To examine the relationship among adopting traumatic exposure questionnaire,social support,self-efficacy,posttraumatic stress disorder( PTSD) and posttraumatic growth( PTG),this study investigates 1185 adolescents at 8. 5 years after Wenchuan earthquake by using social support scale,the self-efficacy scale,the modified DSM-5 PTSD checklist and posttraumatic growth inventory. The structural equation model was used to examine the relationship,wherein the traumatic exposure would be controlled because its importance. The results found that after controlling for traumatic exposure,social support has direct and negative effect on PTSD,and it can also exert indirect and negative effect on PTSD via self-efficacy. In addition,social support has direct and positive effect on PTG,and it may also positively affect PTG via self-efficacy.

There has been a substantial body of literature devoted to answering one question: Which latent model of posttraumatic stress disorder (PTSD) best represents PTSD's underlying dimensionality? This research summary will, therefore, focus on the literature pertaining to PTSD's latent structure as represented in the fourth (DSM-IV, 1994) to the fifth (DSM-5, 2013) edition of the DSM. This article will begin by providing a clear rationale as to why this is a pertinent research area, then the body of literature pertaining to the DSM-IV and DSM-IV-TR will be summarised, and this will be followed by a summary of the literature pertaining to the recently published DSM-5. To conclude, there will be a discussion with recommendations for future research directions, namely that researchers must investigate the applicability of the new DSM-5 criteria and the newly created DSM-5 symptom sets to trauma survivors. In addition, researchers must continue to endeavour to identify the orrect constellations of symptoms within symptom sets to ensure that diagnostic algorithms are appropriate and aid in the development of targeted treatment approaches and interventions. In particular, the newly proposed DSM-5 anhedonia model, externalising behaviours model, and hybrid models must be further investigated. It is also important that researchers follow up on the idea that a more parsimonious latent structure of PTSD may exist.

61The dysphoric arousal model has been deemed optimal within the DSM-IV PTSD literature.61The dysphoric arousal model provided superior fit to data regardless of gender, type of trauma, or measure.61Two six-factor models have been shown to provide superior fit to data compared to the DSM-5 PTSD model.61The seven-factor hybrid model has potential in the DSM-5 literature, but more work is needed.

OBJECTIVE: There has been significant debate about the optimal factor structure of posttraumatic stress disorder (PTSD). In military and veteran samples, most available studies have employed self-report measures, assessed PTSD cross-sectionally, used treatment-seeking samples, and assessed symptoms years after deployment. We extend previous studies by comparing the factor structure of clinician-assessed and self-report Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) PTSD in a nontreatment seeking sample at 4 time points spanning the deployment cycle. METHOD: The data source for this study was the Marine Resiliency Study (MRS), a longitudinal study of 4 battalion cohorts of active-duty male Marines deployed to Iraq and Afghanistan between 2008 and 2012. We examined the fourth cohort (N = 892), which was evaluated 1 month predeployment, and 1, 5, and 8 months postdeployment. RESULTS: Confirmatory factor analyses (CFA) revealed that the 5-factor solution best fit the data across all time points, and across both interview and self-report assessments. CONCLUSION: The temporal consistency and convergence demonstrated by our analyses underscores the validity of the 5-factor model among service members exposed to warzone stressors. In particular, the findings suggest that diagnostic criteria for PTSD may benefit from disaggregating hyperarousal symptoms in military samples. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Posttraumatic Stress Disorder (PTSD) is defined in DSM-IV as an anxiety disorder that encompasses symptom-clusters of reexperiencing, avoidance, and hyperarousal. Several studies have examined the factor structure of PTSD symptoms. To our knowledge, no studies have yet examined the factor structure of loss-related PTSD symptoms in samples exclusively comprised of bereaved individuals. Such an examination is important because it can advance our understanding of the stability of the structure of PTSD symptoms across groups confronted with different aversive life-events and of processes underlying the occurrence of PTSD symptoms after loss. In this study, five alternative models of the factor structure of PTSD symptoms were examined in a sample of 347 mourners. Results showed that, in this group, PTSD symptoms are best conceptualized as forming four factors: reexperiencing, avoidance, dysphoria, and hyperarousal. Patterns of correlations with depression and complicated grief supported the validity of the model.

Until recently, our understanding of relied almost entirely on studies of war veterans and disaster victims. A handful of epidemiologic studies have now been conducted that investigate the natural course of as it occurs in the general population. Estimates of prevalence have tended to vary according to the diagnostic criteria used to define the disorder, assessment procedures, sample characteristics, and the definition of qualifying traumatic events. This article reviews key findings from these studies to provide insight into the burden of in the general population. Possible reasons for the observed difference in lifetime prevalence of between the sexes (a female-to-male lifetime prevalence ratio of 2:1 is typically reported) and factors thought to be associated with an increased risk for the disorder after exposure to trauma are reviewed.

Many studies have suggested that unexpected death of a loved one is an important risk factor of posttraumatic stress disorder (PTSD) and depression among disaster survivors, but few have examined the magnitude of psychiatric morbidities among bereaved survivors. This study examined the prevalence rates of clinically significant PTSD and depressive symptoms and their associated risk factors among Chinese adult survivors following the 2008 Sichuan earthquake. Two hundred and fifty-one bereaved adults were compared with 1474 non-bereaved adult survivors. The estimated rates of PTSD and depressive symptoms were 65.6% and 64.8% for those who lost first-degree family members, 34.1% and 45.5% for those who lost second-degree relatives, and 27.1% and 37.5% for non-bereaved survivors respectively. Loss of a child was a significant predictor of psychopathological symptoms. The results suggested that effective and sustainable mental health services were required, especially for bereaved single-child parents.

We investigate the structural causes and the subject construction of the psychological dilemma of rural parents who lost their only child from the perspective of constructivism theory.The factors of"retribution for sin(karma)" belief,imagination of life in old age without the social safety net,things after death,and acquaintances society constitute the structural background of meaning construction for rural parents who lost their only child,their long and intense psychological dilemma is the result of meaning construction.The solution is through friendship and mutual assistance within their group,to gain spiritual social support from informal social network of the community,so as to promote the psychological predicament ease and social integration.

Since the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders(DSM-IV)published in 1994,there has been an intense debate on the phenotypic model of posttraumatic stress disorder(PTSD)symptom dimensionality.From the initial tripartite DSM-IV model(intrusion,avoidance and emotional numbing,and hyperarousal)to the latest DSM-5based seven-factor hybrid model(intrusion,avoidance,negative affect,anhedonia,externalizing behaviors,anxious arousal,and dysphoric arousal),studies on the phenotypic model of PTSD symptom dimensionality have made substantial progress in recent two decades.The current study began by outlining the previous studies in this field,and then reviewed the findings of the phenotypic model of DSM-IVand DSM-5PTSD symptom dimensionality respectively.After that,limitations with previous studies,in terms of sampling,assessment,design,and psychometrics were discussed.The paper finally indicated the directions for future studies.

自1994年美国《精神障碍诊断与统计手册》第四版公布以来,关于创伤后应激障碍临床症状表型模型的争议一直存在。从最初的3维模型(闯入、回避与情感麻木以及高唤起)到最新的7维混合模型(闯入、回避、负性情绪、快感缺失、外化行为、焦虑性唤起以及精神痛苦性唤起),创伤后应激障碍临床症状表型模型研究已在持续争议中取得了长足进展。为了清晰地反映这一研究进展,我们首先勾勒了20余年来该领域研究的大致脉络,并从基于美国《精神障碍诊断与统计手册》第四版与第五版的表型模型研究两个方面进行了综述,讨论了DSM-IV框架下的两个4维模型和一个5维模型的实证支持、结构比较、外部效度以及它们的心理病理机制,同时探讨了DSM-5框架下两个4维模型、一个5维模型、两个6维模型和一个7为模型的结构比较、各自的实证支持和外部效度;之后又讨论了现有研究在样本选取、评估工具使用、研究设计以及心理测量学等方面存在的局限;最后指出了该领域未来研究的方向,希望能够弥补现有研究设计的不足,探讨核心症状,通过研究找出最优模型,推动其向临床实践的转化。

Parents bereaved by infant death experience a wide range of symptomatology, including posttraumatic stress disorder (PTSD) that may persist for years after the loss. Little research has been conducted on PTSD in fathers who have lost an infant. Mothers report most symptoms to a greater extent than fathers, but not much is known about other sex differences following infant death. The present cross-sectional study examined sex differences in PTSD and sex differences in the relationship between PTSD severity and related variables. Subjects were 361 mothers and 273 fathers who had lost an infant either late in pregnancy, during birth or in the first year of life. Participants filled out questionnaires between 1.2 months and 18 years after the loss (M=3.4 years). Mothers reported significantly more PTSD symptoms, attachment anxiety, emotion-focused coping and feeling let down, but significantly lower levels of attachment avoidance than fathers. Attachment anxiety, attachment avoidance and emotion-focused coping were significantly more strongly associated with PTSD severity in mothers than fathers, but only when examined alone. When all variables and time since the loss were examined together, there were no longer any significant moderation effects of sex. Persistent posttraumatic symptomatology exists in both mothers and fathers long after the loss. There are several sex differences in severity and correlates of PTSD, and a few moderation effects were identified for attachment and emotion-focused coping. Overall, more similarities than differences were found between mothers and fathers in the associations between PTSD and covariates.

