Department of Psychology, University of Memphis, Memphis, Tennessee, USA.
J Trauma Stress. 2014 Feb;27(1):74-81. doi: 10.1002/jts.21880.
Physical injury is prevalent across many types of trauma experiences and can be associated with posttraumatic stress disorder (PTSD) symptoms and physical health effects, including increased medication use. Recent studies suggest that PTSD symptoms may mediate the effects of traumatic injury on health outcomes, but it is unknown whether this finding holds for survivors of different types of traumas. The current study examined cross-sectional relationships between injury, PTSD, and pain and psychiatric medication use in 2 trauma-exposed samples, female survivors of motor vehicle accidents (MVAs; n = 315) and intimate partner violence (IPV; n = 167). Data were obtained from participants at 2 trauma research clinics who underwent a comprehensive assessment of psychopathology following the stressor. Regression with bootstrapping suggested that PTSD symptoms mediate the relationship between injury severity and use of pain medications, R(2) = .11, F(2, 452) = 28.37, p < .001, and psychiatric medications, R(2) = .06, F(2, 452) = 13.18, p < .001, as hypothesized. Mediation, however, was not moderated by trauma type (ps > .05). Results confirm an association between posttraumatic psychopathology and medication usage and suggest that MVA and IPV survivors alike may benefit from assessment and treatment of emotional distress after physical injury.
身体损伤在多种创伤经历中普遍存在,并且可能与创伤后应激障碍(PTSD)症状和身体健康影响有关,包括增加药物使用。最近的研究表明,PTSD 症状可能会影响创伤对健康结果的影响,但尚不清楚这一发现是否适用于不同类型创伤的幸存者。本研究在 2 个创伤暴露样本中,检查了损伤、PTSD 与疼痛和精神科药物使用之间的横断面关系,样本包括机动车事故(MVA)女性幸存者(n=315)和亲密伴侣暴力(IPV)幸存者(n=167)。数据来自于 2 个创伤研究诊所的参与者,他们在应激源后接受了全面的精神病理学评估。使用 bootstrap 回归表明,PTSD 症状在损伤严重程度和使用疼痛药物之间起中介作用,R(2)=.11,F(2,452)=28.37,p<.001,以及在损伤严重程度和精神科药物之间起中介作用,R(2)=.06,F(2,452)=13.18,p<.001,与假设一致。然而,中介作用不受创伤类型的调节(p>.05)。研究结果证实了创伤后精神病理学与药物使用之间的关联,并表明 MVA 和 IPV 幸存者在身体损伤后可能都受益于情绪困扰的评估和治疗。