中国科学院心理健康重点实验室知识库

Background: Preliminary evidence provides support for the proposition that there is a dissociative subtype of Complex posttraumatic stress disorder (CPTSD). Research on this proposition would extend our knowledge on the association between CPTSD and dissociation, guide contemporary thinking regarding placement of dissociation in the nosology of CPTSD, and inform clinically useful assessment and intervention.Objectives: The present study aimed to investigate the co-occurring patterns of CPTSD and dissociative symptoms in a large sample of trauma exposed adolescents from China, and specify clinical features covariates of such patterns including childhood trauma, comorbidities with major depressive disorder (MDD) and generalized anxiety disorder (GAD), and functional impairment.Methods: Participants included 57,984 high school students exposed to the coronavirus disease 2019 (COVID-19) pandemic. CPTSD and dissociative symptoms, childhood traumatic experience, and functional impairment were measured with the Global Psychotrauma Screen for Teenagers (GPS-T). Major depressive disorder (MDD) and generalized anxiety disorder (GAD) symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7), respectively. Latent class analysis (LCA) was employed to test the co-occurring patterns of CPTSD and dissociative symptoms. Analysis of covariance (ANCOVA) and chi-square tests were respectively used to examine between-class differences in continuous and categorical clinical covariates.Results: A 5-class model emerged as the best-fitting model, including resilience, predominantly PTSD symptoms, predominantly disturbances in self-organization (DSO)symptoms, predominantly CPTSD symptoms, and CPTSD dissociative subtype classes. The CPTSD dissociative subtype class showed the lowest level of functioning and the highest rates of MDD, GAD and childhood trauma.Conclusions: Our findings provide initial empirical evidence supporting the existence of a dissociative subtype of CPTSD, and inform for further research and clinical practice on traumatized individuals. The present study identified a dissociative subtype of ICD-11 CPTSD among trauma exposed youth.The dissociative subtype of ICD-11 CPTSD was associated with poorer mental health outcomes.Findings of this study provide initial empirical evidence supporting the existence of a dissociative subtype of CPTSD. Antecedentes: Las pruebas preliminares apoyan la propuesta de que existe un subtipo disociativo del trastorno de estr & eacute;s postraum & aacute;tico complejo (TEPTC). La investigaci & oacute;n sobre esta propuesta ampliar & iacute;a nuestro conocimiento sobre la asociaci & oacute;n entre el TEPTC y la disociaci & oacute;n, guiar & iacute;a el pensamiento contempor & aacute;neo con respecto a la ubicaci & oacute;n de la disociaci & oacute;n en la nosolog & iacute;a del TEPTC e informar & iacute;a sobre evaluaciones e intervenciones cl & iacute;nicamente & uacute;tiles.Objetivos: El presente estudio tuvo como objetivo investigar los patrones concurrentes de TEPTC y s & iacute;ntomas disociativos en una gran muestra de adolescentes de China expuestos a traumas, y especificar las caracter & iacute;sticas cl & iacute;nicas covariables de tales patrones, incluyendo trauma infantil, comorbilidades con trastorno depresivo mayor (EDM) y trastorno de ansiedad generalizada (TAG) y deterioro funcional.M & eacute;todos: Los participantes incluyeron 57.984 estudiantes de secundaria expuestos a la pandemia de la enfermedad por coronavirus 2019 (COVID-19). El TEPTC y los s & iacute;ntomas disociativos, la experiencia traum & aacute;tica infantil y el deterioro funcional se midieron con el Mapeo Global Psicotrauma para Adolescentes (GPS-T por sus siglas en ingles). Los s & iacute;ntomas del trastorno depresivo mayor (TDM) y del trastorno de ansiedad generalizada (TAG) se midieron con el Cuestionario de Salud del Paciente-9 (PHQ-9) y el Trastorno de Ansiedad Generalizada-7 (GAD-7), respectivamente. Se emple & oacute; el an & aacute;lisis de clases latentes (ACL) para analizar los patrones concurrentes del TEPT y los s & iacute;ntomas disociativos. Se utilizaron an & aacute;lisis de covarianza (ANCOVA) y las pruebas de chi-cuadrado respectivamente para examinar las diferencias entre clases en covariables cl & iacute;nicas continuas y categ & oacute;ricas.Resultados: Un modelo de 5 clases emergi & oacute; como el modelo que mejor se ajustaba, incluyendo las clases de resiliencia, s & iacute;ntomas predominantemente de TEPT, s & iacute;ntomas predominantemente de alteraciones en la autoorganizaci & oacute;n (DSO), s & iacute;ntomas predominantemente de TEPTC y subtipo disociativo de TEPTC. La clase del subtipo disociativo del TEPTC mostr & oacute; el nivel m & aacute;s bajo de funcionamiento y las tasas m & aacute;s elevadas de TDM, TAG y trauma infantil.Conclusiones: Nuestros hallazgos proporcionan evidencia emp & iacute;rica inicial que apoya la existencia de un subtipo disociativo de TEPTC e informan para futuras investigaciones y pr & aacute;cticas cl & iacute;nicas en individuos traumatizados.