创伤后应激障碍(PTSD)是一种严重的心理障碍.PTSD常在一个人暴露于一个或多个创伤性事件后产生,如重大的刺激、性侵犯、恐怖事件或对一个人生活其他严重威胁.主要症状包括令人不安重复闪回,对事件的回避或记忆麻木,警觉性增高等.PTSD的诊断是在创伤性事件发生后持续1个月以上.美国精神病学会在2013年5月出版了《精神疾病诊断与统计手册》第5版(DSM-5).DSM-5将PTSD的核心症状修改为4组:①在创伤事件发生后,存在1种(或多种)与创伤事件有关的重新体验症状;②创伤事件后开始持续地回避与创伤事件有关的刺激;③与创伤性事件有关的认知和心境方面的消极改变,在创伤事件发生后开始出现或加重;④与创伤事件有关的警觉性或反应性有显著的改变,在创伤事件发生后开始或加重.近年来,对PTSD的临床研究成为精神病学、心身医学和临床心理学的热点.根据DSM-5的标准和新的临床研究成果,本文对PTSD的病因和发病机制、临床表现、诊断标准、诊断和鉴别诊断、治疗、预防和预后进行了分析.

BACKGROUND: In cross-sectional studies, social support and posttraumatic stress disorder (PTSD) symptoms appear related, in that higher severity of PTSD is associated with lower social support and vice versa. Theoretical models of the causal direction of this relationship differ. Most longitudinal studies suggest that PTSD symptoms erode social support over time, although some suggest that higher social support is prospectively associated with decrease in PTSD symptom severity. It is unclear, though, how social support and PTSD affect each other in the short term. The purpose of this study was to test day-to-day relationships between PTSD and social support to elucidate how PTSD and social support influence each other. METHODS: Using 1173 daily observations from 75 college women who met screening criteria for lifetime sexual assault and past-month PTSD, this study tested same-day and next-day relationships between PTSD and social support using mixed models. RESULTS: Within-person analyses indicated that, when PTSD was higher than usual on a given day, social support was higher the next day. Between-person analyses suggested that people with generally higher social support tended to have lower PTSD symptoms on a given day, but average PTSD symptom severity was not associated with day-to-day fluctuations in social support. CONCLUSIONS: Rather than eroding in response to daily symptoms, social support might be sought out following increases in PTSD, and when received consistently, might reduce symptoms of PTSD in the short term. Interventions that increase college women's access to social support after sexual assault may thus be helpful in addressing PTSD. 2017 Wiley Periodicals, Inc.

Two models of posttraumatic stress disorder (PTSD) have received the most empirical support in confirmatory factor analytic studies: King, Leskin, King, and Weathers (1998) Emotional Numbing model of reexperiencing, avoidance, emotional numbing and hyperarousal; and Simms, Watson, and Doebbeling's (2002) Dysphoria model of reexperiencing, avoidance, dysphoria and hyperarousal. These models only differ in placement of three PTSD symptoms: sleep problems (D1), irritability (D2), and concentration problems (D3). In the present study, we recruited 252 women victims of domestic violence and tested whether there is empirical support to separate these three PTSD symptoms into a fifth factor, while retaining the Emotional Numbing and Dysphoria models remaining four factors. Confirmatory factor analytic findings demonstrated that separating the three symptoms into a separate factor significantly enhanced model fit for the Emotional Numbing and Dysphoria models. These three symptoms may represent a unique latent construct. Implications are discussed.Research highlights? PTSD symptoms of sleep, concentration and irritability problems represent a unique PTSD factor. ? A 5-factor PTSD model fit significantly better than four-factor models. ? The Emotional Numbing model fit better than the Dysphoria model.

Traumatic experiences are relatively common. More than two thirds of persons in the general population may experience a significant traumatic event at some point in their lives, and up to one fifth of people in the United States may experience such an event in any given year (1-5). Although comparable international data are limited, large proportions of populations in many countries have been exposed to terrorism, forced relocation, and violence, which suggests that the overall prevalence of exposure to traumatic events worldwide may be even higher than that in the United States (6, 7).Disasters (e.g., floods, transportation accidents) are traumatic events that are experienced by many people and may result in a wide range of mental and physical health consequences (8). In one survey of US residents, 13 percent of the sample reported a lifetime exposure to natural or human-generated disaster (9). In the National Comorbidity Survey, 18.9 percent of men and 15.2 percent of women reported a lifetime experience of a natural disaster (4). Post-traumatic stress disorder (PTSD) is the most commonly studied and probably the most frequent and debilitating psychological disorder that occurs after traumatic events and disasters (8, 10).

Reduced cortisol coupled with elevated catecholamines has been reported for patients with post-traumatic stress disorder (PTSD) precipitated by war and other traumas considered to be utside the range of usual experiences. It is unclear whether these neuroendocrine abnormalities also occur in PTSD precipitated by more commonly experienced traumas associated with life-threatening illness. Overnight (12-h) urinary cortisol, norepinephrine (NE) and epinephrine (E) were measured in 21 mothers of pediatric cancer survivors with ( n=14) and without PTSD symptoms ( n=7) and in control mothers of healthy children ( n=8). Mothers meeting subthreshold and full PTSD criteria were combined to form the PTSD symptoms group. The PTSD group showed lower total urinary cortisol and a trend for higher total urinary NE than the non-PTSD group, who in turn were no different from controls. There were no significant group effects for E. Cortisol (but not NE) effects remained after controlling for symptoms of co-morbid depression. The finding of reduced cortisol in illness-related PTSD demonstrates neuroendocrine dysregulation similar to that found previously in other types of trauma (e.g., war-related). Future longitudinal studies with repeated urinary collection procedures will be necessary to clarify measurement issues and establish the time course and health implications of the neuroendocrine perturbations.

Objective: To explore Continuing Bonds of the parents who lost their only child("Shi du"parents in Chinese) in China. Methods: Eleven parents from Beijing who experienced the death of their only child participated the study.Data was collected through in-depth interview and objects collection, and analyzed using Interpretative Phenomenological Analysis(IPA). Results: Continuing Bonds were classified into the following five aspects: seeing the deceased again; keeping the belongings of the deceased; mourning and memory; dreaming about the deceased child; internalized Continuing Bonds. Conclusion:"Shi du"parents still keep connection with their children after loss; Continuing Bonds of"Shi du"parents show universal and unique culture characteristics.

Objective: To explore grief reactions of the parents who lost their single child("Shidu"parents in Chinese)in China. Methods: Four parents from Beijing who experienced the death of their single child participated the study. Data was collected by deep interviews and objects collection, and analyzed using thematic analysis. Results: Grief reactions were separated into the following four aspects: 1Emotional reactions, including missing/yearning, loneliness, regret/guilt,helplessness/hopelessness, pity, fear of festival, empty, anxiety, shocked, and pain. 2Cognitive reactions, including disbelief, injustice, hallucinations, intrusive thoughts, rumination, self-deprecation, suicidal ideation. 3Behavioral reactions, including crying, social withdrawal, avoidance of reminders of the deceased, arrange and keep the belongings of the deceased.4Physical reactions, including fatigue, sleeping disturbance, dreams of the deceased. Conclusion:"Shidu"parents experienced great pain after loss;Grief reactions of"Shidu"parents showed universal and unique characteristics.

目的:研究中国失独父母的哀伤反应。方法:采用质性研究方法,选取北京市4名失独父母进行深度访谈,并收集实物资料,采用主题分析法对资料进行分析。结果:失独父母的哀伤反应主要表现在四个方面:情感反应有思念/想念、孤独/孤单、后悔/自责、无奈/无助/无望、不舍/可惜、害怕过节、空、烦躁、震惊、痛苦;认知反应有不相信、不公平、自己倒霉/造孽/赖自己、幻觉、闯入性想法、反刍、自我贬低、自杀意念;行为反应有哭、社交退缩与回避、回避提醒物、冲动行为、整理或者保存遗物;生理反应有疲倦、睡眠问题、梦见已故者。结论:失独父母经历极其强烈的哀伤反应,其哀伤反应有其普遍性和独特性。

The violent death of a loved one leaves survivors at increased risk for a host of negative outcomes, including posttraumatic stress disorder, depression, and intense or prolonged grief. In the wake of increased interest in the phenomenology and course of these responses, there has been a corresponding interest in identifying specific predictors of psychological outcomes among survivors. However, most reviewers have focused primarily on predictors located within the individual survivor, such as coping style and trauma history. Externally located variables are equally important in identifying individuals at risk but have been relatively neglected in the literature. We review the three best-studied external predictor variables: cause of death, relationship of the mourner to the deceased, and social support. For each of these variables, we critically examine studies investigating its relationship to outcomes of violent death survivorship, offer conclusions based on available data, and suggest future directions for research.

