Noyes Russell, Watson David B, Carney Caroline P, Letuchy Elena M, Peloso Paul M, Black Donald W, Doebbeling Bradley N
Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
J Psychosom Res. 2004 Dec;57(6):529-39. doi: 10.1016/j.jpsychores.2004.05.006.
The aim was to examine the influence of combat exposure and other risk factors on the development of hypochondriacal concerns among veterans of the Gulf War and to learn whether these concerns might be a source of increased symptom reporting among them.
Six hundred two veterans who were deployed to the Gulf or elsewhere during the 1991 war took part in a two-phase study of symptoms and illnesses occurring among these veterans. Hypochondriacal beliefs and attitudes were assessed by the Whiteley Index and somatic symptoms by a factor-analytically derived measure. Multiple regression models were developed for these outcomes.
Hypochondriacal concerns were significantly associated with level of education, personal history of depression, number of prewar physical conditions, family history of functional syndromes, negative and positive temperament and disinhibition, military combat, level of military preparedness, social support, and perceived life stress. Somatic symptoms were associated with these same variables, as well as branch of service, family history of physical conditions, combat, and level of combat exposure. A regression model for hypochondriacal concerns included the number of prewar physical conditions, negative temperament, lack of social support, and perceived life stress.
Hypochondriacal concerns were not strongly related to combat exposure. Consequently, it is not likely that such concerns account for increased symptom reporting among the veterans studied. Hypochondriacal concerns appeared to arise in response to threats posed by physical illness. Vulnerability to such threats appeared to center on the personality dimension of negative temperament. This model may serve as a guide to future investigations.
本研究旨在探讨海湾战争退伍军人中,战斗经历及其他风险因素对疑病观念形成的影响,并了解这些观念是否可能是导致他们报告症状增多的原因。
602名在1991年战争期间被部署到海湾地区或其他地方的退伍军人参与了一项关于这些退伍军人出现的症状和疾病的两阶段研究。通过怀特利指数评估疑病信念和态度,通过因子分析得出的测量方法评估躯体症状。针对这些结果建立了多元回归模型。
疑病观念与教育程度、抑郁症个人史、战前身体状况数量、功能性综合征家族史、正负性气质和去抑制、军事战斗、军事准备水平、社会支持以及感知到的生活压力显著相关。躯体症状与这些相同的变量相关,以及与军种、身体状况家族史、战斗和战斗暴露水平相关。一个关于疑病观念的回归模型包括战前身体状况数量、负性气质、缺乏社会支持和感知到的生活压力。
疑病观念与战斗暴露没有密切关系。因此,这些观念不太可能是导致所研究退伍军人症状报告增加的原因。疑病观念似乎是对身体疾病造成的威胁的反应。对这种威胁的易感性似乎集中在负性气质的人格维度上。该模型可为未来的研究提供指导。