Personality traits among veterans with posttraumatic stress disorder

Dosadašnja istraživanja su dokazala da više od 45% ratnih veterana s PTSP-om zadovoljava kriterije za jedan PL, dok oko 16% veterana ima 2 ili više PL. 2013. godine APA je objavila DSM-5 u kojem se predlaže novi, alternativni model PL za DSM-5. Kriteriji za PL prema ovom modelu su poremećaji u funkcioniranju i prisutnost patoloških osobina ličnosti koje se ispituju pomoću upitnika PID-5. Patološke crte ličnosti su negativni afektivitet, odvajanje (eng. detachment), antagonizam, dezinhibicija i psihoticizam. Ovaj model nije još istraživan na populaciji hrvatskih ratnih veterana s PTSP-om. U istraživanju provedenom u KBC Rijeka na uzorku od 31 veterana s PTSP-om ispitivali smo osobine ličnosti pomoću PID-5. Rezultate smo uspoređivali s istraživanjem provedenim na američkim ratnim veteranima s PTSP-om i bez PTSP-a (James LM i dr.) i potvrdili smo kako ratni veterani s PTSP-om iskazuju veći stupanj patologije ličnosti i povišene vrijednosti u svim crtama ličnosti. Posebno su izraženi negativni afektivitet, odvajanje i psihoticizam dok je kod američkih ratnih veterana slabije izražen negativni afektivitet, a visoke vrijednosti u domeni dezinhibicije. Proučavajući udjele osobine ličnosti u cjelokupnoj ličnosti izraženi su redom negativni afektivitet, odvajanje, psihoticizam, dezinhibicija te antagonizam dok su kod veterana bez PTSP-a izraženiji dezinhibicija i antagonizam. Negativni afektivitet i odvajanje su primarno internalizirajuće domene i stoga zaključujemo kako hrvatski ratni veterani s PTSP-om češće imaju komorbiditet s internalizirajućim psihičkim poremećajima (depresija) te veću učestalost izbjegavajućeg, opsesivno-kompulzivnog i shizotipnog PL. Alternativni model PL za DSM-5 pruža priliku za bolji, individualni pristup pacijentu te za razumijevanje i liječenje prisutnih komorbiditeta, što se ne odnosi samo na PL nego na sve psihijatrijske poremećajePrevious research had shown that more than 45% of war veterans with PTSD meet the criteria for a single PD, while about 16% of veterans have 2 or more PDs. In 2013, APA released DSM-5, proposing a new, alternative PD model for the DSM-5. The criteria for PD according to this model are personality dysfunction and the presence of pathological personality traits that are examined using the PID-5 inventory. Pathological personality traits are negative affect, detachment, antagonism, disinhibition and psychoticism. This model hasn't yet been studied in the population of Croatian war veterans with PTSD. In a study conducted in KBC Rijeka on a sample of 31 veterans with PTSD, we examined personality traits using PID-5. We compared the results with a study conducted on American war veterans with and without PTSD (James LM et al.) and confirmed that war veterans with PTSD exhibit a higher degree of personality pathology and elevated values in all personality traits. Negative affectivity, separation and psychoticism are particularly elevated in Croatian war veterans, while American war veterans have lower values for negative affect but higher values in the domain of disinhibition. By studying the proportions of personality traits in the overall personality, negative affectivity, detachment, psychoticism, disinhibition and antagonism were expressed in that order, while in veterans without PTSD, disinhibition and antagonism have higher proportions. Negative affectivity and separation are primarily internalizing domains and therefore we conclude that Croatian war veterans with PTSD are more likely to have comorbidity with internalizing mental disorders (depression) and a higher frequency of avoidant, obsessive-compulsive and schizotypal PD. The alternative PD model provides an opportunity for a better, individual approach to the patient and for understanding and treating the comorbidities present, which applies not only to PL but to all psychiatric disorders