Kaczkurkin Antonia N, Asnaani Anu, Zhong Jody, Foa Edna B
Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Trauma Stress. 2016 Aug;29(4):325-31. doi: 10.1002/jts.22116. Epub 2016 Jul 26.
Trauma experienced in childhood and adolescence negatively affects the development of adaptive regulation of emotions and is associated with greater symptoms of anger. Prior research has suggested that high levels of anger may impede the outcome of treatment in adults with posttraumatic stress disorder (PTSD). The current study investigated whether high levels of anger resulted in poorer treatment outcomes in adolescent girls with PTSD. Participants included 61 female adolescent survivors of sexual abuse or assault who were randomized to either prolonged exposure for adolescents (PE-A) or client-centered therapy (CCT) for traumatized children for 8-14 weekly sessions. Participants were followed for 12 months posttreatment. High levels of state anger at baseline were associated with less improvement in PTSD symptoms in the CCT group than the PE-A group (d = 0.62). The moderating effects of state anger on improvement in PTSD symptoms was significant with emotion regulation difficulties, which may underlie anger symptoms (d = 0.58) in the model. The results of this study suggessted that high state anger was less of an impediment to treatment of PTSD for those receiving PE-A than those receiving less differentiated approaches such as CCT.
童年和青少年时期经历的创伤会对情绪适应性调节的发展产生负面影响，并与更严重的愤怒症状相关。先前的研究表明，高度的愤怒可能会阻碍成年创伤后应激障碍（PTSD）患者的治疗效果。当前的研究调查了高度愤怒是否会导致患有PTSD的青春期女孩治疗效果较差。参与者包括61名遭受性虐待或攻击的女性青少年幸存者，她们被随机分配到青少年延长暴露疗法（PE-A）或针对受创伤儿童的以客户为中心的疗法（CCT），进行为期8 - 14周的每周一次治疗。对参与者进行了治疗后12个月的随访。与PE-A组相比，CCT组基线时的高度状态愤怒与PTSD症状改善较少相关（d = 0.62）。在该模型中，状态愤怒对PTSD症状改善的调节作用与情绪调节困难显著相关，而情绪调节困难可能是愤怒症状的潜在原因（d = 0.58）。这项研究的结果表明，对于接受PE-A治疗的人来说，高度的状态愤怒对PTSD治疗的阻碍小于接受CCT等区分度较低方法治疗的人。
