Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel.
Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel.
Gen Hosp Psychiatry. 2018 Jul-Aug;53:131-138. doi: 10.1016/j.genhosppsych.2018.02.011. Epub 2018 May 16.
According to Edmondson's Enduring Somatic Threat (EST) Model of PTSD Due to Acute Life-Threatening Medical Events, the nature of PTSD in the context of illness may differ from the nature of "traditional" PTSD in that it includes future-oriented alongside past-related intrusive thoughts. Yet almost no empirical studies to date have assessed the putative future-oriented quality of cardiac-disease-induced PTSD (CDI-PTSD). In the current study, we assessed the hypothesized associations between CDI-PTSD and fear of illness progression (FoP) - a novel theoretical conceptualization of patients' future-related anxieties. We hypothesized that FoP would be positively associated with CDI-PTSD, and especially with its specific items of intrusive thoughts. Patients (N = 112) were interviewed three months post-hospitalization for an acute coronary event via use of the PSS-SR-5 (to assess PTSD symptomatology), the FoP-Q-SF (to assess fear of illness progression), and the HADS (to assess anxiety and depression levels). Results indicated a strong positive association between CDI-PTSD and FoP, even when controlling for anxiety and depression. As hypothesized, the concepts of CDI-PTSD and fear of illness progression were strongly associated both at the level of the clusters as well as at the level of the specific items. The current study provides an initial empirical validation of the EST Model, especially regarding the future-oriented nature of PTSD resulting from acute cardiovascular disease.
根据埃德蒙森(Edmondson)关于急性危及生命的医疗事件所致 PTSD 的持久躯体威胁(EST)模型,疾病背景下 PTSD 的性质可能与“传统”PTSD 的性质不同,因为它包括与过去相关的侵入性思维之外的面向未来的思维。然而,迄今为止,几乎没有实证研究评估过心脏病引起的 PTSD(CDI-PTSD)的所谓面向未来的特征。在当前的研究中,我们评估了 CDI-PTSD 与疾病进展恐惧(FoP)之间的假设关联,这是对患者未来相关焦虑的一种新的理论概念化。我们假设 FoP 与 CDI-PTSD 呈正相关,尤其是与它的侵入性思维特定项目呈正相关。通过使用 PSS-SR-5(评估 PTSD 症状)、FoP-Q-SF(评估疾病进展恐惧)和 HADS(评估焦虑和抑郁水平),在急性冠状动脉事件住院后三个月对患者(N=112)进行了访谈。结果表明,即使在控制了焦虑和抑郁之后,CDI-PTSD 和 FoP 之间也存在强烈的正相关。正如假设的那样,CDI-PTSD 和疾病进展恐惧的概念在集群层面以及特定项目层面都存在强烈的关联。本研究初步验证了 EST 模型,特别是关于急性心血管疾病导致的 PTSD 的面向未来的性质。