Pennsylvania State University, The Behrend College, Erie, USA.
Summa Health Traumatic Stress Center, Akron, OH, USA.
J Interpers Violence. 2021 Jul;36(13-14):6418-6439. doi: 10.1177/0886260518818434. Epub 2018 Dec 17.
Prior research has identified both rumination and negative affect (NA) as dimensional constructs related to the development and maintenance of posttraumatic stress disorder (PTSD). While both dimensions demonstrate significant positive relationships with symptoms of PTSD, the relationship between the two within the context of the disorder has yet to be explored. Consistent with prior research in the social anxiety literature, the present study seeks to examine a model of mediation by which rumination accounts for the significant relationship between NA and PTSD symptoms. Participants included 65 female interpersonal trauma survivors diagnosed with PTSD using structured, clinician-administered interviews. Both NA and rumination were observed as significant predictors of PTSD symptoms, and the variables were significantly associated with each other. However, NA was no longer a significant predictor of PTSD symptoms when rumination was entered into the mediation model, suggesting full mediation of the relationship by rumination. Results from the current study suggest a complex relationship between NA and rumination in interpersonal trauma survivors with PTSD, such that a ruminative cognitive coping style may either mitigate or exacerbate PTSD symptoms in the presence of sustained negative emotion. The current findings provide support for a cognitive model of PTSD, within which PTSD symptoms are influenced via negative, ruminative cognitions. Primary implications of these results include (a) the consideration of assessment of rumination in interpersonal trauma survivors with PTSD in clinical settings; (b) the selection of treatment that may address a ruminative cognitive style in this population, given the mediation between subjective distress and PTSD symptoms by rumination; and (c) the necessity for the validation of this mediation model within other traumatized populations.
先前的研究已经确定了反刍思维和负性情绪(NA)作为与创伤后应激障碍(PTSD)的发展和维持相关的维度结构。虽然这两个维度都与 PTSD 症状表现出显著的正相关关系,但在该疾病的背景下,两者之间的关系尚未得到探索。与社会焦虑文献中的先前研究一致,本研究试图检验一种中介模型,即反刍思维解释了 NA 与 PTSD 症状之间显著关系的机制。参与者包括 65 名女性人际创伤幸存者,他们通过结构化的、临床医生管理的访谈被诊断为 PTSD。NA 和反刍思维都被观察为 PTSD 症状的显著预测因子,并且这两个变量彼此之间存在显著的相关性。然而,当将反刍思维纳入中介模型时,NA 不再是 PTSD 症状的显著预测因子,这表明反刍思维完全中介了两者之间的关系。当前研究的结果表明,在 PTSD 人际创伤幸存者中,NA 和反刍思维之间存在复杂的关系,即当持续存在负性情绪时,一种反刍性认知应对方式可能会减轻或加重 PTSD 症状。这些发现为 PTSD 的认知模型提供了支持,在该模型中,PTSD 症状受到负性、反刍性认知的影响。这些结果的主要意义包括:(a)在临床环境中考虑对 PTSD 人际创伤幸存者进行反刍思维评估;(b)鉴于反刍思维在主观痛苦和 PTSD 症状之间的中介作用,在该人群中选择可能会解决反刍性认知风格的治疗方法;(c)需要在其他受创伤的人群中验证这种中介模型。