Mitchell Melissa A, Contractor Ateka A, Dranger Paula, Shea M Tracie
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University.
Choices! Counseling Services.
Psychol Trauma. 2016 May;8(3):293-300. doi: 10.1037/tra0000089. Epub 2015 Oct 12.
Cognitive models of posttraumatic stress disorder (PTSD) propose that rumination about a trauma may increase particular symptom clusters. One type of rumination, termed counterfactual thinking (CFT), refers to thinking of alternative outcomes for an event. CFT centered on a trauma is thought to increase intrusions, negative alterations in mood and cognitions (NAMC), and marked alterations in arousal and reactivity (AAR). The theorized relations between CFT and specific symptom clusters have not been thoroughly investigated. Also, past work has not evaluated whether the relation is confounded by depressive symptoms, age, gender, or number of traumatic events experienced.
The current study examined the unique associations between CFT and PTSD symptom clusters according to the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) in 51 trauma-exposed treatment-seeking individuals.
As predicted, CFT was associated with all PTSD symptom clusters. After controlling for common predictors of PTSD symptom severity (i.e., age, depressive symptoms, and number of traumatic life events endorsed), we found CFT to be significantly associated with the intrusion and avoidance symptom clusters but not the AAR or NAMC symptom clusters.
Results from the present study provide further support for the role of rumination in specific PTSD symptom clusters above and beyond symptoms of depression, age, and number of traumatic life events endorsed. Future work may consider investigating interventions to reduce rumination in PTSD. (PsycINFO Database Record
创伤后应激障碍（PTSD）的认知模型提出，对创伤的反复思考可能会增加特定的症状群。一种反复思考类型，称为反事实思维（CFT），是指对一个事件设想不同的结果。以创伤为中心的CFT被认为会增加闯入性思维、情绪和认知的消极改变（NAMC），以及觉醒和反应性的显著改变（AAR）。CFT与特定症状群之间的理论关系尚未得到充分研究。此外，过去的研究没有评估这种关系是否会受到抑郁症状、年龄、性别或经历的创伤事件数量的混淆。
本研究根据《精神疾病诊断与统计手册》（美国精神病学协会，2013年），对51名寻求治疗的创伤暴露个体中CFT与PTSD症状群之间的独特关联进行了研究。
正如预期的那样，CFT与所有PTSD症状群相关。在控制了PTSD症状严重程度的常见预测因素（即年龄、抑郁症状和认可的创伤性生活事件数量）后，我们发现CFT与闯入性思维和回避症状群显著相关，但与AAR或NAMC症状群无关。
本研究结果进一步支持了反复思考在特定PTSD症状群中的作用，这一作用超出了抑郁症状、年龄和认可的创伤性生活事件数量的影响。未来的研究可以考虑调查减少PTSD中反复思考的干预措施。（PsycINFO数据库记录）
