From Aaron：請各位譯者，翻譯時請先在原文段落下複製一段原文，再用譯文逐行取代原文的方式翻譯，以保留參考文獻連結，感謝各位。
英文條目：https://en.wikipedia.org/wiki/Posttraumatic_stress_disorder
目前中文條目：https://zh.wikipedia.org/wiki/創傷後心理壓力緊張症候群
Jan 22 2017整合至中文维基
"PTSD" redirects here. For the album by Pharoahe Monch, see PTSD (album).
Posttraumatic stress disorder (PTSD)[note 1] is a mental disorder that can develop after a person is exposed to a traumatic event, such as sexual assault, warfare, traffic collisions, or other threats on a person’s life.[1] Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in how a person thinks and feels, and increased arousal. These symptoms last for more than a month after the event. Young children are less likely to show distress but instead may express their memories through play.[1] Those with PTSD are at a higher risk of suicide.[2]
’’’創傷後心理壓力緊張症候群’’’（{{lang|en|Posttraumatic stress disorder}}，簡稱’’’PTSD’’’）[note 1]是一種在人經歷創傷事件（例如[[性侵害]]、[[戰爭]]、[[交通事故]]等對生命構成威脅的事件）後可能產生的[[精神疾病]][1]。其症狀包括關於創傷事件的想法、感受或[[夢]]不斷湧現，以至於擾亂正常生活、因接觸與創傷事件相關的線索而產生精神或身體上的不舒服、嘗試去避免與創傷事件相關的暗示、認知與感受的突然改變、以及[[應激狀態]]頻發等。這些症狀往往會在創傷事件發生後持續一個月以上。相較成人，孩童較少出現身心不適的症狀，但對創傷事件的記憶可能會在其與他人的遊戲互動中體現[1] 。創傷後心理壓力緊張症候群的患者的[[自殺]]風險較高[2]。
<!-- Definition and symptoms -->
’’’創傷後心理壓力緊張症候群’’’ (’’’PTSD’’’)<ref group="note">Acceptable variants of this term exist; see the ’’[[#Terminology|Terminology]]’’ section in this article.</ref> 是一種在人經歷創傷事件（例如[[性侵害]]、[[戰爭]]、[[交通事故]]等對生命構成威脅的事件）後可能產生的[[精神疾病]]<ref name=DSM5>{{cite book |author=American Psychiatric Association |year=2013 |title=Diagnostic and Statistical Manual of Mental Disorders |edition=5th |publisher=American Psychiatric Publishing |location=Arlington, VA |pages=271–280 |isbn=978-0-89042-555-8}}</ref>。其症狀包括關於創傷事件的想法、感受或[[夢]]不斷湧現，以至於擾亂正常生活、因接觸與創傷事件相關的線索而產生精神或身體上的不舒服、嘗試去避免與創傷事件相關的暗示、認知與感受的突然改變、以及[[應急狀態]]頻發等<!-- <ref name=DSM5/> -->。這些症狀往往會在創傷事件發生後持續一個月以上<!-- <ref name=DSM5/> --> 。相較成人，孩童較少出現身心不適的症狀，但對創傷事件的記憶可能會在其與他人的遊戲互動中體現<ref name=DSM5/>。創傷後心理壓力緊張症候群的患者的[[自殺]]風險較高<ref name=BMJ2015>{{cite journal|last1=Bisson|first1=JI|last2=Cosgrove|first2=S|last3=Lewis|first3=C|last4=Robert|first4=NP|title="Post-traumatic stress disorder."|journal=BMJ (Clinical research ed.)|date=26 November 2015|volume=351|pages=h6161|pmc=4663500|pmid=26611143}}</ref>
Most people who have experienced a traumatic event will not develop PTSD.[2] People who experience interpersonal trauma (for example rape or child abuse) are more likely to develop PTSD, as compared to people who experience non-assault based trauma such as accidents and natural disasters.[3] About half of people develop PTSD following rape.[2] Children are less likely than adults to develop PTSD after trauma, especially if they are under ten years of age.[4] Diagnosis is based on the presence of specific symptoms following a traumatic event.[2]
