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创伤后应激障碍症状在机动车事故后创伤史特征与身体健康之间关系的中介作用研究。

An examination of PTSD symptoms as a mediator of the relationship between trauma history characteristics and physical health following a motor vehicle accident.

机构信息

Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

出版信息

Depress Anxiety. 2013 May;30(5):475-82. doi: 10.1002/da.22034. Epub 2012 Dec 5.

Abstract

BACKGROUND

It has been suggested that a history of trauma exposure is associated with increased vulnerability to the physical health consequences of subsequent trauma exposure, and that posttraumatic stress symptoms (PTSS) may serve as a key pathway in this vulnerability. However, few studies have modeled these relationships using mediation, and most have failed to consider whether specific characteristics of the prior trauma exposure have a differential impact on physical and mental health outcomes.

METHODS

The present study examined 180 victims of a serious motor vehicle accident (MVA) who reported prior exposure to traumatic events. PTSS were assessed by clinical interview 6 weeks post-MVA, and physical health was assessed 6 months post-MVA. Using structural equation modeling, the present study examined the extent to which event (age at first trauma, number, and types of trauma) and response (perceptions of life threat, physical injury, and distress) characteristics of prior trauma were related to physical health outcomes following a serious MVA, and whether these relationships were mediated by PTSS.

RESULTS

Results revealed that both event and response characteristics of prior trauma history were associated with poorer physical health, and that PTSS served as a mechanism through which response characteristics, but not event characteristics, led to poorer physical health.

CONCLUSIONS

These results highlight the enduring impact of trauma exposure on physical health outcomes, and underscore the importance of considering multiple mechanisms through which different aspects of prior trauma exposure may impact physical health.

摘要

背景

有研究表明,创伤暴露史与随后创伤暴露对身体健康的负面影响的易感性增加有关,而创伤后应激症状(PTSS)可能是这种易感性的关键途径。然而,很少有研究使用中介模型来模拟这些关系,而且大多数研究都没有考虑到先前创伤暴露的特定特征是否对身心健康结果有不同的影响。

方法

本研究调查了 180 名严重机动车事故(MVA)的受害者,这些受害者报告了先前暴露于创伤事件。PTSS 通过临床访谈在 MVA 后 6 周进行评估,身体健康状况在 MVA 后 6 个月进行评估。本研究使用结构方程模型,考察了先前创伤的事件(首次创伤的年龄、数量和类型)和反应(生命威胁、身体伤害和痛苦的感知)特征与严重 MVA 后身体健康结果的关系程度,以及这些关系是否通过 PTSS 介导。

结果

结果表明,先前创伤史的事件和反应特征都与较差的身体健康有关,而 PTSS 是反应特征(而非事件特征)导致较差身体健康的一个机制。

结论

这些结果强调了创伤暴露对身体健康结果的持久影响,并强调了考虑先前创伤暴露的不同方面可能通过多种机制影响身体健康的重要性。

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