Endocannabinoid (eCB) signaling has been identified as a modulator of adaptation to stress, and is integral to basal and stress-induced glucocorticoid regulation. Furthermore, interactions between eCBs and glucocorticoids have been shown to be necessary for the regulation of emotional memories, suggesting that eCB function may relate to the development of post-traumatic stress disorder (PTSD). To examine this, plasma eCBs were measured in a sample (n = 46) drawn from a population-based cohort selected for physical proximity to the World Trade Center (WTC) at the time of the 9/11 attacks. Participants received a structured diagnostic interview and were grouped according to whether they met diagnostic criteria for PTSD (no PTSD, n = 22; lifetime diagnosis of PTSD = 24). eCB content (2-arachidonoylglycerol (2-AG) and anandamide (AEA)) and cortisol were measured from 8 a.m. plasma samples. Circulating 2-AG content was significantly reduced among individuals meeting diagnostic criteria for PTSD. The effect of reduced 2-AG content in PTSD remained significant after controlling for the stress of exposure to the WTC collapse, gender, depression and alcohol abuse. There were no significant group differences for AEA or cortisol levels; however, across the whole sample AEA levels positively correlated with circulating cortisol, and AEA levels exhibited a negative relationship with the degree of intrusive symptoms within the PTSD sample. This report shows that PTSD is associated with a reduction in circulating levels of the eCB 2-AG. Given the role of 2-AG in the regulation of the stress response, these data support the hypothesis that deficient eCB signaling may be a component of the glucocorticoid dysregulation associated with PTSD. The negative association between AEA levels and intrusive symptoms is consistent with animal data indicating that reductions in AEA promote retention of aversive emotional memories. Future work will aim to replicate these findings and extend their relevance to clinical pathophysiology, as well as to neuroendocrine and molecular markers of PTSD. (C) 2013 Elsevier Ltd. All rights reserved.

Background: Hundreds of individuals lost one or more significant others in the MH17 plane crash in 2014 in Ukraine. The current study is the first to explore subgroups of disaster-bereaved individuals based on presence of psychopathology clusters. This may inform the development of diagnostic instruments and tailored interventions. Objective: Aims of the current study were to examine (1) subgroups based on presence of prolonged grief disorder (PGD), major depressive disorder (MDD), and posttraumatic stress disorder (PTSD) symptom clusters and (2) associations between class membership, disaster-related variables (i.e. experiencing multiple losses, conducting multiple burials for the same deceased, and time to confirmation of death), and a sense of unrealness. Method: Self-rated PGD (10 items of the Traumatic Grief Inventory represented in two symptom clusters), MDD (16-item Quick Inventory Of Depressive Symptomatology represented in one symptom cluster), and PTSD (20-item PTSD Checklist for DSM-5 represented in four symptom clusters) from 167 participants were subjected to latent class analysis to identify subgroups (i.e. classes). Correlates of class membership were assessed using the three-step approach. Results: A three-class solution yielded the best model fit. Class 1 (Resilient class; 20.0%) was predominantly characterized by low probability of PGD, MDD, and PTSD symptom clusters, class 2 (PGD class; 41.8%) by moderate to high probability of presence of PGD, and class 3 (Combined class; 38.2%) by moderate to high probability of presence of PGD, MDD, and PTSD symptom clusters. Compared with the Resilient class, a sense of unrealness was more likely to be experienced by individuals in the PGD class and the Combined class. Conclusions: Our results indicate that subgroups of disaster-bereaved individuals can be distinguished based on the presence of PGD, MDD, and PTSD symptom clusters. A sense of unrealness was the strongest distinguishing feature of the subgroups.

人生活在群体之中 ,生与死自然都会引发人们共同的关怀。传统儒家文化“贵生、乐生、轻死” ,道家却以一个智者观察和审视人生 ,对生死关怀有两种不同的取向 :其一是“全生避死” ,其二是“生死如一”。佛教提倡轮回说 ,其影响有两点 :一是有效打破了传统文化中将人的生活限定在今世的生死观 ;二是通过因果报应 ,使每个人都需要对自己的行为负责 ,从而使世界人生具有了某种道德秩序和意义 ,因而也满足了人对意义的基本需要。

This is the first study of a natural disaster (Hurricane Andrew) in which psychological and neuroendocrine data were collected 1–4 and 9–12 months afterward. Data were assessed using a community sample (N65=65111) of hurricane survivors. Elevated posttraumatic stress symptoms (intrusive and avoidant thoughts) and stress hormones that initially were twice normal control values decreased significantly over time and returned to levels of non-hurricane controls by the end of the year. In contrast to previous reports, suggesting low cortisol in posttraumatic stress disorder (PTSD), our sample had elevated cortisol, perhaps due to the nature of the trauma (i.e., natural disaster vs. crime, rape or war), our timing, or getting samples a few months after the event. In addition, the decrease in stress hormones over the year (cortisol and epinephrine [E]) was related to a decrease in psychological symptoms of trauma. Cortisol and norepinephrine (NE) were both related to the hurricane experience as well (damage and rebuilding; damage and disruption). Gender differences showed women reported more distress, but men had higher NE and cortisol. Finally, cortisol correlated most consistently both cross sectionally and longitudinally with reported days ill.

Little is known regarding changes in the hypothalamic-pituitary-adrenal axis (HPA axis) of adolescent girls with and without posttraumatic stress disorder (PTSD) who have recently experienced sexual abuse. Therefore, in this pilot study, we utilized non-stressed home saliva collection three times a day for three days to assess the levels, diurnal variation and awakening response of cortisol in recently sexually abused adolescent girls.MethodsTwenty-four adolescent girls (mean age: 15 00± 1.5 years) with a history of recent sexual abuse (sexual abuse occurred 10900096 months prior to study enrollment) and 12 healthy, nontraumatized comparison subjects (mean age: 14.8 00± 1.3 years) collected saliva at home upon awakening, 30 min after waking, and in the late afternoon on three consecutive school days.ResultsAmong sexually abused girls, flattening of the morning cortisol awakening response was associated with PTSD severity (r = 090808.41, P < .05) as well as intrusive symptoms (r = 090808.42, P < .05). Increased adversity prior to sexual abuse was also associated with flattening of the cortisol awakening response (r = 090808.53, P < .01).ConclusionsAttenuation of the cortisol awakening response in recently sexually abused girls suggests that alterations in HPA-axis functioning may occur relatively proximate to the traumatic event and correlate with symptom severity of PTSD, intrusive symptoms, and hyperarousal symptoms. These data raise the possibility that subacute alterations in the dynamic secretion of cortisol are directly related to the pathophysiology of sexual abuse-related PTSD symptoms in adolescent girls.

ABSTRACT The Clinician-Administered PTSD Scale (CAPS; Blake et al., 1990) is a structured interview that assesses the 17 key symptoms of posttraumatic stress disorder ( PTSD) as established in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM V; American Psychiatric Association, 1994). CAPS data from 524 treatment-seeking male military veterans were submitted to confirmatory factor analysis to test a series of nested models reflecting alternative representations of PTSD dimensionality: (a) a 4-factor, 1st-order solution; (b) a 2-factor, higher order solution; (c) a single-factor, higher order solution; and (d) a single-factor, 1st-order solution. The model of best fit was the 4-factor, 1st-order solution, containing moderately to highly correlated yet distinct 1st-order factors corresponding to the reexperiencing, effortful avoidance, emotional numbing, and hyperarousal aspects of PTSD. Implications for theory, assessment, and future research are presented in this article. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

To estimate the prevalence of post-traumatic stress disorder (PTSD) and assess determinants related to PTSD symptoms among adult earthquake survivors after the 2008 Wenchuan earthquake in China. Cross-sectional multicluster sample surveys with data collected from four counties. Surveys were conducted separately in four counties in Sichuan Province, with a total of 2004 respondents. Beichuan County and Dujiangyan City were damaged more severely than Yaan County and Langzhong County during the earthquake. In total, 1890 households were represented, with a mean of 2.2 respondents per household. Data were collected using structured interviews, and the Harvard Trauma Questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria were used to diagnose PTSD. The prevalence rates of suspected PTSD were 47.3% (n=436) in heavily damaged areas and 10.4% (n=93) in moderately damaged areas. The prevalence rates of PTSD symptoms among elderly, middle aged and young adults were 55.8%, 50.2% and 28.6% (P=0.001), respectively, in heavily damaged areas. Older age, female gender, unmarried/divorced/widowed, ethnic minority, death of family member, no household income and damaged household were independent risk factors for PTSD symptoms in heavily damaged areas. Interventions designed to reduce PTSD among populations affected by the 2008 earthquake should focus on people without household incomes, those with damaged households and those who experienced the death of a family member. Effective, sustainable and culturally sensitive psychosocial interventions and mental health services are required, and attention should be directed to survivors who experienced the death of a family member, women and older adults following the devastating natural disaster. Governments should support income-generating activities and improve living conditions. Trained field personnel can assist with PTSD assessments and referrals, and existing rural healthcare services can be used to provide treatment for common psychiatric disorders.

This study extends research examining posttraumatic stress disorder symptoms following different types of potentially traumatic events. Specifically, the study examined and compared the symptom patterns observed in those who suffered a major accident, the unexpected death of a loved one, or sexual assault. Based on recent findings, this project also examines those who reported nontraumatic (but stressful) events, as well as comparing symptom patterns across gender. Findings suggest different types of traumas might be associated with differences in severity and patterns of symptoms for women (but not for men), suggesting symptom patterns manifest differently in men and women. Results also call into question the assumption that traumatic events demonstrate different symptom patterns than other types of events.

