a Department of Psychological Sciences , University of Connecticut , Storrs , CT , USA.
Health Psychol Rev. 2018 Mar;12(1):75-109. doi: 10.1080/17437199.2017.1373030. Epub 2017 Sep 19.
Psychological trauma has implications for many aspects of physical health, including preventive health behaviours (PHBs). However, whether trauma exposure additionally contributes to PHBs above and beyond the effects of posttraumatic stress disorder (PTSD) symptoms remains unclear. In this systematic review, 32 studies were analysed to characterise: (1) the relationships between trauma exposure and PHBs, (2) the relationships between PTSD symptoms and PHBs, (3) the unique associations between trauma exposure and PHBs, independent of PTSD symptoms, and (4) the unique associations between PTSD symptoms and PHBs, independent of trauma exposure. Findings were variable across the three examined PHBs (physical activity, diet, medical screening) when only trauma exposure or PTSD symptoms were taken into account. Clearer relationships emerged between trauma exposure and PHBs when PTSD symptoms were taken into account, demonstrating that trauma exposure is related to PHB engagement above and beyond the effects of PTSD symptoms. Additionally, PTSD symptoms shared unique associations with physical activity and screening frequency, which were not explained by trauma exposure. Our review reveals that teasing apart the effects of trauma exposure and PTSD symptoms on PHBs brings greater clarity to the strength and direction of these associations.
心理创伤对身体健康的许多方面都有影响，包括预防性健康行为（PHBs）。然而，创伤暴露是否除了创伤后应激障碍（PTSD）症状的影响之外，还会对 PHBs 产生额外的影响，目前尚不清楚。在这项系统评价中，分析了 32 项研究，以描述：（1）创伤暴露与 PHBs 之间的关系，（2）PTSD 症状与 PHBs 之间的关系，（3）在不考虑 PTSD 症状的情况下，创伤暴露与 PHBs 之间的独特关联，以及（4）在不考虑创伤暴露的情况下，PTSD 症状与 PHBs 之间的独特关联。当仅考虑创伤暴露或 PTSD 症状时，三种被研究的 PHBs（体力活动、饮食、医疗筛查）的结果存在差异。当考虑 PTSD 症状时，创伤暴露与 PHBs 之间的关系更加清晰，表明创伤暴露与 PTSD 症状之外的 PHB 参与有关。此外，PTSD 症状与体力活动和筛查频率有独特的关联，这些关联不能用创伤暴露来解释。我们的综述表明，将创伤暴露和 PTSD 症状对 PHBs 的影响分开，可以更清楚地了解这些关联的强度和方向。
