柬埔寨难民中以胃肠道症状为主的惊恐发作：相关的精神病理学、闪回及灾难性认知。

Gastrointestinal-focused panic attacks among Cambodian refugees: associated psychopathology, flashbacks, and catastrophic cognitions.

作者信息

Hinton Devon E, Chhean Dara, Fama Jeanne M, Pollack Mark H, McNally Richard J

机构信息

Massachusetts General Hospital, Harvard Medical School, Department of Psychiatry, 15 Parkman Street, WACC 812 Boston, USA.

出版信息

J Anxiety Disord. 2007;21(1):42-58. doi: 10.1016/j.janxdis.2006.03.009. Epub 2006 May 2.

DOI:10.1016/j.janxdis.2006.03.009

PMID:16650726

Abstract

Among Cambodian refugees attending a psychiatric clinic, we assessed psychopathology associated with gastrointestinal panic (GIP), and investigated possible causal mechanisms, including "fear of fear" and GIP-associated flashbacks and catastrophic cognitions. GIP (n=46) patients had greater psychopathology (Clinician-Administered PTSD Scale [CAPS] and Symptom Checklist-90-R [SCL]) and "fear of fear" (Anxiety Sensitivity Index [ASI]) than did non-GIP patients (n=84). Logistic regression revealed that general psychopathology (SCL; odds ratio=4.1) and fear of anxiety-related sensations (ASI; odds ratio=2.4) predicted the presence of GIP. Among GIP patients, a hierarchical regression revealed that GIP-associated trauma recall and catastrophic cognitions explained variance in GIP severity beyond a measure of general psychopathology (SCL). A mediational analysis indicated that SCL's effect on GIP severity was mediated by GIP-associated flashbacks and catastrophic cognitions.

摘要

在一家精神病诊所就诊的柬埔寨难民中，我们评估了与胃肠道惊恐（GIP）相关的精神病理学，并研究了可能的因果机制，包括“对恐惧的恐惧”以及与GIP相关的闪回和灾难性认知。与非GIP患者（n = 84）相比，GIP患者（n = 46）具有更严重的精神病理学症状（临床医生管理的创伤后应激障碍量表[CAPS]和症状自评量表90修订版[SCL]）以及“对恐惧的恐惧”（焦虑敏感性指数[ASI]）。逻辑回归显示，一般精神病理学症状（SCL；优势比= 4.1）和对焦虑相关感觉的恐惧（ASI；优势比= 2.4）可预测GIP的存在。在GIP患者中，分层回归显示，与GIP相关的创伤回忆和灾难性认知解释了GIP严重程度的差异，超出了一般精神病理学症状（SCL）的衡量范围。中介分析表明，SCL对GIP严重程度的影响是由与GIP相关的闪回和灾难性认知介导的。