Objective: Various factors contribute to the effective implementation of evidence-based treatments (EBTs). In this study, cognitive processing therapy (CPT) was administered in a Veterans Affairs (VA) posttraumatic stress disorder (PTSD) specialty clinic in which training and supervision were provided following VA implementation guidelines. The aim was to (a).estimate the proportion of variability in outcome attributable to therapists and (b) identify characteristics of those therapists who produced better outcomes. Method: We used an archival database of veterans (n = 192) who completed 12 sessions of CPT by therapists (n = 25) who were trained by 2 nationally recognized trainers, 1 of whom also provided weekly group supervision. Multilevel modeling was used to estimate therapist effects, with therapists treated as,a random factor. The supervisor was asked to retrospectively rate each therapist in terms of perceived effectiveness based on supervision interactions. Using single case study design, the supervisor was interviewed to determine what criteria she used to rate the therapists and emerging themes were coded. Results: When initial level of severity on the PTSD Checklist (PCL; McDonald & Calhoun, 2010; Weathers, Litz, Herman, Huska, & Keane, 1993) was taken into account, approximately 12% of the variability in the PCL at the end of treatment was due to therapists. The trainer, blind to the results, identified the following characteristics and actions of effective therapists: effectively addressing patient avoidance, language used in supervision, flexible interpersonal style, and ability to develop a strong therapeutic alliance. Conclusions: This study adds to the growing body of literature documenting the importance of the individual therapist as an important factor in the change process.

This study examines the factors that determine adult children's financial support for elderly parents, using data from the China Survey on Support Systems for the Elderly conducted in 1992. The findings support the hypotheses of need-based transfers. In both urban and rural areas, children's financial transfers to their elderly parents are based on the parents' need, and familial support compensates for inequalities in elderly persons' access to public resources. The data also suggest that elderly support is an outcome of short- and long-term arrangements between generations. Elderly Chinese, especially those in urban areas, have short-term exchanges with their adult children, providing housing or other services and receiving financial support in return. Also, adult children's support for elderly parents may be a repayment of parental investment made in them earlier.

61Among women who smoke in pregnancy, those with PTSD have the highest cortisol levels.61This study shows additive effects of smoking and PTSD on pregnancy cortisol.61Research on PTSD somatic experience, smoking, and cortisol might inform intervention.61PTSD-specific smoking cessation strategies may help more pregnant women quit smoking.

Abstract Investigating hippocampal subfields may provide new and important insights into the pathophysiology of posttraumatic stress disorder (PTSD). However, no study has examined the hippocampal subfield volume changes in parents with or without PTSD who had lost their only child and could no longer conceive in China. Fifty-seven parents with PTSD (PTSD+), 11 trauma-exposed parents without PTSD (PTSD-), and 39 non-traumatized controls were recruited to examine the hippocampal subfield volumes using magnetic resonance imaging. Correlations of the volumes with the time since trauma and Clinician-Administered PTSD Scale (CAPS) scores were investigated in the PTSD+ group. The volumes of the bilateral cornu ammonis (CA) 2-3, CA4-dentate gyrus (DG), and left subiculum were significantly smaller in the PTSD+ and PTSD- groups than in the controls, but there were no significant differences between the PTSD+ and PTSD- groups. Additionally, the left CA2-3 and CA4-DG volumes reduced more than those on the right side in the PTSD+ and PTSD- groups. The subfield volumes were not related to the time since trauma and the CAPS scores in the PTSD+ group. In conclusion, hippocampal subfield volumes decreased in parents who lost their only child with or without PTSD, and the volumetric reduction may be independent of PTSD and trauma-related. Moreover, the hippocampal volume deficits showed laterality that the left side was affected more than the right, and the hippocampal subfields may show differential vulnerabilities to trauma/PTSD, with the CA2-3 and CA4-DG subfields more sensitive than others.

The loss-of-single-child families in China have reached millions,and the trend still keeps upward.Being unattended in life,losing the economical support and mental pain are the difficulties that loss-of-single-child families have to face,meanwhile the legal protection of loss-of-single-child families is almost blank.Because of the theoretical and legislative limitations,it is not realistic for state compensation now,but as the price of the restrictions of the reproductive rights,it is the basic responsibility of government to make this up.Taking the social compensation fee as the major source of funding for compensation for the loss of the loss-of-single-child families,defining the administrative institution of loss-of-single-child families clearly,establishing special nursing homes for loss-of-single-child families,and revising relevant laws and regulations are the urgent things to do.

生活上无人照料、经济上丧失支援、精神上痛苦不堪、无人养老送终,是失独家庭所必须直面的多重困境,而我国对失独家庭的法律保护却几近为零.因无法突破理论和立法局限,现阶段对失独家庭进行国家赔偿并不现实,但失独补偿是政府责无旁贷的基本责任.为此,我们应该建立全方位的失独家庭救济机制:放宽失独家庭的收养条件,增设不完全收养制度;将社会抚养费全部上缴中央财政作为补偿失独家庭的主要经费来源并大幅提高补偿标准;明确失独家庭管理机构,建立专门失独者养老院;完善相应法律法规,构建制度化法律保障机制.

BACKGROUND: Although bereavement is not usually considered the type of stressor associated with posttraumatic stress disorder (PTSD), a risk factor often associated with poorer bereavement outcomes is when a death is sudden and unexpected. AIMS: The purpose of this exploratory study is to describe PTSD symptoms in survivors bereaved by the suicide of a significant other. The relationship of PTSD to mental health and grief were explored, as well as gender differences in PTSD symptoms. METHOD: To measure PTSD symptoms, the 15-item Impact of Event Scale (IES) was used. RESULTS: The IES intrusion and avoidance subscales were significantly correlated with the mental health subscale of the MOS SF-36 (Medical Outcomes Study-Short Form 36), indicating that lower mental health scores were associated with higher PTSD symptoms. Those survivors scoring higher than 25 on the Inventory of Complicated Grief (ICG) had significantly higher scores on both the intrusion and avoidance subscales of the IES compared with those scoring lower than 25 on the ICG. Females reported significantly higher intrusion symptoms and total stress than males. CONCLUSION: Our results suggest that a death by suicide may lead to the development of PTSD symptoms, at least in some individuals, and is associated with lower mental health quality of life and complicated grief responses.The Author(s) 2016.

独生子女家庭面临的最大的风险莫过于失独。唯一性的内源风险和多样性的外源风险一旦结合，就可能产生出新的失独家庭。根据全国性卫生年鉴统计，每年失独家庭增加7．6万个。专家估计，全国目前有2亿以上的独生子女家庭，预计可能产生1000万个失独家庭。家庭是社会细胞，巨量的“细胞残缺”这是最大的人口风险。

Parents of children with cancer report post-traumatic stress symptoms (PTSS) years after the child's successful treatment is completed. The aim of the present study was to analyze a number of objective and subjective childhood cancer-related factors as predictors of parental PTSS. Data were collected from 224 parents during and after their child's cancer treatment. Data sources include self-report questionnaires and medical records. In a multivariate hierarchical model death of the child, parent's perception of child psychological distress and total symptom burden predicted higher levels of PTSS. In addition, immigrants and unemployed parents reported higher levels of PTSS. The following factors did not predict PTSS: parent gender, family income, previous trauma, child's prognosis, treatment intensity, non-fatal relapse, and parent's satisfaction with the child's care. Although medical complications can be temporarily stressful, a parent's perception of the child's distress is a more powerful predictor of parental PTSS. The vulnerability of unemployed parents and immigrants should be acknowledged. In addition, findings highlight that the death of a child is as traumatic as could be expected.

“失独”描述的是一个家庭中的独生子女由于疾病或意外等原因死亡，而父母丧失生育能力并且没有另外收养子女的状况。当代中国的失独现象与失独问题近年已越来越受到社会关注。有专家估计未来中国即将迎来近千万失独家庭，失独问题业已成为严峻的社会问题。

Post-traumatic stress disorder (PTSD) in response to the World Trade Center (WTC) disaster of 11 September 2001 (9/11) is one of the most prevalent and persistent health conditions among both professional (e.g. police) and non-traditional (e.g. construction worker) WTC responders, even several years after 9/11. However, little is known about the dimensionality and natural course of WTC-related PTSD symptomatology in these populations. Data were analysed from 10 835 WTC responders, including 4035 police and 6800 non-traditional responders who were evaluated as part of the WTC Health Program, a clinic network in the New York area established by the National Institute for Occupational Safety and Health. Confirmatory factor analyses (CFAs) were used to evaluate structural models of PTSD symptom dimensionality; and autoregressive cross-lagged (ARCL) panel regressions were used to examine the prospective interrelationships among PTSD symptom clusters at 3, 6 and 8 years after 9/11. CFAs suggested that five stable symptom clusters best represent PTSD symptom dimensionality in both police and non-traditional WTC responders. This five-factor model was also invariant over time with respect to factor loadings and structural parameters, thereby demonstrating its longitudinal stability. ARCL panel regression analyses revealed that hyperarousal symptoms had a prominent role in predicting other symptom clusters of PTSD, with anxious arousal symptoms primarily driving re-experiencing symptoms, and dysphoric arousal symptoms primarily driving emotional numbing symptoms over time. Results of this study suggest that disaster-related PTSD symptomatology in WTC responders is best represented by five symptom dimensions. Anxious arousal symptoms, which are characterized by hypervigilance and exaggerated startle, may primarily drive re-experiencing symptoms, while dysphoric arousal symptoms, which are characterized by sleep disturbance, irritability/anger and concentration difficulties, may primarily drive emotional numbing symptoms over time. These results underscore the importance of assessment, monitoring and early intervention of hyperarousal symptoms in WTC and other disaster responders.

