst trauma reported, in a clinical sample of 4873 children and adolescents (6–18 years old, M = 14.0, SD = 2.7, 63.7% girls) referred for any reason to the general Child and Adolescent Mental Health Services in Norway. We compared the 95% confidence interval (CI) for each symptom with the 95% CI for overall PTSS within each trauma type. Results: The overall severity of PTSS was higher for sexual trauma (n = 353) than for all other assessed traumas. Furthermore, the severity was significantly higher for domestic violence (n = 407) and bullying/threats (n = 648) than for accidents/medical trauma (n = 213) and sudden loss/serious illness of a loved one (n = 654). Across all assessed worst traumatic experiences, the most commonly endorsed symptoms were psychological cue reactivity, avoidance, and difficulties with sleeping and concentrating. In addition, sexual trauma, domestic violence and bullying/threats were associated with relatively higher levels of negative beliefs and emotions. Sudden loss/serious illness was associated with relatively higher levels of negative emotions. Accidents/medical trauma were not associated with other relatively higher symptoms than avoidance and sleeping and concentration difficulties. Conclusions: The manifestation of PTSS may differ according to the type of trauma exposure. This may have implications for responsiveness to treatment interventions. For example, interventions that target negative beliefs (e.g. cognitive restructuring) may be particularly potent for adolescents who have experienced sexual trauma, family violence, or bullying/threats.
影响因子：
5
作者：
Grimm A;Hulse L;Preiss M;Schmidt S
通讯作者：
Schmidt S
影响因子：
3.8
作者：
Wilkinson, Sam;Dodgson, Guy;Meares, Kevin
通讯作者：
Meares, Kevin
影响因子：
3.3
作者：
Kelley, Lance P.;Weathers, Frank W.;Flood, Amanda M.
通讯作者：
Flood, Amanda M.