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焦虑敏感性干预对创伤暴露个体创伤后应激障碍症状的直接和中介作用

Direct and Mediating Effects of an Anxiety Sensitivity Intervention on Posttraumatic Stress Disorder Symptoms in Trauma-Exposed Individuals.

作者信息

Allan Nicholas P, Short Nicole A, Albanese Brian J, Keough Meghan E, Schmidt Norman B

机构信息

a Department of Psychology , Florida State University , Tallahassee , FL 32306-4301 , USA.

b Department of Psychiatry and Behavioral Sciences , University of Washington, Harborview Medical Center , 325 Ninth Avenue, PS-5035 Box 359911, Seattle , WA 98104 , USA.

出版信息

Cogn Behav Ther. 2015;44(6):512-24. doi: 10.1080/16506073.2015.1075227. Epub 2015 Oct 1.

Abstract

Anxiety sensitivity (AS), or fear of anxious arousal, is a higher-order cognitive risk-factor for posttraumatic stress disorder (PTSD) composed of lower-order physical, cognitive, and social concerns regarding anxiety symptoms. Brief and effective interventions have been developed targeting AS and its constituent components. However, there is limited evidence as to whether an intervention aimed at targeting AS would result in reductions in PTS symptoms and whether the effects on PTS symptoms would be mediated by reductions in AS. Furthermore, there is no evidence whether these mediation effects would be because of the global or more specific components of AS. The direct and indirect effects of an AS intervention on PTS symptoms were examined in a sample of 82 trauma-exposed individuals (M age = 18.84 years, SD = 1.50) selected based on elevated AS levels (i.e., 1 SD above the mean) and assigned to either a treatment (n = 40) or an active control (n = 42) condition. Results indicated that the intervention led to reductions in Month 1 PTS symptoms, controlling for baseline PTS symptoms. Furthermore, this effect was mediated by changes in global AS and AS social concerns, occurring from intervention to Week 1. These findings provide an initial support for an AS intervention in amelioration of PTS symptoms and demonstrate that it is primarily reductions in the higher-order component of AS contributing to PTS symptom reduction.

摘要

焦虑敏感性(AS),即对焦虑唤醒的恐惧,是创伤后应激障碍(PTSD)的一个高阶认知风险因素,它由对焦虑症状的低阶身体、认知和社会担忧组成。针对AS及其组成成分已经开发出了简短而有效的干预措施。然而,关于针对AS的干预是否会导致PTSD症状减轻,以及对PTSD症状的影响是否会通过AS的减轻来介导,证据有限。此外,没有证据表明这些中介效应是由于AS的整体成分还是更具体的成分。在82名基于AS水平升高(即高于均值1个标准差)被选中的创伤暴露个体(年龄M = 18.84岁,标准差 = 1.50)样本中,研究了AS干预对PTSD症状的直接和间接影响,并将其分为治疗组(n = 40)或积极对照组(n = 42)。结果表明,在控制基线PTSD症状的情况下,干预导致第1个月PTSD症状减轻。此外,这种效应是由整体AS和AS社会担忧的变化介导的,这种变化从干预到第1周就已出现。这些发现为AS干预改善PTSD症状提供了初步支持,并表明主要是AS高阶成分的减轻导致了PTSD症状的减轻。

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