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保护因素、应对评估和社会障碍对社区暴力后心理健康的预测作用:社会认知理论的前瞻性检验

Protective Factors, Coping Appraisals, and Social Barriers Predict Mental Health Following Community Violence: A Prospective Test of Social Cognitive Theory.

作者信息

Smith Andrew J, Felix Erika D, Benight Charles C, Jones Russell T

机构信息

Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA.

Salt Lake City Veterans Affairs Healthcare System, Utah, USA.

出版信息

J Trauma Stress. 2017 Jun;30(3):245-253. doi: 10.1002/jts.22197.

DOI:10.1002/jts.22197
PMID:28644538
Abstract

This study tested social cognitive theory of posttraumatic adaptation in the context of mass violence, hypothesizing that pre-event protective factors (general self-efficacy and perceived social support) would reduce posttraumatic stress symptoms (PTSS) and depression severity through boosting post-event coping self-efficacy appraisals (mediator). We qualified hypotheses by predicting that post-event social support barriers would disrupt (moderate) the health-promoting indirect effects of pre-event protective factors. With a prospective longitudinal sample, we employed path models with bootstrapping resampling to test hypotheses. Participants included 70 university students (71.4% female; 40.0% White; 34.3% Asian; 14.3% Hispanic) enrolled during a mass violence event who completed surveys one year pre-event and 5-6 months post-event. Results revealed significant large effects in predicting coping self-efficacy (mastery model, R = .34; enabling model, R = .36), PTSS (mastery model, R = .35; enabling model, R = .41), and depression severity (mastery model, R = .43; enabling model, R = .46). Overall findings supported study hypotheses, showing that at low levels of post-event social support barriers, pre-event protective factors reduced distress severity through boosting coping self-efficacy. However, as post-event social support barriers increased, the indirect, distress-reducing effects of pre-event protective factors were reduced to nonsignificance. Study implications focus on preventative and responsive intervention.

摘要

本研究在大规模暴力事件的背景下检验了创伤后适应的社会认知理论,假设事件前的保护因素(一般自我效能感和感知到的社会支持)会通过提高事件后的应对自我效能感评估(中介变量)来减轻创伤后应激症状(PTSS)和抑郁严重程度。我们通过预测事件后的社会支持障碍会干扰(调节)事件前保护因素对健康的促进性间接影响来对假设进行限定。利用一个前瞻性纵向样本,我们采用带有自抽样重抽样的路径模型来检验假设。参与者包括70名大学生(71.4%为女性;40.0%为白人;34.3%为亚洲人;14.3%为西班牙裔),他们在一次大规模暴力事件期间入学,并在事件前一年和事件后5 - 6个月完成了调查。结果显示,在预测应对自我效能感(掌握模型,R = 0.34;赋能模型,R = 0.36)、PTSS(掌握模型,R = 0.35;赋能模型,R = 0.41)和抑郁严重程度(掌握模型,R = 0.43;赋能模型,R = 0.46)方面有显著的大效应。总体研究结果支持了研究假设,表明在事件后社会支持障碍水平较低时,事件前的保护因素通过提高应对自我效能感降低了痛苦严重程度。然而,随着事件后社会支持障碍的增加,事件前保护因素的间接减轻痛苦的效应降低至不显著。研究意义集中在预防性和反应性干预方面。

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