Fragmentation and Disorganization in PTSD

描述(由候选人提供)：假设创伤叙述中的碎片化，或缺乏处理、连贯和整合，对创伤后应激障碍的病因、维持和治疗至关重要。碎片化被认为是导致创伤后应激障碍症状的原因，而创伤叙述的情感和认知处理被认为是成功恢复创伤后应激障碍的必要条件。断言碎片化对创伤后应激障碍的重要性的理论是基于这样的概念：创伤叙述是独一无二的，而碎片化是对创伤后应激障碍的定义。这里提出的研究将探索创伤后应激障碍和非创伤后应激障碍个体中消极、积极和创伤叙述的碎片化。这项拟议研究的目标是调查碎片化与创伤叙述、创伤后应激障碍症状和治疗恢复的关系。具体地说，研究1将通过叙事类型来考察碎片化，以考察作为创伤叙事的独特特征的碎片化。此外，它还将把上述叙事分析扩展到四个样本，即创伤后应激障碍、没有创伤暴露的创伤后应激障碍、惊恐障碍和没有精神病理的个体，以调查碎片化作为创伤后应激障碍诊断的独特之处。研究2将通过比较舍曲林和长时间暴露的叙事组织结果来调查创伤后应激障碍治疗方式和治疗反应对碎片化的影响。这些研究将揭示分裂与情绪叙述类型、创伤后应激障碍诊断和创伤后应激障碍康复的关系，结果可能会影响目前的治疗重点。

DESCRIPTION (provided by candidate): It is hypothesized that fragmentation, or a lack of processing, coherence, and integration in a trauma narrative, is critical to the etiology, maintenance, and treatment of PTSD. Fragmentation is hypothesized to lead to PTSD symptoms, while emotional and cognitive processing of the trauma narrative is thought necessary for successful PTSD recovery. Theories asserting the importance of fragmentation to PTSD are based on the notions that trauma narratives are unique and that fragmentation is defining of PTSD. The studies proposed here will explore fragmentation in negative, positive, and trauma narratives in PTSD and non-PTSD individuals. The goals of the proposed research are to investigate fragmentation as it relates to trauma narratives, PTSD symptoms, and therapeutic recovery. Specifically, Study 1 will examine fragmentation by narrative type to investigate fragmentation as uniquely characteristic of trauma narratives. In addition, it will extend the above narrative analysis to four samples, PTSD, trauma-exposed no PTSD, panic disorder, and no psychopathology individuals, to investigate fragmentation as unique to PTSD diagnosis. Study 2 will investigate the effects of PTSD treatment modality and treatment response on fragmentation by comparing narrative organization outcomes for sertraline and prolonged exposure. These studies will inform the relationship of fragmentation to type of emotional narrative, PTSD diagnosis and PTSD recovery, and results may impact current treatment emphases.