While posttraumatic stress disorder (PTSD) symptoms in the recently published Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are clustered into four factors, emerging confirmatory factor analytic studies suggest that this disorder is best characterized by seven symptom clusters, including re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptoms. To date, however, data are lacking regarding the relation between this novel model of DSM-5 PTSD symptoms and measures of clinical significance in this population (e.g., functioning). Using data from the National Health and Resilience in Veterans Study (NHRVS), a contemporary, nationally representative sample of 1484 U.S. veterans, we evaluated clinical and functional correlates of a novel 7-factor model of DSM-5 PTSD symptoms. Differential patterns of associations were observed between DSM-5 PTSD symptom clusters, and psychiatric comorbidities, suicidal ideation, hostility, and functioning and quality of life. Anhedonia symptoms, in particular, were strongly related to current depression, as well as reduced mental functioning and quality of life. Externalizing behaviors were most strongly related to hostility, supporting the convergent validity of this construct. Cross-sectional design and employment of self-report measures. These results suggest that a more refined 7-factor model of DSM-5 PTSD symptoms may provide greater specificity in understanding associations with comorbid psychopathology, suicidal ideation, and functioning and quality of life in U.S. veterans. They further suggest that prevention and treatment efforts that target distinct aspects of the PTSD phenotype may be more effective in mitigating key clinical and functional outcomes in this population.

Background:Little research has examined the diagnostic utility and factor structure of commonly used posttraumatic stress disorder (PTSD) assessment instruments in older persons. Methods:A total of 206 adults aged 60 or older (mean age = 69 years; range = 60–92), who resided in the Galveston Bay area when Hurricane Ike struck in September 2008, completed a computer-assisted telephone interview two–five months after this disaster. Using the PTSD Checklist (PCL), PTSD symptoms were assessed related both to this disaster and to participants’ worst lifetime traumatic event. Total PCL scores were compared to PCL-based,Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)-derived probable diagnoses of PTSD to determine optimal cut scores. Confirmatory factor analyses (CFAs) were conducted to evaluate PTSD symptom structure. Results:Receiver operating characteristic analyses indicated that a PCL score of 39 achieved optimal sensitivity and specificity in assessing a PCL-based, algorithm-derived DSM-IV diagnosis of worst event-related PTSD; and that a score of 37 optimally assessed probable Ike-related PTSD. CFAs revealed that a recently proposed five-factor model – comprised of re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal factors – provided a better fitting representation of both worst event- and disaster-related PTSD symptoms than alternative models. Current Ike-related anxious arousal symptoms demonstrated a significantly stronger association with current generalized anxiety than depressive symptoms, thereby supporting the construct validity of this five-factor model of PTSD symptomatology. Conclusions:A PCL score of 37 to 39 may help identify probable PTSD in older persons. The expression of PTSD symptoms in older adults may be best characterized by a recently proposed five-factor model with distinct dysphoric arousal and anxious arousal clusters.

Abstract Interest in the problem of method biases has a long history in the behavioral sciences. Despite this, a comprehensive summary of the potential sources of method biases and how to control for them does not exist. Therefore, the purpose of this article is to examine the extent to which method biases influence behavioral research results, identify potential sources of method biases, discuss the cognitive processes through which method biases influence responses to measures, evaluate the many different procedural and statistical techniques that can be used to control method biases, and provide recommendations for how to select appropriate procedural and statistical remedies for different types of research settings.

It is argued that P-values and the tests based upon them give unsatisfactory results, especially in large samples. It is shown that, in regression, when there are many candidate independent variables, standard variable selection procedures can give very misleading results. Also, by selecting a single model, they ignore model uncertainty and so underestimate the uncertainty about quantities of interest. The Bayesian approach to hypothesis testing, model selection, and accounting for model uncertainty is presented. Implementing this is straightforward through the use of the simple and accurate BIC approximation, and it can be done using the output from standard software. Specific results are presented for most of the types of model commonly used in sociology. It is shown that this approach overcomes the difficulties with P-values and standard model selection procedures based on them. It also allows easy comparison of nonnested models, and permits the quantification of the evidence for a null hypothesis of interest, such as a convergence theory or a hypothesis about societal norms.

Sustaining meaning in life, maintaining emotional well-being, and balancing attachments to the living and the deceased are features associated with the psychological (and often private) impact of loss. In the Two-Track Model of Bereavement, the loss process is conceptualized along two distinct but interactive axes that attend to these overt and covert aspects of the response to loss. Whereas Track I is concerned with biopsychosocial functioning in the wake of loss, it is Track II that focuses on the bereaved's ongoing emotional attachment and relationship to the deceased. The contributions of the model to theory and research can serve to clarify our thinking about bereavement as a process resonating throughout one's life. Initially, research and clinical findings from bereaved parents are presented to illustrate the Two-Track Model and its contribution to the deepening of our understanding of loss throughout the life cycle. The contributions of the model to clinical practice are then considered for their ability to clarify our thinking and interventions. Two clinical cases illustrate situations where a predominant focus is on one or the other of these tracks. Ultimately, the Two-Track Model of Bereavement's use extends to the organization and clarification of theory, research, and clinical work.

<a name="Abs1"></a>A family of scaling corrections aimed to improve the chi-square approximation of goodness-of-fit test statistics in small samples, large models, and nonnormal data was proposed in Satorra and Bentler (1994). For structural equations models, Satorra-Bentler's (SB) scaling corrections are available in standard computer software. Often, however, the interest is not on the overall fit of a model, but on a test of the restrictions that a null model say<i>M</i> ₀ implies on a less restricted one<i>M</i> ₁. If<i>T</i> ₀ and<i>T</i> ₁ denote the goodness-of-fit test statistics associated to<i>M</i> ₀ and<i>M</i> ₁, respectively, then typically the difference<i>T</i> _<i>d</i>=<i>T</i> ₀&#8722;<i>T</i> ₁ is used as a chi-square test statistic with degrees of freedom equal to the difference on the number of independent parameters estimated under the models<i>M</i> ₀ and<i>M</i> ₁. As in the case of the goodness-of-fit test, it is of interest to scale the statistic<i>T</i> _<i>d</i> in order to improve its chi-square approximation in realistic, that is, nonasymptotic and nonormal, applications. In a recent paper, Satorra (2000) shows that the difference between two SB scaled test statistics for overall model fit does not yield the correct SB scaled difference test statistic. Satorra developed an expression that permits scaling the difference test statistic, but his formula has some practical limitations, since it requires heavy computations that are not available in standard computer software. The purpose of the present paper is to provide an easy way to compute the scaled difference chi-square statistic from the scaled goodness-of-fit test statistics of models<i>M</i> ₀ and<i>M</i> ₁. A Monte Carlo study is provided to illustrate the performance of the competing statistics.

pAbstract/p pBackground/p pIn the period following wars and other forms of armed conflict, health and quality of life of mothers is a major concern as they have the closest contact with children. The present study was performed to examine the impact of exposure to events related to armed conflicts on post traumatic stress disorder (PTSD) among women raising children, and to identify factors that alleviate the negative consequences of exposure to traumatic events./p pMethods/p pA structured interview survey was conducted in Kabul Province, Afghanistan, in 2006. The subjects were the mothers of children less than 5 years old randomly selected from 1400 households in Kabul Province, Afghanistan. Symptoms of PTSD were assessed according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Exposure to traumatic events related to armed conflict, experience of hardship with regard to basic needs, resources that the subjects seek for mental health support, and socioeconomic variables were evaluated. Logistic regression analysis was performed to determine the association between PTSD symptoms and predictor variables./p pResults/p pThe prevalence rate of PTSD among 1172 women participated in this study was 29.8%. The most prevalent symptom was arousal (74.8%), followed by re-experiencing (54.9%) and avoidance (33.7%). The prevalence rate of PTSD symptoms among subjects who reported having experienced at least one event related to armed conflict (52.7%) was significantly higher than that among those who reported no such experiences (9.6%). Experience of food shortage was independently associated with PTSD. Seeking support for mental health was related to lower prevalence of PTSD symptoms among those who reported no direct experience of events related to armed conflict. However, no such relationship was observed with PTSD symptoms among those who reported having direct experience of events related to armed conflict./p pConclusion/p pDirect exposure to traumatic events was significantly associated with PTSD symptoms among women raising children. For those who had experienced armed conflict-related events, food security mitigated the occurrence of PTSD symptoms; however, support seeking behavior did not show a significant mitigating influence on PTSD. Means to alleviate the negative influence of exposure to armed conflicts on the quality of life of women should be developed from the viewpoint of quality of mental health support and avoidance of material hardship./p

Much of the debate surrounding the dimensionality of PTSD relates to three specific Hyperarousal symptoms (D1–D3) and whether they are appropriate indicators of one of two broad constructs that constitute PTSD: Dysphoria or Hyperarousal. This study addressed this issue by testing a series of confirmatory factor models to determine which factor, or factors, these symptoms measured the strongest. Data from individuals who satisfied the conditions for Criterion A of the diagnostic criteria for a DSM-IV diagnosis of PTSD ( n = 12,467) in the 2004–2005 NESARC were used in the analysis. The results revealed that the D1–D3 symptoms were not clear indicators of either factor, but measured both Dysphoria and Hyperarousal. Two symptoms, however, loaded more highly on the Dysphoria, rather than Hyperarousal, factor. The present findings lend support to the factor model proposed by Simms et al. [Simms, L. J., Watson, D., & Doebbeling, B. N. (2002). Confirmatory factor analyses of posttraumatic stress symptoms in deployed and non-deployed veterans of the Gulf War. Journal of Abnormal Psychology, 111, 637–647] but also question the use of symptoms that are not unique indicators of specific factors.

