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死产后的创伤后应激障碍:创伤特征、控制点、创伤后认知。

Posttraumatic Stress Disorder Following Stillbirth: Trauma Characteristics, Locus of Control, Posttraumatic Cognitions.

作者信息

Chung Man Cheung, Reed Jacqueline

机构信息

Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, Ho Tim Building, Shatin NT, Hong Kong.

University of Plymouth, Plymouth, UK.

出版信息

Psychiatr Q. 2017 Jun;88(2):307-321. doi: 10.1007/s11126-016-9446-y.

Abstract

This study examined the incidence of PTSD and psychiatric co-morbidity among women who experienced stillbirth and investigated the relationship between locus of control, trauma characteristics of stillbirth, posttraumatic cognitions, PTSD and co-morbid psychiatric symptoms following stillbirth. Fifty women recorded information on stillbirth experiences, and completed the Posttraumatic Stress Diagnostic Scale, General Health Questionnaire-28, Edinburgh Post-natal Depression Scale, Rotter's Locus of Control Scale and the Posttraumatic Cognitions Inventory. 60, 28 and 12 % met the diagnostic criteria for probable full-PTSD, partial and no-PTSD respectively. Sixty-two percent and 54 % scored at or above the cutoff of the General Health Questionnaire-28 and postnatal depression respectively. Women who experienced stillbirth reported significantly more psychiatric co-morbid and post-natal depressive symptoms than the comparison group. Both groups were similar in locus of control. Women who experienced stillbirth reported negative cognitions about the self the most. After adjusting for postnatal depression, trauma characteristics were significantly correlated with Posttraumatic cognitions which, in turn, were significantly correlated with PTSD and psychiatric co-morbidity. Locus of control was not significantly correlated with psychological outcomes. Mediational analyses showed that negative cognitions about self mediated the relationship between trauma characteristics and psychiatric co-morbidity only. Women reported a high incidence of probable PTSD and co-morbid psychiatric symptoms following stillbirth. Stillbirth trauma characteristics influenced how they negatively perceived themselves. This then specifically influenced general psychological problems rather than PTSD symptoms.

摘要

本研究调查了死产女性中创伤后应激障碍(PTSD)的发病率及精神共病情况,并探究了心理控制源、死产创伤特征、创伤后认知、PTSD以及死产后共病精神症状之间的关系。五十名女性记录了死产经历,并完成了创伤后应激诊断量表、一般健康问卷-28、爱丁堡产后抑郁量表、罗特心理控制源量表以及创伤后认知量表。分别有60%、28%和12%的女性符合可能的完全型PTSD、部分型和无PTSD的诊断标准。分别有62%和54%的女性在一般健康问卷-28及产后抑郁量表上的得分达到或超过临界值。经历死产的女性报告的精神共病和产后抑郁症状显著多于对照组。两组在心理控制源方面相似。经历死产的女性对自我的消极认知最多。在对产后抑郁进行校正后,创伤特征与创伤后认知显著相关,而创伤后认知又与PTSD和精神共病显著相关。心理控制源与心理结果无显著相关性。中介分析表明,对自我的消极认知仅在创伤特征与精神共病之间起中介作用。女性报告死产后可能患PTSD及共病精神症状的发生率较高。死产创伤特征影响了她们对自身的消极认知。这进而特别影响了一般心理问题而非PTSD症状。

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