Prevention may be possible when therapy is targeted at those with early symptoms but is not effective when carried out among all people following trauma.[2] The main treatments for people with PTSD are counselling and medication.[5] A number of different types of therapy may be useful.[6] This may occur one-on-one or in a group.[5] Antidepressants of the selective serotonin reuptake inhibitor type are the first-line medications for PTSD and result in benefit in about half of people.[7] These benefits are less than those seen with therapy.[2] It is unclear if using medications and therapy together has greater benefit.[2][8] Other medications do not have enough evidence to support their use and in the case of benzodiazepines may worsen outcomes.[9][10]
大多數人不會因經歷創傷事件而罹患創傷後心理壓力緊張症候群[2] 。相對於經歷非人身侵犯性的創傷（例如事故或自然災害），經歷因人際互動而造成的創傷（例如[[強姦]]或[[
待兒童|兒童時期受到虐待]]）的人更容易患病[3] 。約一半經歷被強姦的人事後都會產生此病[2] 。相較成人，兒童（特別是年齡小於十歲的兒童）較不容易罹患創傷後心理壓力緊張症候群[4] 。診斷創傷後心理壓力緊張症候群時，需結合患者在經歷創傷事件後出現的特異性症狀[2]。
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大多數人不會因經歷創傷事件而罹患創傷後心理壓力緊張症候群<ref name=BMJ2015/> 相對於經歷非人身侵犯性的創傷（例如事故或自然災害），經歷因人際互動而造成的創傷（例如[[強姦]]或[[兒童時期受到虐待]]）的人更容易患病<ref name=Zoladz>{{cite journal|last1=Zoladz|first1=Phillip|title=Current status on behavioral and biological markers of PTSD: A search for clarity in a conflicting literature|journal=Neuroscience and Biobehavioral Reviews|date=June 2013|volume=37|issue=5|pages=860–895|doi=10.1016/j.neubiorev.2013.03.024|pmid=23567521}}</ref> 約一半經歷被強姦的人事後都會產生此病<ref name=BMJ2015/>。相較成人，兒童（特別是年齡小於十歲的兒童）較不容易罹患創傷後心理壓力緊張症候群<ref name=UK2005>{{cite web |last=National Collaborating Centre for Mental Health (UK) |title=Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care |layurl=http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0015848/ |laysource=Pubmed Health (plain English) |work=NICE Clinical Guidelines, No. 26 |publisher=Gaskell (Royal College of Psychiatrists) |url=https://www.ncbi.nlm.nih.gov/books/NBK56494/ |year=2005}} {{open access}}</ref>。 診斷創傷後心理壓力緊張症候群時，需結合患者在經歷創傷事件後出現的特異性症狀<ref name=BMJ2015/>。
創傷後心理壓力緊張症候群可通過針對患者的早期症狀進行[[心理治療（針對創傷的行為認知治療）]]以達到預防，但非針對性的干預措施對於預防都是無效的[2] 。目前用於治療創傷後心理壓力緊張症候群的主要方法為心理諮商與藥物治療[5] 。以個人或是群體方式進行的的許多種心理治療方式都對創傷後心理壓力緊張症候群有一定療效[5][6] 。[[選擇性血清素回攝抑制劑(SSRIs)]]類[[抗抑鬱劑]]是治療創傷後心理壓力緊張症候群的一線藥物，約一半的患者在服藥後病情有一定改善[7]。但藥物治療的效果不及心理治療[2]。現仍未明合併藥物與心理治療是否會對患者產生更好的治療效果[2][8]。其他藥物缺乏其用於治療創傷後心理壓力緊張症候群有效的證據，甚至[[苯二氮䓬類藥物]]的使用還會使病情加重[9][10].