Confirmatory factor analysis was used to compare 6 models of posttraumatic stress disorder (PTSD) symptoms, ranging from 1 to 4 factors, in a sample of 3,695 deployed Gulf War veterans (N = 1,896) and nondeployed controls (N = 1,799). The 4 correlated factors-intrusions, avoidance, hyperarousal, and dysphoria-provided the best fit. The dysphoria factor combined traditional markers of numbing and hyperarousal. Model superiority was cross-validated in multiple subsamples, including a subset of deployed participants who were exposed to traumatic combat stressors. Moreover, convergent and discriminant validity correlations suggested that intrusions may be relatively specific to PTSD, whereas dysphoria may represent a nonspecific component of many disorders. Results are discussed in the context of hierarchical models of anxiety and depression.

Abstract People confronted with homicidal loss have to cope with separation distress, related to their loss, and traumatic distress, associated with the circumstances surrounding the death. These reactions are related to complicated grief (CG) and posttraumatic stress disorder (PTSD). The psychological effects for people who have lost someone through homicide, in terms of PTSD and CG, are largely unclear. This cross-sectional study (a) examined the prevalence of self-rated PTSD and self-rated CG in a community-based sample of 312 spouses, family members, and friends of homicide victims and (b) aimed to identify socio-demographic, loss-related, and perpetrator-related correlates of PTSD and CG. Participants were recruited via support organizations for homicidally bereaved individuals in the Netherlands (i.e., support group), and by casemanagers of a governmental organization, which offers practical, non-psychological, support to bereaved families (i.e., casemanager group). Prevalence of self-rated PTSD was 30.9% (support group) and 37.5% (casemanager group), prevalence of CG was 82.7% (support group) and 80.6% (casemanager group). PTSD and CG severity scores varied as a function of the relationship with the victim; parents were at greater risk to develop emotional problems, compared with other relatives of the victim. Time since loss was negatively associated with PTSD and CG scores. The Author(s) 2014.

Genetic factors are important in the development of posttraumatic stress disorder (PTSD) following exposure to traumatic events. However, the molecular genetic underpinnings of this disorder remain largely unresolved. The present study investigated the association between ADCYAP1R1 rs2267735 genotype and PTSD symptoms in a highly traumatized sample of Chinese adults. Participants included 326 victims who experienced 2008 Wenchuan earthquake and lost their children during the disaster. PTSD symptoms were assessed with the PTSD Checklist (PCL). The ADCYAP1R1 rs2267735 SNP was genotyped with the Sequenom iPlex chemistries and the MassARRAY system. The results indicated that although the rs2267735 ‘CC’ genotype was not associated with total PTSD symptoms, it could significantly predict severity of PTSD's emotional numbing symptoms in women. A relatively small sample exposed to specific traumatic events was used, and PTSD was assessed using a self-reported instrument. The findings suggest that the PACAP–PAC1 receptor pathway may play an important role in female human responses to traumatic stress, and carry implications for better understanding and treating of posttraumatic psychopathology.

Abstract) and the four-factor dysphoria model Simms et al. (Journal of Abnormal Psychology 111:637鈥647, ). Further examination of the external convergent and discriminant validity revealed that except for the dysphoric arousal factor, the remaining four PTSD factors yielded significantly different correlations with external measures of anxiety vs. depression. The findings add to the limited literature on the factor structure of PTSD in youths and on the five-factor PTSD model. In addition, they provide more detail into the latent psychopathological processes of PTSD, and inform the forthcoming DSM-5.

Objective:This research aimed to explore the prevalence of Post-traumatic Stress Disorder(PTSD) and its symptoms classification among Chinese HIV-positive patients.Methods:Ninety-one(sample 1) and 366 HIV-positive patients(sample 2) completed the Traumatic Events Questionnaire and PTSD Checklist-Civilian Version(PCL-C).The Structured Clinical Interview for DSM-IV AXIS I Disorders(SCID-I) was conducted in sample 1.In sample 2,confirmatory factor analysis was performed to test three competitive models.Results:1The optimal cut-off point of PCL-C for PTSD in HIV sample was 44,with the sensitivity of 0.842,the specificity of 0.906 and the diagnostic efficiency of 0.94.The prevalence of PTSD was 41.80%.2The inter-correlated four-factor model was the best fit for the data.Conclusion:The prevalence of PTSD in HIV-positive people was rather high and the PTSD symptoms classification was best described by the four-factor model,indicating a fairly good cross-sample validation of this model.

目的:本研究考察我国艾滋病感染者中创伤后应激障碍的发病率及其症状结构。方法:样本1为云南省HIV感染者91名,样本2为该省和北京HIV感染者366名,施测自编创伤事件问卷及创伤后应激障碍检查表(PCLC),用DSM-Ⅳ轴Ⅰ障碍定式临床检查病人版(SCID-I)访谈对样本1被试进行诊断评估,确定PCL-C区分PTSD的分界点;用验证性因素分析比较PTSD症状结构的3个竞争模型。结果:1再体验-回避-麻木-警觉一阶四因子模型拟合最优;2PCL-C区分HIV感染者罹患PTSD的最佳分界点为44分,对应敏感度0.842,特异度0.906,诊断效能0.94,样本1中PTSD发病率为41.80%。结论:PTSD在HIV感染者人群中发病率高,PCL-C在该人群中呈一阶四因子一阶相关结构,提示该种症状分类具有跨样本一致性。

Recent work has focused on explicating the relations among the current mood and anxiety disorders. This research has yielded some important findings (e.g., the very strong link between generalized anxiety disorder and the unipolar mood disorders). I discuss problems associated with disorder-based analyses, however, and I argue that they need to be supplemented by examining relations among the specific symptom dimensions within these diagnostic classes. I demonstrate that two quantitative elements need to be considered when analyzing the properties of symptoms-the level of specificity and the magnitude of the general distress variance. These quantitative elements can be used to organize relevant symptoms into four groups (i.e., a quadripartite model) that reflect varying combinations of distress and specificity I illustrate the value of this approach by reviewing the properties of the major symptom dimensions within posttraumatic stress disorder, obsessive-compulsive disorder, and major depression.

Posttraumatic Stress Disorder (PTSD) has been repeatedly linked to changes in glucocorticoid (GC) sensitivity. To increase our understanding of this phenomenon and its potential relevance for PTSD development and treatment, the current study investigates the interplay between two key moderators, glucocorticoid receptor (GRα) and GR co-chaperone FKBP5, and their relation to GC sensitivity. A GC sensitivity assay was performed in 52 Bosnian war refugees (19m; 40.8±8.7 years) clinically diagnosed with PTSD to divide the patient group into a high (HS) and a low (LS) GC sensitivity group. Expression of GRα and FKBP5 mRNA was quantified by real-time RT-PCR. Links between gene expression and GC sensitivity were driven by the HS group of PTSD patients, which also showed increased expression of GRα but not FKBP5 compared to the LS group. Further, expressions of FKBP5 and GRα were strongly correlated in the HS patient group, while this association was missing in the LS PTSD group. Our findings suggest that PTSD phenotypes may be characterized by differences in intracellular signaling transduction processes. The associations of expression of GRα and FKBP5 in the high-sensitive PTSD subgroup may thereby reflect physiological adaptation to preserve immune-relevant GC signaling. Further research is needed to understand the role and consequences of GRα-FKBP5 dissociation in low GC sensitivity PTSD patients.

Objective:To explore the prevalence of posttraumatic stress disorder(PTSD),the mental health problem,and the correlates of them in women who were exposed to Wenchuan earthquake.Methods:The PTSD Check List-Civilian Version(PCL-C),Social Support Rating Scale(SSRS) and General Health Questionnaire(GHQ-28) were used to investigate 99 women who were exposed to Wenchuan earthquake(47 experienced bereavements in earthquake,52 did not experienced bereavements).Results:①There were significant differences of the detectable rates of PTSD and mental health problem between the women who experienced bereavements and did not.②There was a significant positive correlation between PCL-C and the GHQ-28 overall score and every dimension.③There was a significant main effect of bereavement status on overall score and every dimensions of post-traumatic stress disorder.④Social support was a protective factor for PTSD symptoms and mental health problems in women who exposed to Wenchuan Earthquake,and the bereavement was a risk factor.

