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创伤后应激障碍患者和伴有广场恐惧症的惊恐障碍患者在日常生活中重新体验症状、分离和回避行为。

Reexperiencing symptoms, dissociation, and avoidance behaviors in daily life of patients with PTSD and patients with panic disorder with agoraphobia.

机构信息

Department of Psychology, Harvard University, Cambridge, Massachusetts 02138-2044, USA.

出版信息

J Trauma Stress. 2013 Aug;26(4):443-50. doi: 10.1002/jts.21822. Epub 2013 Jul 25.

Abstract

Panic attacks are frequently perceived as life threatening. Panic disorder (PD) patients may therefore experience symptoms of posttraumatic stress disorder (PTSD). The authors explored this in 28 healthy controls, 17 PTSD patients, and 24 PD patients with agoraphobia who completed electronic diaries 36 times during 1 week. Patient groups frequently reported dissociation as well as thoughts, memories, and reliving of their trauma or panic attacks. PTSD patients reported more trauma/panic attack thoughts (incidence rate ratio [IRR] = 2.9) and memories (IRR = 2.8) than PD patients. Patient groups relived their trauma or panic attacks equally frequently, and reported comparable bodily reactions and distress associated with trauma or panic attack memories. Clinical groups avoided trauma or panic attack reminders more often than healthy controls (avoidance of trauma- or panic attack-related thoughts (IRR = 8.0); avoidance of things associated with the trauma or panic attack (IRR = 40.7). PD patients avoided trauma or panic attack reminders less often than PTSD patients (avoidance of trauma- or panic attack-related thoughts [IRR = 2.5]; avoidance of things associated with the trauma or panic attack [IRR = 4.1]), yet these differences were nonsignificant when controlling for functional impairment. In conclusion, trauma-like symptoms are common in PD with agoraphobia and panic attacks may be processed similarly as trauma in PTSD.

摘要

惊恐发作常被视为危及生命。因此,惊恐障碍(PD)患者可能会出现创伤后应激障碍(PTSD)的症状。作者在 28 名健康对照者、17 名 PTSD 患者和 24 名伴有广场恐怖症的 PD 患者中对此进行了研究,这些患者在 1 周内通过电子日记共完成了 36 次记录。患者组经常报告分离以及对其创伤或惊恐发作的想法、记忆和重现。PTSD 患者报告的创伤/惊恐发作相关想法(发病率比 [IRR] = 2.9)和记忆(IRR = 2.8)比 PD 患者多。患者组同样频繁地重现其创伤或惊恐发作,并且报告了与创伤或惊恐发作记忆相关的类似身体反应和痛苦。与健康对照组相比,临床组更常避免创伤或惊恐发作的提示(避免与创伤或惊恐发作相关的想法(IRR = 8.0);避免与创伤或惊恐发作相关的事物(IRR = 40.7)。PD 患者避免创伤或惊恐发作提示的频率低于 PTSD 患者(避免与创伤或惊恐发作相关的想法 [IRR = 2.5];避免与创伤或惊恐发作相关的事物 [IRR = 4.1]),但在控制功能障碍后,这些差异无统计学意义。总之,伴有广场恐怖症的 PD 中常见类似创伤的症状,而惊恐发作在 PTSD 中可能与创伤类似地被处理。

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