Anxiety Disorders Clinic, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada.
J Behav Ther Exp Psychiatry. 2012 Sep;43(3):877-83. doi: 10.1016/j.jbtep.2011.12.007. Epub 2012 Jan 10.
Intrusions are often considered the hallmark of posttraumatic stress disorder (PTSD). Despite this, relatively little is known about factors that give rise to intrusions. Cognitive models of PTSD highlight the importance of pre-existing cognitive vulnerabilities, cognitive processing and anxiety during a traumatic event, as well as negative responses to trauma sequelae. However, few studies have examined multiple forms of peritraumatic processes, and rumination in response to trauma intrusions using analogue trauma tasks, and none have examined whether broader anxious ruminative processes contribute to intrusion development. In addition, little work has investigated the role of post-state anxiety in intrusions, and anxiety may be related to both peritraumatic processing and rumination. The current study employed a distressing film paradigm to examine key tenets of cognitive models of PTSD. Ninety-one female university students completed measures of anxiety, rumination in response to anxious symptoms, peritraumatic dissociation, data driven processing, lack of self referent processing, intrusions, and rumination in response to intrusions of the distressing film. Results revealed that peritraumatic dissociation, data driven processing, and self referent processing were associated with intrusion development, with lack of self referent processing being a strong predictor of intrusion development. Post-state anxiety and rumination in response to intrusions also predicted intrusion development. Discussion focuses on implications of cognitive processes and anxiety in theories of intrusion development.
闯入通常被认为是创伤后应激障碍(PTSD)的标志。尽管如此,对于导致闯入的因素知之甚少。PTSD 的认知模型强调了预先存在的认知脆弱性、创伤事件期间的认知加工和焦虑,以及对创伤后果的负面反应的重要性。然而,很少有研究同时考察创伤前过程的多种形式,以及使用模拟创伤任务对创伤闯入的反刍,也没有研究过更广泛的焦虑性反刍过程是否会导致闯入的发展。此外,很少有研究调查状态后焦虑在闯入中的作用,而且焦虑可能与创伤前加工和反刍都有关。本研究采用令人痛苦的电影范式来检验 PTSD 认知模型的主要原则。91 名女性大学生完成了焦虑、对焦虑症状的反刍、创伤前解离、数据驱动加工、缺乏自我参照加工、闯入以及对痛苦电影闯入的反刍的测量。结果表明,创伤前解离、数据驱动加工和自我参照加工与闯入发展有关,缺乏自我参照加工是闯入发展的强有力预测因素。状态后焦虑和对闯入的反刍也预测了闯入的发展。讨论集中在认知过程和焦虑在闯入发展理论中的意义。