Interpersonal self-support is a personality factor that is believed in China to protect against distress. This study explored the relation among interpersonal self-support, venting coping, and posttraumatic stress disorder (PTSD) symptoms in a sample of 311 15 to 1602year-olds students 1802months after the Wenchuan earthquake using the Interpersonal Self-Support Scale for Adolescent Students (ISSS-AS), the Coping Style Scale of Middle School Students (CSSMSS), and the Impact of Event Scale-Revised (IES-R). As expected, a moderation model was not supported and venting coping mediated the effect of low interpersonal responsibility ( b 65=65610.11, p 65<650.001) and low interpersonal openness ( b 65=65610.08, p 65<650.001) on PTSD symptoms. Interpersonal independence was inversely related to PTSD symptoms. Overall, the current findings supported the venting coping mediation model with regard to the relationship between interpersonal self-support traits and PTSD symptoms, and have contributed to current knowledge with respect to the relation of personality, venting coping and PTSD symptoms.

目的：考察极重灾区妇女创伤后应激症状、心理健康问题的发生特点及影响因素。方法：对汶川地震极重灾区99名妇女（47名地震中丧亲妇女,52名未丧亲妇女）采用创伤后应激障碍检查表平民版（PCL-C）、社会支持量表（SSRS）和一般健康问卷（GHQ28）进行测查。结果：①）极重灾区妇女PTSD总检出率37.4%,丧亲妇女检出率55.3%,未丧亲妇女21.1%,心理健康问题总检出率79.8%,丧亲妇女检出率为89.3%,未丧亲妇女检出率71.2%,丧亲妇女检出率均显著高于未丧亲妇女。文化程度不同的妇女PTSD检出率有显著差异。②总体PCL-C与GHQ-28测量结果之间各维度均呈现显著正相关。③丧亲状况的主效应显著,丧亲妇女和未丧亲妇女之间创伤后应激症状总分及各维度分数均存在显著差异。④丧亲是极重灾区妇女PTSD症状和心理健康的危险因素;社会支持是保护性因素。

独生子女的死亡使失独者陷入急性应激障碍(ASD)之中,如果缺乏及时的专业干预,三个月后便进入创伤后应激障碍(PTSD)阶段。中国特殊的社会文化背景和人际关系结构,往往使他们的病情在外部文化情境等结构性压力和核心依恋对象死亡等心理依恋断裂的双重作用下,发展演化为重度创伤后应激障碍。因此,除了从源头上优化失独人群生活的人文情境以外,失独危机事件的应激管理、依恋关系重建为导向的心理治疗,是预防和治疗失独人群重度创伤后应激障碍的主要途径。

目的:探讨突发群体事件后社区居民创伤后应激障碍(PTSD)和抑郁症发病的相关因素.方法:乌鲁木齐市 某突发群体事件后2个月,对事发地之一沿街社区年龄≥15岁的居民931人进行调查.由精神科医生以美国精神障碍诊断与统计手册第4版修订版(DSM-Ⅳ -TR)轴Ⅰ障碍临床定式检查患者版进行检查,使用DSM-Ⅳ对各类精神障碍进行诊断,计算PTSD和抑郁症的检出率.用创伤后应激障碍筛查表 (PTSD7)、艾森克人格问卷(EPQ)和应付方式问卷(CSQ)评估应激症状和人格及应付方式,分析PTSD和抑郁症发病的相关因素.结果:PTSD 检出率为13.5％,抑郁症为8.7％,排在所有精神障碍检出率的前两位.将931人按诊断结果分4组,即无病组(n =705)、PTSD组(n=72)、抑郁症组(n=28)和PTSD抑郁症共病组(n=53).无病组EPQ神经质得分小于其他3组 [(5.8±4.8) vs.(10.6±5.1),(10.9±4.9),(14.0±5.2)],PTSD组和抑郁症组小于共病组(均P＜0.01).无病组的CSQ退避、 幻想、自责、合理化4个因子得分均低于其他3组,共病组的自责因子得分高于其他3组,无病组和抑郁症组的求助因子得分高于共病组.Logistic回归分 析显示,年龄大、事发时暴露程度高,神经质、掩饰性和自责得分高者更容易出现PTSD(OR=1.03 ～ 3.95)和抑郁症(OR=1.04 ～4.33).结论:突发群体事件后社区居民PTSD和抑郁症检出率较高,心理创伤后PTSD和抑郁症发病的危险因素有年龄大、事发时暴露程度高,以及较 高水平的神经质、掩饰性和自责.

To assess whether having a subsequent child had an effect on the mental health of Chinese mothers who lost a child during an earthquake.A cross-sectional survey of bereaved mothers was conducted 30 to 34 months after the 2008 Sichuan earthquake using individual structured interviews to assess sociodemographic characteristics, post-disaster experiences and mental health. The interviews incorporated standardized psychometric measures of anxiety, depression, post-traumatic stress disorder (PTSD) and complicated grief (CG). Social support was also assessed. An adjusted model taking potential confounders into account was used to explore any association between psychological symptoms and the birth of a subsequent child.The prevalence of psychological symptoms was higher in mothers who did not have a child after losing the first one. In an adjusted model, symptoms of anxiety (odds ratio, OR: 3.37; 95% confidence interval, CI: 1.51-7.50), depression (OR: 9.47; 95% CI: 2.58-34.80), PTSD (OR: 5.11; 95% CI: 2.31-11.34) and CG (OR: 10.73; 95% CI: 1.88-61.39) were significantly higher among the 116 women without a subsequent child than among the 110 mothers who had another child after bereavement. More than two thirds of the mothers with new infants had clinically important psychological symptoms.Women who have lost an only child in a natural disaster are especially vulnerable to long-term psychological problems, especially if they have reached an age when conception is difficult. Research should focus on developing and evaluating interventions designed to provide women with psychosocial support and reproductive services.

目的:对创伤后应激障碍(PTSD)的相关文献进行内容分析.方法:计算机检索知网、万方、贵州数字图书馆等数据库,收集2004年1月-2014年9月关于PTSD的相关文献.由3名研究者独立对文献进行筛选、编码和制作类目表,并根据类目表进行内容分析.结果:最终确定54篇硕士论文,10篇博士论文和710篇期刊文献为内容分析样本.2010年PTSD研究论文数量达到顶峰,共118篇;关注研究对象的文献共531篇、研究症状345篇、创伤类型408篇、影响因素528篇、发病机制136篇、治疗方法198篇.其中,以社会人员为研究对象的文献占72.13％,多方面综合症状的文献占55.36％,创伤类型为自然灾害的文献占46.81％,影响因素为综合因素的文献占26.89％,发病机制为生理机制的文献占74.27％,治疗方法为心理治疗的文献占45.96％.结论:创伤后应激障碍的患病对象范围广、影响因素多,研究注重多方面综合症状、自然灾害创伤类型、生物学发病机制以及心理治疗.

Abstract Converging lines of evidence have called into question the validity of conceptualizations of posttraumatic stress disorder (PTSD) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 2000) and suggested alternative structural models of PTSD symptomatology. We conducted a meta-analysis of 40 PTSD studies (N = 14,827 participants across studies) that used a DSM-based measure to assess PTSD severity. We aggregated correlation matrices across studies and then applied confirmatory factor analysis to the aggregated matrices to test the fit of competing models of PTSD symptomatology that have gained support in the literature. Results indicated that both prominent 4-factor models of PTSD symptomatology yielded good model fit across subsamples of studies; however, the model comprising Intrusions, Avoidance, Hyperarousal, and Dysphoria factors appeared to fit better across studies. Results also indicated that the best fitting models were not moderated by measure or sample type. Results are discussed in the context of structural models of PTSD and implications for the diagnostic nosology. PsycINFO Database Record (c) 2010 APA, all rights reserved

This study investigated the psychological reactions of survivors of the 512 Wenchuan earthquake in China and the risk factors associated with those reactions. The Impact of Event Scale-Revised (IES-R), Type D Scale-14 (DS14), a self-developed trauma experience questionniare, and a demographic questionnaire were administered to 956 earthquake survivors (389 males and 567 females) in Mianzhu, one of the cities most affected by the earthquake. The results showed that postraumatic stress disorder (PTSD) symptoms affected 84.8% of survivors one to two months after the earthquake. Significant risk factors associated with PTSD symptoms included: (1) being female; (2) older age; (3) higher exposure to traumatic events during the earthquake; and (4) negative affect in Type-D personality.