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創傷後心理壓力緊張症候群可通過針對患者的早期症狀進行[[心理治療（針對創傷的行為認知治療）]]以達到預防，但非針對性的干預措施對於預防都是無效的<ref name=BMJ2015/> 。目前用於治療創傷後心理壓力緊張症候群的主要方法為心理諮商與藥物治療 <ref name=NIH2016/>。以 [[心理治療|個人]] 或是群體方式進行的的許多種心理治療方式都對創傷後心理壓力緊張症候群有一定療效<ref name=NIH2016/><ref name=Haa2015>{{cite journal|last1=Haagen|first1=JF|last2=Smid|first2=GE|last3=Knipscheer|first3=JW|last4=Kleber|first4=RJ|title=The efficacy of recommended treatments for veterans with PTSD: A metaregression analysis.|journal=Clinical Psychology Review|date=August 2015|volume=40|pages=184–94|pmid=26164548|doi=10.1016/j.cpr.2015.06.008}}</ref> 。[[選擇性血清素回攝抑制劑(SSRIs)]]類[[抗抑鬱劑]]是治療創傷後心理壓力緊張症候群的一線藥物，約一半的患者在服藥後病情有一定改善<ref name=Berg2009>{{cite journal|last1=Berger|first1=W|last2=Mendlowicz|first2=MV|last3=Marques-Portella|first3=C|last4=Kinrys|first4=G|last5=Fontenelle|first5=LF|last6=Marmar|first6=CR|last7=Figueira|first7=I|title=Pharmacologic alternatives to antidepressants in posttraumatic stress disorder: a systematic review.|journal=Progress in neuro-psychopharmacology & biological psychiatry|date=17 March 2009|volume=33|issue=2|pages=169–80|pmid=19141307|doi=10.1016/j.pnpbp.2008.12.004|pmc=2720612}}</ref>。但藥物治療的效果不及心理治療<ref name=BMJ2015/>。 現仍未明合併藥物與心理治療是否會對患者產生更好的治療效果<ref name=BMJ2015>{{cite journal|last1=Bisson|first1=JI|last2=Cosgrove|first2=S|last3=Lewis|first3=C|last4=Robert|first4=NP|title=Post-traumatic stress disorder.|journal=BMJ (Clinical research ed.)|date=26 November 2015|volume=351|pages=h6161|pmid=26611143|pmc=4663500}}</ref><ref>{{cite journal|last1=Hetrick|first1=SE|last2=Purcell|first2=R|last3=Garner|first3=B|last4=Parslow|first4=R|
title=Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD).|journal=The Cochrane database of systematic reviews|date=7 July 2010|issue=7|pages=CD007316|pmid=20614457|doi=10.1002/14651858.CD007316.pub2}}</ref> 其他藥物缺乏其用於治療創傷後心理壓力緊張症候群有效的證據，甚至[[
苯二氮䓬类|苯二氮䓬類藥物]]的使用還會使病情加重<ref name=Gui2015>{{cite journal|last1=Guina|first1=J|last2=Rossetter|first2=SR|last3=DeRHODES|first3=BJ|last4=Nahhas|first4=RW|last5=Welton|first5=RS|title=Benzodiazepines for PTSD: A Systematic Review and Meta-Analysis.|journal=Journal of Psychiatric Practice|date=July 2015|volume=21|issue=4|pages=281–303|pmid=26164054|doi=10.1097/pra.0000000000000091}}</ref><ref name=Hos2015>{{Cite journal | last1 = Hoskins | first1 = M. | last2 = Pearce | first2 = J. | last3 = Bethell | first3 = A. | last4 = Dankova | first4 = L. | last5 = Barbui | first5 = C. | last6 = Tol | first6 = WA. | last7 = van Ommeren | first7 = M. | last8 = de Jong | first8 = J. | last9 = Seedat | first9 = S. | title = Pharmacotherapy for post-traumatic stress disorder: systematic review and meta-analysis. | journal = Br J Psychiatry | volume = 206 | issue = 2 | pages = 93–100 | year = February 2015 | doi = 10.1192/bjp.bp.114.148551 | pmid = 25644881 |quote = Some drugs have a small positive impact on PTSD symptoms}}</ref>
