创伤及应激相关障碍的核心特征与治疗  

Core symptoms and treatments of trauma-and stressor-related disorders

作　　者：郝凤仪 张道龙[2] 

机构地区：[1]重庆医科大学附属第一医院,重庆400016 [2]美国伊利诺伊大学精神医学系,芝加哥il60612

出　　处：《四川精神卫生》2018年第1期67-69,共3页Sichuan Mental Health

摘　　要：DSM-5中,创伤及应激相关障碍的代表性疾病是创伤后应激障碍、适应障碍、反应性依恋障碍及脱抑制性社会参与障碍。这组障碍与暴露于创伤性或应激性事件有关。个体可表现焦虑、恐惧症状、快感缺失、烦躁、外化的愤怒和攻击性及分离症状等。创伤后应激障碍发生于经历或目睹创伤性事件之后,存在侵入性症状、回避相关刺激、认知与心境存在负性改变、警觉性增加,且症状持续超过1个月;适应障碍发生于应激源出现后3个月内,表现为超出应有程度的情绪反应或行为变化,应激源或其结果终止后症状持续时间不超过6个月;反应性依恋障碍与脱抑制性社会参与障碍的诊断均需有严重的童年期社会忽略或剥夺史,但前者表现为抑郁及退缩行为,后者表现为脱抑制与缺乏社交边界。创伤及应激相关障碍的治疗方法包括药物治疗和心理咨询等。The category of trauma-and stressor-related disorders include post-traumatic stress disorder( PTSD),adjustment disorder,reactive attachment disorder,disinhibited social engagement disorder and so on. These disorders are associated with exposure to traumatic or stressful events. Individual may show anxiety,fear,anhedonia,dysphoria,externalization of anger or aggression,and dissociation which are common symptoms. PTSD occurs after experiencing or witnessing traumatic events. Symptoms persist for more than one month,including intrusion symptoms,avoidance of relevant stimuli,negative alterations in cognitions and mood,and increased alertness. Adjustment disorder like excessive emotional responses or behavioral changes normally occur within three months of the onset of the stressors,however,symptoms do not persist for more than an additional six months after the stressor or the consequences have terminated. To diagnose reactive attachment disorder and disinhibited social engagement disorder requires the presence of serious social neglect or deprivation experienced in childhood,which with the former represented as depressive symptoms and withdrawn behavior, while the latter contained disinhibition and lack of social boundaries. Psychotropic medication and psychotherapy are the primary methods of treating trauma-and stressor-related disorders.

关 键 词：创伤及应激相关障碍 创伤后应激障碍 适应障碍 反应性依恋障碍 脱抑制性社会参与障碍 诊断 治疗 

分 类 号：R395.5[哲学宗教—心理学]