Objective:To investigate the prevalence and related factors of post-traumatic stress disorder(PTSD) among community residents after the Wenchuan Earthquake,and to provide the information for the psychological and medical intervention.Methods:A total of 820 community residents aged 12 years or older were randomly selected from 2 large communities in Anxian and Shifang cities.The demographic situation and health state were collected the subjects were assessed with the PTSD Checklist-Civilian Version(PCL-C) and Perceived Social Support Scale(PSSS).The diagnosis of PTSD were made with the Diagnostic and Statistical Mental Disorders(IV Edition) criteria.Results:Among the 820 retrieved questionnaires,785 were valid.In the 785 questionnaires,male to female ratio was 1:1.41,and the mean age was(43±18)years;26.0% of subjects suffered from physical diseases,28.4% had drinking habits before the earthquake,and 23.6% had drinking behavior after earthquake.The mean score of PSSS was(61.05±10.54),and there were no significant differences in PSSS score between different age groups.The prevalence of PTSD in this sample was 12.4%(97/785).Logistic regression analysis showed that female(OR=2.070,95% CI:1.274～3.365),experience of being buried(OR=2.806,95%CI:1.249 ～6.306),losing relatives(OR=1.537,95%CI:1.087～2.173),and low PSSS score(OR=0.961,95%CI:0.941～0.979) were the risk factors for PTSD.Conclusion:In the post-disaster reconstruction process,the community residents suffer from the psychological problems after the earthquake.Female,experience of being buried,losing relatives,and low PSSS score may be the risk factors for PTSD and should be paid more attention.

The problem of common method biases has being given more and more attention in the field of psychology, but there is little research about it in China, and the effects of common method bias are not well controlled. Generally, there are two ways of controlling common method biases, procedural remedies and statistical remedies. In this paper, statistical remedies for common method biases are provided, such as factor analysis, partial correlation, latent method factor, structural equation model, and their advantages and disadvantages are analyzed separately. Finally, suggestions of how to choose these remedies are given.

The problem of common method biases has being given more and more attention in the field of psychology, but there is little research about it in China, and the effects of common method bias are not well controlled. Generally, there are two ways of controlling common method biases, procedural remedies and statistical remedies. In this paper, statistical remedies for common method biases are provided, such as factor analysis, partial correlation, latent method factor, structural equation model, and their advantages and disadvantages are analyzed separately. Finally, suggestions of how to choose these remedies are given.

目前国家对独生子女死亡家庭的扶助措施存在支持力度偏弱、覆盖程度不足的问题。文章以中国现存独生子女总量结构估计为出发点,对城乡独生子女规模、死亡风险、死亡人数、49岁以上失独父母人数、城乡失独家庭扶助标准进行分析,结果显示,目前农村的独生子女总量低于城镇,但每个年龄段的农村人口死亡概率都高于城镇,导致农村失独家庭规模大于城镇。文章建议国家提高现行的失独家庭扶助标准,并对农村和城镇失独家庭采取同样的保障标准,地方财政可以在国家扶助制度之外进一步对失独家庭进行扶助。

AbstractTo examine the underlying substructure of DSM-5 PTSD in an adolescent sample, this study used a confirmatory factor analysis alternative model approach to assess 813 adolescents two and a half years after the Ya'an earthquake. Participants completed the PTSD Checklist for DSM-5, the Center for Epidemiologic Studies Depression Scale for Children, and the Screen for Child Anxiety Related Emotional Disorders. The results found that the seven-factor hybrid PTSD model entailing intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal had significantly better fit indices than other alternative models. Depression and anxiety displayed high correlations with the seven-factor model. The findings suggested that the seven-factor model was more applicable to adolescents following the earthquake, and may carry important implications for further clinical practice and research on posttraumatic stress symptomatology.

为考察地震后青少年创伤后应激障碍(PTSD)的潜在症状结构,本研究采用儿童创伤后应激障碍症状量表和儿童抑郁量表,对汶川地震一年后的746名中学生进行调查。利用验证性因素分析对竞争模型进行比较,结果发现包括侵入性、回避性、麻木性、精神痛苦性唤起和焦虑性唤起等5个症状的PTSD精神痛苦性唤起模型显著优于DSM-IV的PTSD模型、4维情感麻木模型和4维精神痛苦模型。效度分析的结果发现,PTSD精神痛苦性唤起模型具有良好的外部区分效度。所有结果均表明PTSD精神痛苦性唤起模型在汶川地震后青少年群体中具有良好的适用性,可以作为判定震后青少年PTSD症状的有效标准。

The Yaan earthquake in 2013,another destructive natural disaster that occurred in Sichuan,China after the Wenchuan earthquake in 2008,has caused widespread loss of life and property.Adolescent survivors of this earthquake experienced significant psychological reactions,and posttraumatic stress disorder(PTSD) is often considered to be the most frequent one in the aftermath of disasters.Many researchers,to date,have examined the reason for the high prevalence of PTSD,and found that the severity of traumatic exposure was a precondition of PTSD.However,not all the traumatized people been exposed to traumatic events would experience PTSD.This can be attributed to the differences in cognitive reaction.The shattered world assumption suggests that the extent of core beliefs being challenged by traumatic event can activate the development of different cognitive reactions and elicit the development of PTSD.According to the cognitive evaluation theory,people exposed to traumatic events can also take different strategies to cope the traumatic clues,and negative coping strategies,such as intrusive rumination,are important risk factors for PTSD.What calls for special attention is that both the shattered world assumption and the cognitive evaluation theory emphasize the effect of cognition after traumatic exposure in the developing process of PTSD,and they also share the same limit in clinical intervention for PTSD by ignoring the role of emotion.Thus,some researchers suggest that more attention should be paid to people's emotive reactions,such as fear,in the PTSD study.And based on the model of fear network,traumatic exposure can make people experience more fear for the trauma,which may in turn increase the likelihood of the appearance of PTSD.While traumatic exposure,core beliefs challenge,intrusive rumination and subjective fear were theoretically speculated as important risk factors,the specific paths how traumatic exposure elicits PTSD by these factors are unclear.Furthermore,the predictive utility of these risk factors has not been evaluated in an integrated model,and the relationship between cognitive reactions and emotive reactions in the developing process of PTSD has not been examined.In addition,previous researchers mainly studied the general adults or college students,and few focused on the adolescent survivors after disaster.Regarding the above limitations,the current study aimed to explore the role of core beliefs challenge,intrusive rumination,and subjective fear in the association between traumatic exposure and PTSD among adolescent survivors six months after the Yaan earthquake.310 adolescent survivors were selected from several junior and senior middle schools in the county of Lushan,the area most severely affected by the Yaan earthquake.Participants completed Traumatic Exposure Questionnaire,Subjective Fear Questionnaire,Core Beliefs Inventory,The Event Related Rumination Inventory and The Revised Child PTSD Symptom Scale six months after the Yaan earthquake.The results found that both the mean level and the prevalence of PTSD were relatively low.The mean level of PTSD of male students was lower than that of female students,and the mean level of PTSD of grade 1 students in senior middle school was higher than that of all the other grade students who participated in the survey.The analysis of structural equation model found that the severity of traumatic exposure had positive effect on PTSD by core beliefs challenge and by that via the multiple mediator effect of intrusive rumination.Moreover,traumatic exposure could positively affect PTSD by the severity of subjective fear via the multiple mediator effect of intrusive rumination.However,the severity of traumatic exposure had no effect on PTSD by intrusive rumination or subjective fear.

采用创伤暴露程度问卷、核心信念量表、主观害怕程度问卷、反刍问卷和创伤后应激障碍问卷,以雅安地震6个月后的310名中学生为被试,考察其创伤暴露程度、核心信念挑战、主观害怕程度、侵入性反刍与创伤后应激障碍之间的关系。结果发现,雅安地震6个月后青少年的创伤后应激障碍的发生率及整体水平较低,其中男生水平低于女生,高一年级学生水平相对高于初一、初二和高二年学生。结构方程模型的结果显示,创伤暴露程度可以通过核心信念挑战对创伤后应激障碍起正向预测作用,也可以通过核心信念挑战经侵入性反刍的多重中介来正向预测创伤后应激障碍;创伤暴露程度还可以通过主观害怕程度经侵入性反刍的多重中介来正向预测创伤后应激障碍。但是创伤暴露程度不能直接通过侵入性反刍预测创伤后应激障碍,也不能通过主观害怕程度直接预测创伤后应激障碍。

Objective:To explore the mediating role of depression and caregivers' distress in the relationship between posttraumatic stress disorder and quality of life in women with breast cancer.Methods:A total of 221 patients were surveyed with PTSD Symptom Scale,Functional Assessment of Cancer Therapy-Breast and Patient Health Questionnaire-9;using Caregiver Self-assessment Questionnaires to test their primary caregivers.Results:(1)The incidence of PTSD in patients with breast cancer was 7.2%;(2)PTSD could directly affect the quality of life in patients with breast cancer(尾=-0.59,t=-10.72,P0.001),depression and caregivers' stress exerted mediating effects on the relationship between PTSD and quality of life.The confidence interval from Bootstrap output were 95%[-0.19,-0.10]and 95%[-0.10,-0.01].Conclusion:The depression of breast cancer patients and the pressure of their caregivers are important factors in patients with PTSD affecting the quality of life.In order to improve the quality of life of patients,we should not only pay more attention to improve the patients' depression,but also to alleviate primary caregivers' psychological pressure in the treatment and rehabilitation process in women with breast cancer.