Abstract：
Few studies have examined changes in posttraumatic-stress disorder (PTSD) symptomatology across an extended time period during the COVID-19 pandemic. This study used a longitudinal cohort design to examine: (1) changes in overall PTSD symptoms and symptom clusters; (2) moderators of change; (3) the clinical significance of observed changes; and (4) correlates of clinically meaningful changes. Community adults (N = 1412) were assessed using the PTSD Checklist for DSM-5 (PCL-5) at 10 timepoints (October 2018 - April 2022). Changes in overall PCL-5 score and symptom clusters were substantially moderated by pre-pandemic clinical severity (i.e., above/below PCL-5 cut-off). Pre-pandemic non-clinical participants exhibited increases in overall scores, Cluster D (negative cognitions), and Cluster E (arousal), while clinically elevated participants exhibited decreases overall and in all clusters. Regarding clinical significance, 12% of pre-pandemic non-clinical participants exhibited clinically meaningful increases, and 4% exhibited decreases. Conversely, 42% of the pre-pandemic elevated group exhibited clinically meaningful decreases, while 6% exhibited increases. Pandemic impacts in numerous psychosocial domains were associated with clinically meaningful change. Collectively, these findings reveal substantively divergent trajectories by pre-pandemic severity and PTSD symptom cluster. The large proportion of pre-pandemic high-severity participants exhibiting sizable decreases was an unexpected notable observation.
摘要：
很少有研究检查在COVID-19大流行期间，创伤后应激障碍(PTSD)症状学在很长一段时间内的变化。这项研究使用纵向队列设计来检查：（1）总体PTSD症状和症状群的变化；（2）变化的调节因素；（3）观察到的变化的临床意义；（4）临床意义变化的相关性。在10个时间点（2018年10月至2022年4月）使用DSM-5（PCL-5）的PTSD清单评估社区成年人（N=1412）。总体PCL-5评分和症状群的变化基本上受到大流行前临床严重程度的影响(即，高于/低于PCL-5截止值)。大流行前非临床参与者的总分增加，群集D（负认知），和集群E（唤醒），而临床升高的参与者表现出整体和所有集群的下降。关于临床意义，12%的大流行前非临床参与者表现出临床意义的增加，4%表现出下降。相反，42％的大流行前升高组表现出临床意义的下降，而6%的人表现出增长。许多社会心理领域的大流行影响与临床意义的变化有关。总的来说，这些发现通过大流行前的严重程度和PTSD症状群揭示了实质上不同的轨迹.大流行前高严重性参与者的很大一部分表现出相当大的下降是一个意想不到的值得注意的观察结果。
