VICTIMS OF VIOLENCE--FAMILY RISK FOR PTSD FOLLOWING RAPE

暴力受害者——强奸后的家庭患创伤后应激障碍的风险

• 批准号: 3387271
• 负责人: JONATHAN R DAVIDSON
• 金额: $ 30.56万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-09-30 至 1994-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3387271
• 关键词: anxiety disorders; crime victims; disease /disorder proneness /risk; dissociative hysteria; female; human subject; interview; major depression; posttraumatic stress disorder; rape; anxiety disorders; crime victims; disease /disorder proneness /risk; dissociative hysteria; female; human subject; interview; major depression; posttraumatic stress disorder; rape

Rape trauma is often followed by persistent post-traumatic stress disorder (PTSD), a form of chronic anxiety which causes significant distress, morbidity and suicidality; it may also impair recovery after rape. However, not all rape victims develop chronic PTSD, thus it is important to understand which risk factors might increase the likelihood of this complication. There is evidence that family history (FH) of anxiety serves as a risk factor for PTSD in a variety of populations and this proposal examines the hypothesis that an FH of anxiety disorder occurs more frequently in rape victims who develop chronic PTSD than in those who do not, and that the risk will be similar to a group of anxious controls. It also examines the hypothesis that a positive family history for anxiety will act as an independent risk factor for post-rape PTSD after taking into account aspects of the trauma. Although co-morbid depression is often observed in association with PTSD, we expect that familial depression will not be a risk factor for developing PTSD, and that there will be no increased familial depression among PTSD probands. To accomplish these objectives, we will compare rape victims with groups of age and sex matched non-psychiatric controls, and controls with depression and anxiety. Five groups will be defined as follows: Group A will comprise rape victims with PTSD, recruited from the Psychiatry Department (n=30) (A1) and from the rape crisis center or advertisement (n=30) (A2). Group B will comprise psychiatric rape victims without PTSD recruited from the Psychiatry Department (Group B1) (n=30), and from the rape crisis center or advertisement (B2)(n=30). Group C will comprise major depressed controls without a history of rape or PTSD (n=30). Group D will comprise anxiety disorder patients without a history of rape or PTSD (N=30). Group E will comprise two non-psychiatric control groups, one of whom will be rape victims recruited by advertisement or from the centers (n=15, E1), and the other being non-rape controls (n=30) recruited by advertisement. Approximately 675 first degree relatives will be interviewed by trained raters, and information will be obtained through close relatives of unavailable relatives. The SCID will be used for establishing psychiatric diagnoses. Familial morbid risk (MR) will be calculated by the Kaplan-Meier method, and Breslow and Mantel-Cox statistics. Log linear models will be also be used. We will also perform multivariate analysis of possible risk factors for development of PTSD after rape, to examine the role of familial anxiety in combination with measures of trauma, and of personality variables (neuroticism, extraversion). The study may have important practical value, since recognition of vulnerability to chronic PTSD after rape will enable counselors to identify those for whom short term rape crisis counseling may be insufficient to achieve recovery. In such people, longer term or specialized treatment may be necessary.

强奸创伤通常是持续的创伤后应激障碍 （PTSD），一种慢性焦虑，会引起严重的困扰， 发病率和自杀；强奸后也可能会损害恢复。 但是，并非所有强奸受害者都会发展为慢性PTSD，因此重要的是 了解哪些风险因素可能会增加此的可能性 并发症。 有证据表明，焦虑的家族史（FH）是一种风险 PTSD在各种人群中的因素，该提案研究了 假设焦虑症的FH在强奸中更频繁地发生 发展慢性PTSD的受害者比没有的受害者 风险将类似于一组焦虑对照。 它还检查了 假设焦虑的积极家族史将充当 考虑到强奸后PTSD的独立危险因素 创伤的各个方面。 尽管在 与PTSD相关，我们预计家族性抑郁将不会是 开发PTSD的危险因素，不会增加 PTSD概率之间的家族抑郁症。 为了实现这些目标，我们将将强奸受害者与 年龄和性别匹配的非精神病控制和抑郁症的控制 和焦虑。 五组将定义如下： A组将与PTSD组成强奸受害者，从精神病学招募 部门（n = 30）（A1）以及强奸危机中心或广告 （n = 30）（A2）。 B组将包括没有PTSD的精神病强奸受害者 从精神病学系（B1组）（n = 30）招募，从 强奸危机中心或广告（B2）（n = 30）。 C组将包括 没有强奸或PTSD病史的主要凹陷控制（n = 30）。 团体 D将包括没有强奸病史或PTSD病史的焦虑症患者 （n = 30）。 E组将组成两个非心理对照组，其中之一 谁将是广告或中心招募的强奸受害者 （n = 15，e1），另一个是非强奸对照（n = 30） 广告。 大约有675位一级亲戚将接受训练 评估者和信息将通过 无法获得的亲戚。 SCID将用于建立精神病学 诊断。 家族病态风险（MR）将通过Kaplan-Meier方法计算， 以及Breslow和Mantel-Cox统计。 日志线性模型也将是 用过的。 我们还将对可能风险因素进行多元分析 强奸后开发PTSD，以检查家族焦虑的作用 结合创伤的度量和人格变量 （神经质，外向性）。 该研究可能具有重要的实用价值，因为 强奸后易受长期PTSD的脆弱性将使辅导员能够确定 那些短期强奸危机咨询的人可能不足 实现恢复。 在这样的人中，长期或专业治疗可能 有必要。