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理解创伤后应激障碍:创伤性损伤幸存者的疾病认知

Making Sense of Posttraumatic Stress Disorder: Illness Perceptions Among Traumatic Injury Survivors.

作者信息

Wong Eunice C, Kennedy David, Marshall Grant N, Gaillot Sarah

出版信息

Psychol Trauma. 2011 Mar;3(1):67-76. doi: 10.1037/a0020587.

Abstract

More than 1.5 million persons in the United States sustain traumatic physical injuries each year. A significant proportion of traumatic injury survivors develop serious mental health problems such as posttraumatic stress disorder (PTSD), yet few obtain professional mental health care. According to the commonsense model of self-regulation (Leventhal, Diefenbach, & Leventhal, 1992), illness-related perceptions can influence coping responses including the use of professional treatment. Using the commonsense model as a guiding framework, we conducted semi-structured interviews with non-treatment seeking trauma injury survivors with PTSD (N = 23). Illness perceptions regarding the following key conceptual dimensions were examined: PTSD symptoms (identity), experienced or perceived consequences of PTSD symptoms, and beliefs about the causes, controllability, and course of PTSD symptoms. Results revealed that no respondents identified their symptoms as indicative of PTSD. Common illness perceptions included believing that symptoms would be short-lived, that symptoms were reflective of poor physical health or were a natural reaction to life in a violent community, and that symptoms were functionally adaptive. Respondents also reported exerting some limited control over symptoms by relying on religious forms of coping. None of the respondents perceived professional treatment as being able to completely control symptoms. Findings indicated that respondents' conceptualizations of PTSD symptoms may have inhibited the recognition of symptoms as a serious mental health condition that warrants professional treatment.

摘要

美国每年有超过150万人遭受身体创伤。相当一部分创伤幸存者会出现诸如创伤后应激障碍(PTSD)等严重的心理健康问题,但很少有人能获得专业的心理健康护理。根据自我调节的常识模型(Leventhal、Diefenbach和Leventhal,1992),与疾病相关的认知会影响应对反应,包括使用专业治疗。以常识模型为指导框架,我们对23名患有创伤后应激障碍且未寻求治疗的创伤幸存者进行了半结构化访谈。研究了以下关键概念维度的疾病认知:创伤后应激障碍症状(特征)、创伤后应激障碍症状的经历或感知后果,以及关于创伤后应激障碍症状的原因、可控性和病程的信念。结果显示,没有受访者将自己的症状认定为创伤后应激障碍的表现。常见的疾病认知包括认为症状会是短暂的,症状反映了身体健康不佳或对暴力社区生活的自然反应,以及症状具有功能适应性。受访者还报告说,通过依赖宗教应对方式对症状有一定的有限控制。没有受访者认为专业治疗能够完全控制症状。研究结果表明,受访者对创伤后应激障碍症状的概念化可能阻碍了他们将症状识别为需要专业治疗的严重心理健康状况。

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