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Does dissociation moderate treatment outcomes of narrative exposure therapy for PTSD? A secondary analysis from a randomized controlled clinical trial.分离是否会影响 PTSD 的叙事暴露疗法的治疗效果?一项随机对照临床试验的二次分析。
Behav Res Ther. 2014 Jun;57:21-8. doi: 10.1016/j.brat.2014.03.010. Epub 2014 Apr 12.
2
Comorbidity of PTSD in anxiety and depressive disorders: prevalence and shared risk factors.创伤后应激障碍在焦虑和抑郁障碍中的共病情况:患病率及共同风险因素。
Child Abuse Negl. 2014 Aug;38(8):1320-30. doi: 10.1016/j.chiabu.2014.01.017. Epub 2014 Mar 13.
3
Out-of-body-induced hippocampal amnesia.离体诱导的海马体遗忘症。
Proc Natl Acad Sci U S A. 2014 Mar 25;111(12):4421-6. doi: 10.1073/pnas.1318801111. Epub 2014 Mar 10.
4
Emergency department predictors of posttraumatic stress reduction for trauma-exposed individuals with and without an early intervention.针对有或没有早期干预的创伤暴露个体,急诊科中创伤后应激减轻的预测因素。
J Consult Clin Psychol. 2014 Apr;82(2):336-41. doi: 10.1037/a0035537. Epub 2014 Feb 3.
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Posttraumatic stress disorder and cognitive function: findings from the mind your heart study.创伤后应激障碍与认知功能:来自“关注你的心脏”研究的结果。
J Clin Psychiatry. 2013 Nov;74(11):1063-70. doi: 10.4088/JCP.12m08291.
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Cognitive impairment in depression: a systematic review and meta-analysis.抑郁症中的认知障碍:一项系统评价与荟萃分析。
Psychol Med. 2014 Jul;44(10):2029-40. doi: 10.1017/S0033291713002535. Epub 2013 Oct 29.
7
Experimentally-induced dissociation impairs visual memory.实验诱导的分离会损害视觉记忆。
Conscious Cogn. 2013 Dec;22(4):1189-94. doi: 10.1016/j.concog.2013.07.007. Epub 2013 Sep 8.
8
Working memory impairment as a common component in recurrent depressive disorder and certain somatic diseases.工作记忆损害作为复发性抑郁症和某些躯体疾病的共同组成部分。
Neuro Endocrinol Lett. 2013;34(5):436-45.
9
Neuropsychological findings in pediatric maltreatment: relationship of PTSD, dissociative symptoms, and abuse/neglect indices to neurocognitive outcomes.儿童虐待的神经心理学发现:创伤后应激障碍、分离症状、虐待/忽视指数与神经认知结果的关系。
Child Maltreat. 2013 Aug;18(3):171-83. doi: 10.1177/1077559513497420. Epub 2013 Jul 25.
10
Cognitive deficits and functional outcomes in major depressive disorder: determinants, substrates, and treatment interventions.重度抑郁症的认知缺陷和功能结果:决定因素、基础和治疗干预。
Depress Anxiety. 2013 Jun;30(6):515-27. doi: 10.1002/da.22063. Epub 2013 Mar 6.

分离症状与复发性抑郁症且有创伤暴露史患者的神经心理表现降低有关。

Dissociative symptoms are associated with reduced neuropsychological performance in patients with recurrent depression and a history of trauma exposure.

作者信息

Parlar Melissa, Frewen Paul A, Oremus Carolina, Lanius Ruth A, McKinnon Margaret C

机构信息

Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada.

Mood Disorders Research Unit, St. Joseph's Healthcare, Hamilton, Canada.

出版信息

Eur J Psychotraumatol. 2016 Feb 25;7:29061. doi: 10.3402/ejpt.v7.29061. eCollection 2016.

DOI:10.3402/ejpt.v7.29061
PMID:26927902
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4770862/
Abstract

BACKGROUND

Although preliminary work suggests that dissociative symptoms may impact neuropsychological performance in trauma-exposed populations, the relation between dissociation and cognitive performance has not been explored in patients with depression.

OBJECTIVE

The present study examined dissociative symptoms in relation to neuropsychological performance in participants with a primary diagnosis of recurrent major depressive disorder (MDD) and a history of trauma exposure.

METHOD

Twenty-three participants with MDD and 20 healthy controls who did not differ in age, sex, education, or IQ were assessed. In addition to a standardized neuropsychological battery assessing frontotemporally mediated cognitive processes, participants completed clinical measures assessing dissociative symptoms, illness severity, and past history of trauma exposure.

RESULTS

Among participants with MDD, greater severity of derealization was associated with reduced performance on measures of delayed visuospatial recall and recognition on a task of verbal memory recognition. In addition, more severe depersonalization was associated with slower processing speed and a response style lending itself toward better performance in a less active environment.

CONCLUSIONS

These findings point toward dissociative symptoms as a transdiagnostic factor associated with neuropsychological dysfunction in patients with depression and a history of trauma. Limitations and recommendations for future research are discussed.

摘要

背景

尽管初步研究表明分离症状可能会影响遭受创伤人群的神经心理表现,但尚未在抑郁症患者中探讨分离与认知表现之间的关系。

目的

本研究调查了患有复发性重度抑郁症(MDD)且有创伤暴露史的参与者的分离症状与神经心理表现之间的关系。

方法

对23名患有MDD的参与者和20名年龄、性别、教育程度或智商无差异的健康对照者进行了评估。除了一套评估额颞叶介导的认知过程的标准化神经心理测试外,参与者还完成了评估分离症状、疾病严重程度和既往创伤暴露史的临床测量。

结果

在患有MDD的参与者中,人格解体的严重程度越高,与言语记忆识别任务中的延迟视觉空间回忆和识别测量表现降低相关。此外,更严重的人格解体与处理速度较慢以及在较不活跃环境中表现更好的反应方式相关。

结论

这些发现表明,分离症状是与有创伤史的抑郁症患者神经心理功能障碍相关的一个跨诊断因素。讨论了本研究的局限性及对未来研究的建议。