Heinz Adrienne J, Makin-Byrd Kerry, Blonigen Daniel M, Reilly Patrick, Timko Christine
Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA; National Center for PTSD, Dissemination and Training Division, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA.
National Center for PTSD, Dissemination and Training Division, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA.
J Subst Abuse Treat. 2015 Mar;50:59-66. doi: 10.1016/j.jsat.2014.10.014. Epub 2014 Nov 5.
This study examined posttraumatic stress disorder (PTSD) symptom severity and impulsivity as predictors of aggressive behavior among 133 male military veterans entering substance abuse treatment who endorsed difficulty controlling anger in the past year. At treatment intake, participants completed measures assessing PTSD symptom severity, impulsivity and aggressive behavior. Perpetration of aggressive behavior was reassessed 4 months later. Results from multivariate models indicated that PTSD symptom severity and impulsivity explained unique variance in aggressive behavior at intake but not follow-up. Mediation models indicated that the association between PTSD symptom severity and aggressive behavior was accounted for by impulsivity. The identification of impulsivity as a key mediator between trauma symptoms and aggressive behavior has significant clinical and research implications. Based on these findings, clinicians are encouraged to consider a standard assessment of impulsivity and the selection of interventions that target impulsivity as a trans-diagnostic process among at-risk client populations.
本研究调查了133名进入药物滥用治疗项目的男性退伍军人的创伤后应激障碍（PTSD）症状严重程度和冲动性，这些退伍军人在过去一年中表示难以控制愤怒情绪。在治疗开始时，参与者完成了评估PTSD症状严重程度、冲动性和攻击行为的测量。4个月后重新评估攻击行为的发生情况。多变量模型的结果表明，PTSD症状严重程度和冲动性在治疗开始时解释了攻击行为的独特方差，但在随访时没有。中介模型表明，PTSD症状严重程度与攻击行为之间的关联是由冲动性介导的。将冲动性确定为创伤症状与攻击行为之间的关键中介具有重要的临床和研究意义。基于这些发现，鼓励临床医生考虑对冲动性进行标准评估，并选择针对冲动性的干预措施，将其作为高危客户群体中的一种跨诊断过程。
