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创伤事件暴露背景下的情感不接纳:焦虑敏感性对初级保健环境中拉丁裔创伤应激症状和残疾的解释作用。

Emotional nonacceptance within the context of traumatic event exposure: The explanatory role of anxiety sensitivity for traumatic stress symptoms and disability among Latinos in a primary care setting.

作者信息

Viana Andres G, Paulus Daniel J, Bakhshaie Jafar, Garza Monica, Valdivieso Jeanette, Ochoa-Perez Melissa, Lemaire Chad, Cardoso Jodi Berger, Zvolensky Michael J

机构信息

Department of Psychology, University of Houston, Houston, TX, United States.

Department of Psychology, University of Houston, Houston, TX, United States.

出版信息

Gen Hosp Psychiatry. 2017 Jan-Feb;44:30-37. doi: 10.1016/j.genhosppsych.2016.10.007. Epub 2016 Oct 27.

DOI:10.1016/j.genhosppsych.2016.10.007
PMID:28041573
Abstract

OBJECTIVE

Research has found that Latinos (versus non-Latino Whites) evince higher rates of posttraumatic stress symptoms (PTS) and posttraumatic stress disorder (PTSD), yet little attention has been given to intra-individual, emotion-related processes to explicate the higher incidence of these symptoms among Latinos.

METHOD

Participants included 183 trauma-exposed adult Latinos (88.5% female; Mage=37.7, SD=10.7 and 93.4% reported Spanish as their first language) who attended a community-based primary healthcare clinic in Houston. It was hypothesized that anxiety sensitivity would explain the relation between emotional nonacceptance and traumatic stress symptoms, namely re-experiencing, avoidance, and arousal difficulties as well as overall disability. Additionally, it was expected that the observed effects would be evident above and beyond the variance accounted for by number of traumas reported, gender, age, marital status, educational status, years living in the U.S., and negative affectivity.

RESULTS

Consistent with our hypotheses, difficulties accepting negative emotions were associated with increased trauma-related re-experiencing, avoidance, and arousal difficulties. Additionally, anxiety sensitivity was an underlying mechanism in the association between emotional nonacceptance and all but one facet of traumatic stress symptoms (i.e., re-experiencing symptoms) and disability. Alternative models yielded no significant effects, providing greater confidence in the direction of the hypothesized effects.

CONCLUSION

Findings are discussed in the context of their significance for informing the development of specialized intervention strategies that target anxiety sensitivity for Latinos in primary care with elevated risk for PTS and PTSD by their heightened levels of emotional nonacceptance.

摘要

目的

研究发现,拉丁裔(与非拉丁裔白人相比)表现出更高的创伤后应激症状(PTS)和创伤后应激障碍(PTSD)发生率,但对于个体内部与情绪相关的过程关注较少,这些过程可以解释拉丁裔中这些症状的较高发生率。

方法

参与者包括183名遭受过创伤的成年拉丁裔(88.5%为女性;年龄中位数=37.7,标准差=10.7;93.4%报告称西班牙语是他们的第一语言),他们在休斯顿的一家社区初级医疗诊所就诊。研究假设焦虑敏感性可以解释情绪不接纳与创伤应激症状之间的关系,即再次体验、回避和唤醒困难以及总体功能障碍。此外,预计观察到的效应在控制了报告的创伤数量、性别、年龄、婚姻状况、教育程度、在美国居住的年限以及消极情感性所解释的变异之外仍将显著。

结果

与我们的假设一致,难以接受负面情绪与创伤相关的再次体验、回避和唤醒困难增加有关。此外,焦虑敏感性是情绪不接纳与除创伤应激症状的一个方面(即再次体验症状)和功能障碍之外的所有方面之间关联的潜在机制。替代模型没有产生显著效应,这为假设效应的方向提供了更大的信心。

结论

研究结果在其对制定专门干预策略的意义的背景下进行了讨论,这些策略针对初级保健中因情绪不接纳程度较高而有PTS和PTSD高风险的拉丁裔人群的焦虑敏感性。

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