In the United States about 3.5% of adults have PTSD in a given year, and 9% of people develop it at some point in their life.[1] In much of the rest of the world, rates during a given year are between 0.5% and 1%.[1] Higher rates may occur in regions of armed conflict.[2] It is more common in women than men.[5] Symptoms of trauma-related mental disorders have been documented since at least the time of the ancient Greeks.[11] During the World Wars study increased and it was known under various terms including "shell shock" and "combat neurosis".[12] The term "posttraumatic stress disorder" came into use in the 1970s in large part due to the diagnoses of US military veterans of the Vietnam War.[13] It was officially recognized by the American Psychiatric Association in 1980 in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III).[14]
在美國，每年约有3.5%的成人罹患創傷後心理壓力緊張症候群，9%的人則在其一生中某個階段得到[1]。在其他國家其每年發生率約在0.5-1%之間[1]。而在[[武裝衝突]]頻發地區其發生率可能會較此有所上升[2] 。總體來說，生理女性個體的發病率會高於生理男性[5]。迄今對因創傷引起的精神障礙的最早文字記載可追溯至[[古希臘時代]][11] 。[[兩次世界大戰]]使得學界增加對創傷後心理壓力緊張症候群的研究，在此期間與多稱呼也用於代指此疾病，包括[[彈震症]]（又稱：砲彈休克症，英文: shell shock）以及戰爭性神經官能症（英文: combat neurosis）。創傷後心理壓力緊張症候群一稱呼於20世紀70年代開始被使用，這主要是由於[[越南戰爭]]後美國退伍軍人相關疾病診斷的影響[13]。1980年在[[精神疾病診斷與統計手冊]]第三版（DSM-III）中，創傷後心理壓力緊張症候被[[美國精神醫學學會]]認正式認定為一種精神疾病[14]。
<!-- Epidemiology and history-->
在美國，每年约有3.5%的成人罹患創傷後心理壓力緊張症候群，9%的人則在其一生中某個階段得到<ref name=DSM5/>。在其他國家其每年發生率約在0.5-1%之間<ref name=DSM5/> 。而在[[战争|武裝衝突]]頻發地區其發生率可能會較此有所上升<ref name=BMJ2015/> 總體來說，生理女性個體的發病率會高於生理男性<ref name=NIH2016>{{cite web|title=Post-Traumatic Stress Disorder|url=http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml|website=National Institute of Mental Health|accessdate=10 March 2016|date=February 2016}}</ref>。 迄今對因創傷引起的精神障礙的最早文字記載可追溯至[[古希臘時代]]。<ref>{{cite book|last1=Carlstedt|first1=Roland|title=Handbook of Integrative Clinical Psychology, Psychiatry, and Behavioral Medicine Perspectives, Practices, and Research.|date=2009|publisher=Springer Pub. Co.|location=New York|isbn=9780826110954|page=353|url=https://books.google.ca/books?id=4Tkdm1vRFbUC&pg=PA353}}</ref>。[[兩次世界大戰]]使得學界增加對創傷後心理壓力緊張症候群的研究，在此期間與多稱呼也用於代指此疾病，包括“[[彈震症]]”（又稱：砲彈休克症，英文: {{lang|en|shell shock}}）以及“戰爭性神經官能症”（英文: {{lang|en|combat neurosis}}）<ref>{{cite book|last1=Herman|first1=Judith|title=Trauma and Recovery: The Aftermath of Violence--From Domestic Abuse to Political Terror|date=2015|publisher=Basic Books|isbn=9780465098736|page=9|url=https://books.google.ca/books?id=ABhpCQAAQBAJ&}}</ref>。創傷後心理壓力緊張症候群一稱呼於20世紀70年代開始被使用，這主要是由於[[越南戰爭]]後美國退伍軍人相關疾病診斷的影響<ref>{{cite book|last1=Klykylo|first1=William M.|title=Clinical child psychiatry|date=2012|publisher=John Wiley & Sons|location=Chichester, West Sussex, UK|isbn=9781119967705|page=Chapter 15|edition=3.|url=https://books.google.ca/books?id=EL8eMEkxzkYC&pg=PT411}}</ref>。1980年在[[精神疾病診斷與統計手冊]]第三版（DSM-III）中，創傷後心理壓力緊張症候被[[美國精神醫學學會]]認正式認定為一種精神疾病<ref>{{cite journal|last1=Friedman|first1=MJ|title=Finalizing PTSD in DSM-5: getting here from there and where to go next.|journal=Journal of traumatic stress|date=October 2013|volume=26|issue=5|pages=548–56|pmid=24151001|doi=10.1002/jts.21840}}</ref>
[[File:Posttraumatic stress disorder.webm|thumb|upright=1.3|Video explanation]]
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Most people who have experienced a traumatic event will not develop PTSD.<ref name=BMJ2015/> People who experience interpersonal trauma (for example [[rape]] or [[child abuse]]) are more likely to develop PTSD, as compared to people who experience non-assault based trauma such as accidents and natural disasters.<ref name=Zoladz>{{cite journal|last1=Zoladz|first1=Phillip|title=Current status on behavioral and biological markers of PTSD: A search for clarity in a conflicting literature|journal=Neuroscience and Biobehavioral Reviews|date=June 2013|volume=37|issue=5|pages=860–895|doi=10.1016/j.neubiorev.2013.03.024|pmid=23567521}}</ref> About half of people develop PTSD following rape.