Rocha-Rego Vanessa, Fiszman Adriana, Portugal Liana Catarina, Garcia Pereira Mirtes, de Oliveira Letícia, Mendlowicz Mauro V, Marques-Portella Carla, Berger William, Freire Coutinho Evandro Silva, Mari Jair J, Figueira Ivan, Volchan Eliane
Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Brazil.
J Affect Disord. 2009 May;115(1-2):269-73. doi: 10.1016/j.jad.2008.09.005. Epub 2008 Oct 8.
Previous studies suggested the importance of peritraumatic reactions as predictors of PSTD symptoms severity. Despite mounting evidence that tonic immobility occurs under intense life threats its role as predictor of PTSD severity remains by and large understudied. The objective of this study was to investigate the role of peritraumatic reactions (tonic immobility, panic and dissociation) as predictors of PTSD symptoms severity.
Participants were 32 victims of urban violence with PTSD diagnosed through the SCID-I. In order to evaluate PTSD symptoms at baseline, we used the Post-Traumatic Stress Disorder Checklist-Civilian Version. To assess peritraumatic reactions we employed the Physical Reactions Scale, the Peritraumatic Dissociative Experiences Questionnaire and Tonic Immobility questions. As confounding variables, we considered negative affect (measured by the Positive and Negative Affect Schedule-Trait Version), sex and time elapsed since trauma.
Tonic immobility was the only predictor of PTSD symptoms severity that kept the statistical significance after controlling for potential confounders.
This study was based on a relatively small sample recruited in a tertiary clinic, a fact that may limit the generalizability of its findings. The retrospective design may have predisposed to recall bias.
Our study provides good reason to conduct more research on tonic immobility in PTSD with other samples and with different time frames in an attempt to replicate these stimulating results.
先前的研究表明创伤周围反应作为创伤后应激障碍(PTSD)症状严重程度预测指标的重要性。尽管有越来越多的证据表明强直性静止在强烈的生命威胁下会出现,但其作为PTSD严重程度预测指标的作用在很大程度上仍未得到充分研究。本研究的目的是调查创伤周围反应(强直性静止、惊恐和解离)作为PTSD症状严重程度预测指标的作用。
参与者为32名城市暴力受害者,通过《精神疾病诊断与统计手册》第一版(SCID-I)诊断为患有PTSD。为了在基线时评估PTSD症状,我们使用了《创伤后应激障碍检查表-平民版》。为了评估创伤周围反应,我们采用了身体反应量表、创伤周围解离体验问卷和强直性静止问题。作为混杂变量,我们考虑了消极情绪(通过正负性情绪量表-特质版测量)、性别以及创伤发生后的时间。
在控制了潜在混杂因素后,强直性静止是PTSD症状严重程度的唯一具有统计学意义的预测指标。
本研究基于在一家三级诊所招募的相对较小的样本,这一事实可能会限制其研究结果的普遍性。回顾性设计可能易出现回忆偏差。
我们的研究为在其他样本和不同时间框架下对PTSD中的强直性静止进行更多研究提供了充分理由,以期复制这些令人振奋的结果。