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创伤后应激障碍中的自伤行为:潜在调节因素的考察

Self-injurious behaviors in posttraumatic stress disorder: an examination of potential moderators.

作者信息

Dixon-Gordon Katherine L, Tull Matthew T, Gratz Kim L

机构信息

University of Mississippi Medical Center, 2500 North State St., Jackson, MS 39211, United States.

University of Mississippi Medical Center, 2500 North State St., Jackson, MS 39211, United States.

出版信息

J Affect Disord. 2014 Sep;166:359-67. doi: 10.1016/j.jad.2014.05.033. Epub 2014 May 28.

Abstract

BACKGROUND

Despite increasing evidence for a relation between posttraumatic stress disorder (PTSD) and self-injurious behaviors (SIB), limited research has examined the factors that may moderate the associations between PTSD and both nonsuicidal SIB (deliberate self-harm; DSH) and suicidal SIB (suicide attempts). Nonetheless, research suggests that characteristics of the traumatic event, co-occurring borderline personality disorder (BPD), and emotion dysregulation may influence the relations between PTSD and SIB.

METHODS

Thus, the aim of this study was to examine the moderating role of these factors in the association between PTSD and SIB (including history and frequency of DSH and suicide attempts, and DSH versatility) among a sample of substance use disorder inpatients with (n=116) and without (n=130) a history of PTSD.

RESULTS

Results from stepwise regression analyses indicate that sexual assault-related PTSD predicted suicide attempt frequency and DSH versatility among those with PTSD. Furthermore, results from hierarchical linear and logistic regression analyses suggest that co-occurring BPD moderates the relationship between PTSD and both DSH history and versatility and emotion dysregulation moderates the relationship between PTSD and DSH frequency. Specifically, the relations between PTSD and DSH outcomes were stronger among participants with co-occurring BPD and higher levels of emotion dysregulation.

LIMITATIONS

This study is limited by its reliance on cross-sectional, self-report data.

CONCLUSIONS

Despite limitations, findings suggest distinct risk factors for suicide attempts and DSH, and highlight the importance of examining characteristics of the trauma and associated BPD and emotion dysregulation in assessing risk for SIB in PTSD.

摘要

背景

尽管越来越多的证据表明创伤后应激障碍(PTSD)与自我伤害行为(SIB)之间存在关联,但针对可能调节PTSD与非自杀性SIB(故意自我伤害;DSH)及自杀性SIB(自杀未遂)之间关联的因素的研究却很有限。尽管如此,研究表明创伤事件的特征、共病的边缘性人格障碍(BPD)以及情绪调节障碍可能会影响PTSD与SIB之间的关系。

方法

因此,本研究的目的是在一组有(n = 116)和无(n = 130)PTSD病史的物质使用障碍住院患者样本中,检验这些因素在PTSD与SIB(包括DSH和自杀未遂的病史及频率,以及DSH的多样性)之间关联中的调节作用。

结果

逐步回归分析结果表明,与性侵犯相关的PTSD可预测有PTSD者的自杀未遂频率和DSH多样性。此外,分层线性和逻辑回归分析结果表明,共病的BPD调节PTSD与DSH病史及多样性之间的关系,情绪调节障碍调节PTSD与DSH频率之间的关系。具体而言,在共病BPD且情绪调节障碍水平较高的参与者中,PTSD与DSH结果之间的关系更强。

局限性

本研究受限于其对横断面自我报告数据的依赖。

结论

尽管存在局限性,但研究结果表明了自杀未遂和DSH的不同风险因素,并强调了在评估PTSD中SIB风险时,检查创伤特征以及相关的BPD和情绪调节障碍的重要性。

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