SOCIAL STATUS AND POST TRAUMATIC STRESS DISORDER IN US V

美国 V 的社会地位和创伤后应激障碍

• 批准号: 2903279
• 负责人: BRUCE P DOHRENWEND
• 金额: $ 41.37万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-28 至 2002-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2903279
• 关键词: African American; Hispanic Americans; behavioral /social science research tag; caucasian American; clinical research; disease /disorder onset; disease /disorder proneness /risk; education; environmental stressor; epidemiology; gender difference; human data; interview; mental disorder diagnosis; military personnel; nurses; occupations; posttraumatic stress disorder; psychological stressor; racial /ethnic difference; relapse /recurrence; social status; socioeconomics; veterans; war /peace

The broad objective is to explain differences in rates of Post-Traumatic Stress Disorder (PTSD) and comorbid disorders in U.S. Vietnam veterans from different social statuses indicated by gender, ethnic/racial background, and parental socioeconomic status (SES). The specific aims involve tests of alternative hypotheses about the primacy of exposure to environmental war- zone stressors, the role of antecedent personal predispositions, and the influence of endogenous cultural factors associated with the differing social statuses. The data for these tests come from the National Vietnam Veterans Readjustment Study (NVVRS). The NVVRS was conducted by the Research Triangle Institute (RTI) in response to a Congressional mandate to investigate PTSD and other psychological problems in the U.S. veterans. The study of nationwide samples of 3,016 Vietnam Theater veterans other Vietnam Era veterans, and non-veterans began in 1984, and the intensive data collection continued over the next several years. The veteran samples were drawn from military records and interviewed in detail about their premilitary lives, their military experiences, and their lives following the war as well as a wide variety of psychological symptoms and problems. In addition, a subsample of respondents consisting of 343 Theater veterans and 93 Era veterans were given intensive research diagnostic examinations by experienced clinicians. These subsample diagnoses contain the only data in the study on onset and course of PTSD, and reports of results of the study thus far have focused on current PTSD in the larger samples. The rate of current PTSD (present 15 to 20 years after the war) was 15.2 percent in male Theater veterans, six times as high as for the Era comparison sample. This rate of persistent or recurrent PTSD was especially high in Hispanics (27.9 percent) and African-Americans (20.6 percent) compared to nonHispanic whites (13.7 percent). These ethnic/racial differences are reduced but do not disappear when parental socioeconomic status (SES) is controlled. Among female Theater veterans, mainly nonHispanic white nurses, the 8.5 percent rate of current PTSD is substantially lower than for males. Very large majorities of both male and female Theater veterans with current PTSD were diagnosed with other concomitant psychiatric disorders. The reasons for these gender and racial/ethnic differences are unknown. The proposed study will focus almost exclusively on the diagnosed subsample in order to investigate alternative explanations of the group differences as the hypotheses apply to initial onset and to course of PTSD and comorbid disorders. Plans are set forth for utilizing existing measures and developing new ones necessary for the task from the NVVRS data, and for a variety of statistical analyses using descriptive statistics, graphical methods, and logistic and Gaussian multivariate regression. The long term goal is to increase knowledge of how humans adapt or fail to adapt to adversity and stress, and to contribute to the account of an historic event in the life of this nation.

总体目标是解释不同社会地位（以性别、民族/种族背景和父母社会经济地位（SES）表示）的美国越战退伍军人中创伤后应激障碍（PTSD）和共存疾病发生率的差异。 具体目标包括测试关于暴露于战区环境压力源的首要性、先前个人倾向的作用以及与不同社会地位相关的内生文化因素的影响等替代假设。这些测试的数据来自国家越南退伍军人调整研究（NVVRS）。 NVVRS 是由三角研究研究所 (RTI) 开展的，旨在响应国会的一项调查美国退伍军人的创伤后应激障碍 (PTSD) 和其他心理问题的任务。 这项研究于 1984 年开始，对全国范围内的 3,016 名越战老兵、其他越战老兵和非退伍军人进行了样本研究，并在接下来的几年里继续进行密集的数据收集。 这些退伍军人样本是从军事记录中抽取的，并详细采访了他们的入伍前生活、军事经历、战后生活以及各种心理症状和问题。 此外，由经验丰富的临床医生对由 343 名战区退伍军人和 93 名时代退伍军人组成的受访者子样本进行了深入的研究诊断检查。 这些子样本诊断包含研究中关于 PTSD 发病和病程的唯一数据，并且迄今为止的研究结果报告都集中在较大样本中当前的 PTSD。男性战区退伍军人当前患有创伤后应激障碍（战后 15 至 20 年）的比例为 15.2%，是 Era 比较样本的六倍。 与非西班牙裔白人 (13.7%) 相比，西班牙裔美国人 (27.9%) 和非裔美国人 (20.6%) 的持续性或复发性 PTSD 比率尤其高。 当父母的社会经济地位（SES）受到控制时，这些民族/种族差异会减少，但不会消失。 在女性战区退伍军人中，主要是非西班牙裔白人护士，当前 PTSD 的发病率为 8.5%，远低于男性。 绝大多数患有创伤后应激障碍的男性和女性战区退伍军人都被诊断出患有其他伴随的精神疾病。 这些性别和种族/民族差异的原因尚不清楚。拟议的研究将几乎完全集中于诊断的子样本，以便研究群体差异的替代解释，因为这些假设适用于 PTSD 和共病疾病的初始发作和病程。 制定了利用现有措施并根据 NVVRS 数据开发任务所需的新措施的计划，以及使用描述性统计、图形方法以及逻辑和高斯多元回归进行各种统计分析的计划。长期目标是增加对人类如何适应或无法适应逆境和压力的了解，并为记录这个国家生活中的历史事件做出贡献。