Department of Psychology.
California School of Professional Psychology.
Psychol Trauma. 2019 Feb;11(2):156-164. doi: 10.1037/tra0000404. Epub 2018 Sep 13.
Following the World Trade Center (WTC) terrorist attack in New York City, prevalence rates of posttraumatic stress disorder (PTSD) and depression remain elevated. Although social support and self-efficacy have been associated with PTSD, little is known about their differential effect on PTSD and depressive comorbidity.
WTC tower survivors ( = 1,304) were assessed at Wave 1 (2003-2004), Wave 2 (2006-2007), Wave 3 (2011-2012), and Wave 4 (2015-2016).
At Wave 4, 13.0% of participants had probable PTSD, a decrease from 16.5% at Wave 1. In addition, 4.1% (54) were identified as having PTSD alone, 6.8% (89) had depression alone, and 8.9% (116) had comorbid PTSD and depression. Of those with PTSD, 68.2% also had comorbid depression. WTC tower survivors with PTSD and comorbid depression reported greater PTSD symptom severity and were more likely to have had greater exposure to the events of 9/11 (adjusted odds ratio [a] = 1.14) and lower self-efficacy (a = 0.85) than those with depression alone. Less perceived social support predicted only depression and not PTSD, whereas less perceived self-efficacy equally predicted having PTSD or depression (a = 0.76).
Findings indicate that self-efficacy may be more important to the severity and chronicity of PTSD symptoms than social support. Multivariate comparisons suggest that PTSD with comorbid depression is a presentation of trauma-dependent psychopathologies, as opposed to depression alone following trauma, which was independent of trauma exposure and may be secondary to the traumatic event and posttraumatic response. Implications for assessment and treatment are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
在纽约市世界贸易中心（WTC）恐怖袭击事件发生后，创伤后应激障碍（PTSD）和抑郁症的患病率仍然居高不下。尽管社会支持和自我效能感与 PTSD 有关，但对于它们对 PTSD 和抑郁共病的不同影响知之甚少。
对 WTC 塔幸存者（n=1304）进行了 4 次评估，分别是波 1（2003-2004 年）、波 2（2006-2007 年）、波 3（2011-2012 年）和波 4（2015-2016 年）。
在波 4 时，13.0%的参与者患有 PTSD，较波 1 时的 16.5%有所下降。此外，4.1%（54 人）被确定为仅患有 PTSD，6.8%（89 人）仅患有抑郁症，8.9%（116 人）患有 PTSD 和抑郁症共病。在患有 PTSD 的人群中，有 68.2%的人同时患有共病性抑郁症。患有 PTSD 和共病性抑郁症的 WTC 塔幸存者报告称 PTSD 症状严重程度更高，并且更有可能经历过更多与 9/11 事件相关的事件（调整后的优势比[a]=1.14），并且自我效能感更低（a=0.85），而与仅患有抑郁症的人群相比。较少的感知社会支持仅预测抑郁症，而不预测 PTSD，而较少的感知自我效能感则同样预测患有 PTSD 或抑郁症（a=0.76）。
研究结果表明，与社会支持相比，自我效能感可能对 PTSD 症状的严重程度和持续性更为重要。多元比较表明，患有 PTSD 和共病性抑郁症的患者表现为创伤相关精神病理学，而不是创伤后出现的单纯抑郁症，这与创伤暴露无关，可能是创伤事件和创伤后反应的结果。讨论了对评估和治疗的影响。（PsycINFO 数据库记录（c）2019 APA，保留所有权利）。
