Dissociative subtype of DSM-5 posttraumatic stress disorder in US veterans

被引:41
作者
Tsai, Jack [1 ,2 ]
Armour, Cherie [3 ]
Southwick, Steven M. [2 ,4 ]
Pietrzak, Robert H. [2 ,4 ]
机构
[1] US Dept Vet Affairs, New England Mental Illness Res Educ & Clin Ctr, West Haven, CT USA
[2] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA
[3] Univ Ulster, Psychol Res Inst, Coleraine BT52 1SA, Londonderry, North Ireland
[4] VA Connecticut Healthcare Syst, US Dept Vet Affairs, Natl Ctr Posttraumat Stress Disorder, Clin Neurosci Div, West Haven, CT USA
关键词
Posttraumatic stress disorder; Dissociation; Veterans; Substance abuse; QUALITY-OF-LIFE; NATIONAL-HEALTH; LATENT PROFILE; PTSD; IRAQ; RESILIENCE; DEPRESSION; VALIDATION; HOSTILITY; CRITERIA;
D O I
10.1016/j.jpsychires.2015.04.017
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) formally introduced a dissociative subtype of posttraumatic stress disorder (PTSD). This study examined the proportion of U.S. veterans with DSM-5 PTSD that report dissociative symptoms; and compared veterans with PTSD with and without the dissociative subtype and trauma-exposed controls on sociodemographics, clinical characteristics, and quality of life. Multivariable analyses were conducted on a nationally representative sample of 1484 veterans from the National Health and Resilience in Veterans Study (second baseline survey conducted September October, 2013). Of the 12.0% and 5.2% of veterans who screened positive for lifetime and past-month DSM-5 PTSD, 19.2% and 16.1% screened positive for the dissociative subtype, respectively. Among veterans with PTSD, those with the dissociative subtype reported more severe PTSD symptoms, comorbid depressive and anxiety symptoms, alcohol use problems, and hostility than those without the dissociative subtype. Adjusting for PTSD symptom severity, those with the dissociative subtype continued to report more depression and alcohol use problems. These results underscore the importance of assessing, monitoring, and treating the considerable proportion of veterans with PTSD and dissociative symptoms. Published by Elsevier Ltd.
引用
收藏
页码:67 / 74
页数:8
相关论文
共 52 条
[21]  
Kroenke K, 2009, PSYCHOSOMATICS, V50, P613, DOI 10.1176/appi.psy.50.6.613
[22]   Anger, dissociation, and PTSD among male veterans entering into PTSD treatment [J].
Kulkarni, Madhur ;
Porter, Katherine E. ;
Rauch, Sheila A. M. .
JOURNAL OF ANXIETY DISORDERS, 2012, 26 (02) :271-278
[23]  
LABOVITZ S, 1968, AM SOCIOL, V3, P220
[24]   THE DISSOCIATIVE SUBTYPE OF POSTTRAUMATIC STRESS DISORDER: RATIONALE, CLINICAL AND NEUROBIOLOGICAL EVIDENCE, AND IMPLICATIONS [J].
Lanius, Ruth A. ;
Brand, Bethany ;
Vermetten, Eric ;
Frewen, Paul A. ;
Spiegel, David .
DEPRESSION AND ANXIETY, 2012, 29 (08) :701-708
[25]   Emotion Modulation in PTSD: Clinical and Neurobiological Evidence for a Dissociative Subtype [J].
Lanius, Ruth A. ;
Vermetten, Eric ;
Loewenstein, Richard J. ;
Brand, Bethany ;
Schmahl, Christian ;
Bremner, J. Douglas ;
Spiegel, David .
AMERICAN JOURNAL OF PSYCHIATRY, 2010, 167 (06) :640-647
[26]  
MARMAR CR, 1994, AM J PSYCHIAT, V151, P902
[27]   PTSD and conflict behavior between veterans and their intimate partners [J].
Miller, Mark W. ;
Wolf, Erika J. ;
Reardon, Annemarie F. ;
Harrington, Kelly M. ;
Ryabchenko, Karen ;
Castillo, Diane ;
Freund, Rachel ;
Heyman, Richard E. .
JOURNAL OF ANXIETY DISORDERS, 2013, 27 (02) :240-251
[28]  
National Center for Posttraumatic Stress Disorder, 2014, DSM 5 CRIT PTSD
[29]  
Nicholson AA, 2015, NEUROPSYCHO IN PRESS
[30]   PSYCHOLOGICAL RESILIENCE IN OLDER US VETERANS: RESULTS FROM THE NATIONAL HEALTH AND RESILIENCE IN VETERANS STUDY [J].
Pietrzak, Robert H. ;
Cook, Joan M. .
DEPRESSION AND ANXIETY, 2013, 30 (05) :432-443