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创伤后应激、抑郁和焦虑症状与创伤暴露消防员的焦虑敏感和情绪调节之间的独特和交互作用。

The unique and interactive effects of anxiety sensitivity and emotion dysregulation in relation to posttraumatic stress, depressive, and anxiety symptoms among trauma-exposed firefighters.

机构信息

University of Houston, Department of Psychology, Houston, TX, USA.

University of Houston, Department of Psychology, Houston, TX, USA; Texas Institute of Measurement Evaluation and Statistics (TIMES), Houston, TX, USA.

出版信息

Compr Psychiatry. 2018 Jul;84:54-61. doi: 10.1016/j.comppsych.2018.03.012. Epub 2018 Apr 6.

Abstract

BACKGROUND

Firefighters are chronically exposed to traumatic events. Relatedly, past work has documented high rates of psychiatric problems, such as posttraumatic stress symptoms and depression, among firefighters. Less is known regarding anxiety symptoms among firefighters. Moreover, little work has examined risk/maintenance factors related to these symptoms among firefighters. Doing so may be important to developing interventions tailored to trauma-exposed firefighters. The current study examined symptoms of posttraumatic stress, depression, panic disorder, and social anxiety among trauma-exposed firefighters.

PROCEDURE

Using structural equation modeling, the main and interactive effects of anxiety sensitivity and emotion dysregulation were examined in relation to these symptom outcomes. Participants included 787 male urban firefighters reporting at least one past traumatic event.

RESULTS

There was a statistically significant main effect of anxiety sensitivity on each outcome. Emotion dysregulation exerted a statistically significant main effect on posttraumatic stress, depression, and social anxiety symptoms. Interactive effects of anxiety sensitivity and emotion dysregulation did not reach statistical significance but examination of effect sizes suggests that interactive effects may be present for posttraumatic stress symptoms (R = 0.011), depression (R = 0.008), and panic (R = 0.016) such that emotion dysregulation is more strongly related to outcomes when anxiety sensitivity levels are relatively lower. All effects were evident after controlling for trauma severity and history of armed forces service.

CONCLUSION

Overall, results suggest that anxiety sensitivity and emotion dysregulation represent unique risk/maintenance factors related to a broad range of emotional symptoms among trauma-exposed firefighters. These findings replicate patterns found among the general population and extend the findings to potentially vulnerable firefighters.

摘要

背景

消防员长期接触创伤性事件。相关研究表明,消防员中存在较高的精神健康问题,如创伤后应激症状和抑郁。而对于消防员的焦虑症状则知之甚少。此外,很少有研究探讨与消防员这些症状相关的风险/维持因素。这样做可能对于开发针对创伤暴露消防员的干预措施很重要。本研究考察了创伤暴露消防员的创伤后应激、抑郁、惊恐障碍和社交焦虑症状。

方法

使用结构方程模型,检验了焦虑敏感和情绪失调的主要和交互作用与这些症状结果的关系。参与者包括 787 名报告至少有一次过去创伤事件的男性城市消防员。

结果

焦虑敏感对每个结果都有统计学上显著的主要影响。情绪失调对创伤后应激、抑郁和社交焦虑症状有统计学上显著的主要影响。焦虑敏感和情绪失调的交互作用没有达到统计学意义,但对效应大小的检验表明,交互作用可能存在于创伤后应激症状(R=0.011)、抑郁(R=0.008)和惊恐(R=0.016)中,即当焦虑敏感水平相对较低时,情绪失调与结果的关系更为密切。在控制创伤严重程度和武装部队服务史后,所有效应均明显。

结论

总体而言,结果表明焦虑敏感和情绪失调是创伤暴露消防员广泛情绪症状的独特风险/维持因素。这些发现复制了在一般人群中发现的模式,并将研究结果扩展到潜在的脆弱消防员。

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