Background

Revealing the dynamic interplay between posttraumatic stress disorder (PTSD) symptom clusters has always been an important topic in traumatic stress studies. Based on longitudinal studies, different hypotheses have been proposed to explain PTSD symptom dynamics. But currently, no study have been conducted to test these hypotheses in children and adolescents.

Methods

Data were derived from a longitudinal study of child and adolescent traumatic event survivors of an explosion accident (N = 659). DSM-5 PTSD symptoms was measured by the PTSD Checklist-5 (PCL-5) at 4, 8, and 13 months after the disaster. Latent difference score (LDS) modeling was used to evaluate the dynamic interplay between clusters.

Results

The results of LDS model indicated that intrusion level positively predicted subsequent rate of increase for hyperarousal (p = .008) and negative changes in cognitions and mood symptoms (p = .036). Also, intrusion level trended to positively predict subsequent increase rate of avoidance symptoms (p = .059).

Conclusions

This study expands previous knowledge of dynamic relations between symptom clusters during the maintenance and fluctuation of child and adolescent PTSD symptoms. By using new methodology, this study provided novel evidence for the hypothesis that intrusion symptom plays an important role in maintaining other PTSD symptoms.

中文翻译：

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儿童和青少年DSM-5 PTSD症状群之间动态相互作用的测试

背景

揭示创伤后应激障碍（PTSD）症状群之间的动态相互作用一直是创伤应激研究的重要课题。基于纵向研究，提出了不同的假设来解释PTSD症状的动力学。但是目前，还没有进行研究来检验儿童和青少年的这些假设。

方法

数据来自对爆炸事故的儿童和青少年创伤事件幸存者的纵向研究（N = 659）。在灾难发生后的第4、8和13个月，通过PTSD Checklist-5（PCL-5）测量了DSM-5 PTSD症状。潜在差异评分（LDS）建模用于评估集群之间的动态相互作用。

结果

LDS模型的结果表明，侵入水平正向预测增加为过度反应（随后率p = 0.008），并在认知负变化和情绪症状（p = 0.036）。同样，入侵水平趋向于积极预测随后的回避症状发生率（p = .059）。

结论

这项研究扩大了在维持和波动儿童和青少年PTSD症状期间症状群之间动态关系的先前知识。通过使用新的方法，这项研究为以下假设提供了新的证据：入侵症状在维持其他PTSD症状中起着重要作用。