<ref name=BMJ2015/> Children are less likely than adults to develop PTSD after trauma, especially if they are under ten years of age.<ref name=UK2005>{{cite web |last=National Collaborating Centre for Mental Health (UK) |title=Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care |layurl=http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0015848/ |laysource=Pubmed Health (plain English) |work=NICE Clinical Guidelines, No. 26 |publisher=Gaskell (Royal College of Psychiatrists) |url=https://www.ncbi.nlm.nih.gov/books/NBK56494/ |year=2005}} {{open access}}</ref> Diagnosis is based on the presence of specific symptoms following a traumatic event.<ref name=BMJ2015/>
<!-- Prevention and treatment -->
Prevention may be possible when [[trauma focused cognitive behavioral therapy|therapy]] is targeted at those with early symptoms but is not effective when carried out among all people following trauma.<ref name=BMJ2015/> The main treatments for people with PTSD are counselling and medication.<ref name=NIH2016/> A number of different types of therapy may be useful.<ref name=Haa2015>{{cite journal|last1=Haagen|first1=JF|last2=Smid|first2=GE|last3=Knipscheer|first3=JW|last4=Kleber|first4=RJ|title=The efficacy of recommended treatments for veterans with PTSD: A metaregression analysis.|journal=Clinical Psychology Review|date=August 2015|volume=40|pages=184–94|pmid=26164548|doi=10.1016/j.cpr.2015.06.008}}</ref> This may occur [[Individual therapy|one-on-one]] or in a group.<ref name=NIH2016/> [[Antidepressants]] of the [[selective serotonin reuptake inhibitor]] type are the first-line medications for PTSD and result in benefit in about half of people.<ref name=Berg2009>{{cite journal|last1=Berger|first1=W|last2=Mendlowicz|first2=MV|last3=Marques-Portella|first3=C|last4=Kinrys|first4=G|last5=Fontenelle|first5=LF|last6=Marmar|first6=CR|last7=Figueira|first7=I|title=Pharmacologic alternatives to antidepressants in posttraumatic stress disorder: a systematic review.|journal=Progress in neuro-psychopharmacology & biological psychiatry|date=17 March 2009|volume=33|issue=2|pages=169–80|pmid=19141307|doi=10.1016/j.pnpbp.2008.12.004|pmc=2720612}}</ref> These benefits are less than those seen with therapy.<ref name=BMJ2015/> It is unclear if using medications and therapy together has greater benefit.<ref name=BMJ2015>{{cite journal|last1=Bisson|first1=JI|last2=Cosgrove|first2=S|last3=Lewis|first3=C|last4=Robert|first4=NP|title=Post-traumatic stress disorder.|journal=BMJ (Clinical research ed.)|date=26 November 2015|volume=351|pages=h6161|pmid=26611143|pmc=4663500}}</ref><ref>{{cite journal|last1=Hetrick|first1=SE|last2=Purcell|first2=R|last3=Garner|first3=B|last4=Parslow|first4=R|
