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应对方式、适应能力和社会支持在调解从伊拉克和阿富汗返回的退伍军人创伤后应激障碍与社会功能之间关系中的作用。

The role of coping, resilience, and social support in mediating the relation between PTSD and social functioning in veterans returning from Iraq and Afghanistan.

机构信息

VA New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut, USA.

出版信息

Psychiatry. 2012 Summer;75(2):135-49. doi: 10.1521/psyc.2012.75.2.135.

DOI:10.1521/psyc.2012.75.2.135
PMID:22642433
Abstract

Posttraumatic stress disorder (PTSD) is one of the most common psychiatric disorders among veterans returning from Iraq and Afghanistan. Little research has examined variables that may mediate the relation between PTSD and aspects of social functioning, such as relationship satisfaction and family functioning. In this cross-sectional study, a total of 164 veterans who were seeking VA primary care or mental health care within one year after returning from Iraq and/or Afghanistan were screened for PTSD and completed a series of questionnaires that assessed social functioning, coping, and life satisfaction. Results showed that the 86 (52%) veterans who screened positive for PTSD reported greater difficulties in their relationships with romantic partners, less cohesion in their families, less social support, poorer social functioning, and lower life satisfaction compared to other treatment-seeking veterans. Less social support from the community, excessive worry, decreased acceptance of change, and lower availability of secure relationships mediated the association between PTSD and poor social functioning. The relation between PTSD and lower partner satisfaction was mediated by greater cognitive social avoidance and lower availability of secure relationships. These results suggest that psychotherapeutic interventions that address these mediating variables may help improve social functioning in treatment-seeking veterans with PTSD.

摘要

创伤后应激障碍(PTSD)是从伊拉克和阿富汗返回的退伍军人中最常见的精神障碍之一。很少有研究探讨可能在 PTSD 与社会功能的各个方面(如关系满意度和家庭功能)之间起中介作用的变量。在这项横断面研究中,共有 164 名退伍军人在从伊拉克和/或阿富汗返回后的一年内寻求 VA 初级保健或心理健康护理,他们接受了 PTSD 的筛查,并完成了一系列评估社会功能、应对方式和生活满意度的问卷。结果表明,86 名(52%)筛查出 PTSD 的退伍军人报告与浪漫伴侣的关系更困难,家庭凝聚力更低,社会支持更少,社会功能更差,生活满意度更低,与其他寻求治疗的退伍军人相比。社区提供的社会支持较少、过度担忧、对变化的接受程度降低以及安全关系的可用性降低,这几个因素在 PTSD 与较差的社会功能之间起中介作用。PTSD 与伴侣满意度降低之间的关系由认知性社交回避增加和安全关系的可用性降低来介导。这些结果表明,解决这些中介变量的心理治疗干预可能有助于改善 PTSD 治疗寻求退伍军人的社会功能。

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