Raab Phillip A, Mackintosh Margaret-Anne, Gros Daniel F, Morland Leslie A
a National Center for Posttraumatic Stress Disorder, Pacific Islands Division, Department of Veterans Affairs Pacific Islands Healthcare System , Honolulu.
b Ralph H. Johnson Veterans Affairs Medical Center and the Department of Psychiatry and Behavioral Sciences , Medical University of South Carolina , Charleston.
Psychiatry. 2015;78(4):328-40. doi: 10.1080/00332747.2015.1082337.
Cognitive theories have proposed the idea of content specificity, which holds that emotional disorders are associated with unique sets of negative cognitions. The existent research exploring the content specificity related to posttraumatic stress disorder (PTSD) and depression is sparse, and research is especially needed in veteran samples. The purpose of this study was to examine the associations of PTSD symptom clusters and comorbid depressive symptoms with posttraumatic cognitions.
This study was cross-sectional in design, and the sample consisted of data from 150 male combat veterans with PTSD drawn from the baseline assessments of a large clinical trial. Analyses involved a series of separate and simultaneous linear regressions to examine the unique associations of comorbid depressive symptoms and PTSD symptom clusters with posttraumatic cognitions, as well as post hoc analyses to examine the mediational role of comorbid depressive symptoms.
Findings demonstrated that posttraumatic negative cognitions about the self and self-blame were most strongly associated with comorbid depressive symptoms and the depression-related PTSD numbing cluster. Comorbid depressive symptoms also partially mediated nearly all the relationships between posttraumatic cognitions and PTSD symptom clusters.
The findings of this study suggest that posttraumatic cognitions about the self and self-blame are not specific to PTSD but rather are more strongly related to symptoms of depression and negative affect. The results also suggest a potential pathway from posttraumatic cognitions to PTSD through the partially mediating influence of comorbid depression, and highlight the need to assess and treat comorbid depression in veterans with PTSD.
认知理论提出了内容特异性的观点,即认为情绪障碍与独特的负面认知集相关。探索与创伤后应激障碍(PTSD)和抑郁症相关的内容特异性的现有研究很少,退伍军人样本尤其需要开展研究。本研究的目的是检验PTSD症状群和共病抑郁症状与创伤后认知之间的关联。
本研究为横断面设计,样本包括来自一项大型临床试验基线评估的150名患有PTSD的男性退伍军人的数据。分析包括一系列单独和同时进行的线性回归,以检验共病抑郁症状和PTSD症状群与创伤后认知的独特关联,以及检验共病抑郁症状中介作用的事后分析。
研究结果表明,关于自我和自责的创伤后负面认知与共病抑郁症状以及与抑郁相关的PTSD麻木症状群关联最为紧密。共病抑郁症状也部分介导了创伤后认知与PTSD症状群之间几乎所有的关系。
本研究结果表明,关于自我和自责的创伤后认知并非PTSD所特有,而是与抑郁症状和负面影响的关联更为紧密。研究结果还表明了一条从创伤后认知通过共病抑郁的部分中介作用到PTSD的潜在途径,并强调了评估和治疗患有PTSD的退伍军人共病抑郁的必要性。