大学生复杂性创伤后应激障碍的网络结构及其性别差异研究

Complex Post-Traumatic Stress Disorder in College Students:Examining Network Structure and Gender Differences

为了解大学生复杂性创伤后应激障碍(CPTSD)的结构特征及其性别差异,采用国际创伤问卷调查了813位大学生。网络分析结果发现回避想法、高警觉和失败感是CPTSD网络中心性最高的症状,男女网络整体连通性之间没有显著差异,但个别症状的局部连通性及其中心性排序存在较大差异。在男生中,高警觉、难以保持亲密感情是中心性最高的症状;在女生中,回避想法、失败感和难以保持亲密感情是中心性最高的症状;无价值感和失败感的局部连通性在男女之间的差异较大。这些结果拓展了以往CPTSD的性别差异研究,说明了CPTSD的网络结构存在性别差异。在具体的CPTSD干预中,可以将回避想法和失败感作为女大学生的靶点症状进行干预,将高警觉作为男大学生的靶点症状进行干预。

Prior studies have suggested that college students always report multiple traumatic experiences,such as childhood traumatic experiences(e.g.abuse and neglect).Suffering from these experiences may lead to negative psychological outcomes,including depression,post-traumatic stress disorders,and complex post-traumatic stress disorder(CPTSD).These outcomes,CPTSD in particular,may continue to exist for many years or lifetime for traumatized college students.The aim of this study was to examine college students’CPTSD and compare gender differences in its structure by using network analysis.To be specific,CPTSD is expected to occur after exposure to prolonged and repeated interpersonal traumatic events.Its symptoms include not only the core symptoms of PTSD(e.g.,re-experience,avoidance and sense of threat),but also three symptoms of disturbance in self-organization(DSO),including affective dysregulation,disturbances in relationships,and negative self-concept.The impact of gender on CPTSD is controversial,and relevant research is confined to the comparison of the incidence or severity of CPTSD,but few studies have focused on the differences in its inherent symptoms and their connectivity.To understand the structural characteristics of CPTSD among college students and potential gender differences,this study used the International Trauma Questionnaire(ITQ)to evaluate CPTSD among 813 college students,and used the method of network analysis.First,the CPTSD symptom network of college students was constructed and the centrality of each symptom was estimated.It was found that internal reminders,being on guard and failure were the most strongly connected symptoms of the CPTSD network among college students.Second,the CPTSD symptom networks of male and female college students were constructed and the centrality of each symptom was estimated.It was found that being on guard and difficulty in staying close to others were the most strongly connected symptoms in males,whereas internal reminders,failure and difficulty in staying close to others were the most strongly connected symptoms in females.In addition,the network comparison test was conducted on the CPTSD symptom networks of male and female college students.The results found that there was no significant difference in the overall network connectivity between males and females,but there were significant differences in the local connectivity of individual symptoms,among which sense of worthlessness and failure were the most.These results,on the one hand,expand previous studies on gender differences in CPTSD,indicating that there are gender differences in the network structure of CPTSD.On the other hand,results also provide inspiration for clinical intervention.That is,the differences in CPTSD network structure between male and female students can prompt us to intervene in CPTSD.In college students,internal reminders and sense of failure are used as target symptoms for females to intervene;being on guard is used as target symptoms for males to intervene.