Nightingale J, Williams R M
Department of Clinical Psychology, Institute of Psychiatry, London, UK.
Br J Clin Psychol. 2000 Sep;39(3):243-54. doi: 10.1348/014466500163266.
To test hypotheses derived from a suggestion of Williams (1989) that negative attitudes towards emotional expression act as a predisposing or maintaining factor for post-traumatic stress reactions following a traumatic event.
The study employed a prospective design in which attitudes to emotional expression, the 'Big Five' personality factors (Costa & McCrae, 1992a) and initial symptoms and injury severity within 1 week of a road traffic accident were used to predict the development of post-traumatic stress disorder 6 weeks post-accident.
Sixty victims of road traffic accidents randomly selected from attenders at a large A&E department were assessed by questionnaire and interview. Measures comprised a 4-item scale relating to emotional expression, standardized scales for intrusion and avoidance features of traumatic experiences, and for anxiety and depression and the NEO-FFI Five Factor Personality Inventory. Forty-five of these participants responded to a postal questionnaire follow-up. In this survey the battery was repeated and also included a self-report diagnostic measure of post-traumatic stress disorder (PTSD).
The percentage of the sample meeting DSM-IV diagnostic criteria for PTSD at 6 weeks post-trauma was 30.8%. A small but significant relationship was found for negative attitudes to emotional expression at 1 week to predict intrusive symptoms and diagnosis at 6 weeks, over and above the independent relationships of initial symptoms, initial injury severity, personality and coping. The emotional expression measure was largely stable between the two points of measurement. More negative attitudes to emotional expression were related to less openness, extraversion and agreeableness personality domains.
Some support for the hypotheses was found in relation to the development of PTSD and for the status of attitudes to emotion as a stable trait related to personality factors. The potential importance of attitudes to emotional expression in therapy and other work is discussed.
检验源自威廉姆斯（1989年）的一项建议的假设，即对情感表达的消极态度是创伤事件后创伤后应激反应的诱发或维持因素。
本研究采用前瞻性设计，其中对情感表达的态度、“大五”人格因素（科斯塔和麦克雷，1992a）以及道路交通事故发生后1周内的初始症状和损伤严重程度被用于预测事故发生6周后创伤后应激障碍的发展。
从一家大型急症室的就诊者中随机选取60名道路交通事故受害者，通过问卷调查和访谈进行评估。测量指标包括一个与情感表达相关的4项量表、创伤经历的侵入和回避特征的标准化量表、焦虑和抑郁量表以及NEO-FFI五因素人格量表。其中45名参与者回复了一份邮寄问卷调查随访。在这次调查中，重复了上述量表，并且还包括一项创伤后应激障碍（PTSD）的自我报告诊断测量。
创伤后6周符合DSM-IV创伤后应激障碍诊断标准的样本百分比为30.8%。发现创伤后1周时对情感表达的消极态度与创伤后6周时的侵入性症状和诊断之间存在小但显著的关系，这一关系超出了初始症状、初始损伤严重程度、人格和应对方式的独立关系。情感表达测量在两次测量点之间基本稳定。对情感表达的更消极态度与开放性、外向性和宜人性人格领域得分较低相关。
在创伤后应激障碍的发展以及情感态度作为与人格因素相关的稳定特质的地位方面，发现了对这些假设的一些支持。讨论了情感表达态度在治疗和其他工作中的潜在重要性。