title=Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD).|journal=The Cochrane database of systematic reviews|date=7 July 2010|issue=7|pages=CD007316|pmid=20614457|doi=10.1002/14651858.CD007316.pub2}}</ref> Other medications do not have enough evidence to support their use and in the case of [[benzodiazepine]]s may worsen outcomes.<ref name=Gui2015>{{cite journal|last1=Guina|first1=J|last2=Rossetter|first2=SR|last3=DeRHODES|first3=BJ|last4=Nahhas|first4=RW|last5=Welton|first5=RS|title=Benzodiazepines for PTSD: A Systematic Review and Meta-Analysis.|journal=Journal of Psychiatric Practice|date=July 2015|volume=21|issue=4|pages=281–303|pmid=26164054|doi=10.1097/pra.0000000000000091}}</ref><ref name=Hos2015>{{Cite journal | last1 = Hoskins | first1 = M. | last2 = Pearce | first2 = J. | last3 = Bethell | first3 = A. | last4 = Dankova | first4 = L. | last5 = Barbui | first5 = C. | last6 = Tol | first6 = WA. | last7 = van Ommeren | first7 = M. | last8 = de Jong | first8 = J. | last9 = Seedat | first9 = S. | title = Pharmacotherapy for post-traumatic stress disorder: systematic review and meta-analysis. | journal = Br J Psychiatry | volume = 206 | issue = 2 | pages = 93–100 | year = February 2015 | doi = 10.1192/bjp.bp.114.148551 | pmid = 25644881 |quote = Some drugs have a small positive impact on PTSD symptoms}}</ref>
<!-- Epidemiology and history-->
In the United States about 3.5% of adults have PTSD in a given year, and 9% of people develop it at some point in their life.<ref name=DSM5/> In much of the rest of the world, rates during a given year are between 0.5% and 1%.<ref name=DSM5/> Higher rates may occur in regions of [[armed conflict]].<ref name=BMJ2015/> It is more common in women than men.<ref name=NIH2016>{{cite web|title=Post-Traumatic Stress Disorder|url=http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml|website=National Institute of Mental Health|accessdate=10 March 2016|date=February 2016}}</ref> Symptoms of trauma-related mental disorders have been documented since at least the time of the [[ancient Greek]]s.<ref>{{cite book|last1=Carlstedt|first1=Roland|title=Handbook of Integrative Clinical Psychology, Psychiatry, and Behavioral Medicine Perspectives, Practices, and Research.|date=2009|publisher=Springer Pub. Co.|location=New York|isbn=9780826110954|page=353|url=https://books.google.ca/books?id=4Tkdm1vRFbUC&pg=PA353}}</ref> During the [[World war|World Wars]] study increased and it was known under various terms including "[[shell shock]]" and "combat neurosis".<ref>{{cite book|last1=Herman|first1=Judith|title=Trauma and Recovery: The Aftermath of Violence--From Domestic Abuse to Political Terror|date=2015|publisher=Basic Books|isbn=9780465098736|page=9|url=https://books.google.ca/books?id=ABhpCQAAQBAJ&}}</ref> The term "posttraumatic stress disorder" came into use in the 1970s in large part due to the diagnoses of US military veterans of the [[Vietnam War]].<ref>{{cite book|last1=Klykylo|first1=William M.|title=Clinical child psychiatry|date=2012|publisher=John Wiley & Sons|location=Chichester, West Sussex, UK|isbn=9781119967705|page=Chapter 15|edition=3.|url=https://books.google.ca/books?id=EL8eMEkxzkYC&pg=PT411}}</ref> It was officially recognized by the [[American Psychiatric Association]] in 1980 in the third edition of the ’’[[Diagnostic and Statistical M
anual of Mental Disorders]]’’ (DSM-III).<ref>{{cite journal|last1=Friedman|first1=MJ|title=Finalizing PTSD in DSM-5: getting here from there and where to go next.|journal=Journal of traumatic stress|date=October 2013|volume=26|issue=5|pages=548–56|pmid=24151001|doi=10.1002/jts.21840}}</ref>
[[File:Posttraumatic stress disorder.webm|thumb|upright=1.3|Video explanation]]
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