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在经历创伤性机动车事故后前往急诊科就诊后的睡眠障碍和侵入性记忆:一项探索性分析。

Sleep disturbance and intrusive memories after presenting to the emergency department following a traumatic motor vehicle accident: an exploratory analysis.

作者信息

Luik Annemarie I, Iyadurai Lalitha, Gebhardt Isabel, Holmes Emily A

机构信息

Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.

Department of Epidemiology, Erasmus MC University Medical Centre, Rotterdam, Netherlands.

出版信息

Eur J Psychotraumatol. 2019 Jan 14;10(1):1556550. doi: 10.1080/20008198.2018.1556550. eCollection 2019.

Abstract

: Sleep disturbances are common after traumatic events and have been hypothesized to be a risk factor in the development of psychopathology such as that associated with posttraumatic stress disorder (PTSD). : To assess the association between intrusive memories, a core clinical feature of PTSD, and self-reported sleep disturbance shortly after experiencing or witnessing a motor vehicle accident, and whether a brief behavioural intervention (trauma reminder cue and Tetris gameplay) reduced sleep disturbance post-trauma. : The exploratory analyses included 71 participants (mean age 39.66, standard deviation 16.32; 37 women, 52.1%) enrolled in a previously published proof-of-concept randomized controlled trial. Participants were recruited from the emergency department after experiencing or witnessing a traumatic motor vehicle accident. Intrusive memories were assessed with a daily paper-and-pen diary for one week post-trauma, and sleep disturbances with three questions from the Impact of Event Scale-Revised assessing problems initiating sleep, problems maintaining sleep and dreams about the event at one week and one month post-trauma. Missing data were imputed 15 times. : The total number of intrusive memories during the first week post-trauma suggested weak to moderate pooled intercorrelations with problems initiating and maintaining sleep. An ordinal regression using imputed data suggested that the intervention had no effect on sleep disturbances, while completers only analyses suggested an improvement in problems maintaining sleep at one week. : This exploratory study suggested that experiencing early intrusive memories is related to sleep disturbances. Sleep disturbance might be a particularly important construct to assess in studies involving intrusive memories post-trauma.

摘要

创伤事件后睡眠障碍很常见,并且据推测是精神病理学发展的一个风险因素,比如与创伤后应激障碍(PTSD)相关的精神病理学。为了评估PTSD的核心临床特征——侵入性记忆,与经历或目睹机动车事故后不久自我报告的睡眠障碍之间的关联,以及一种简短的行为干预(创伤提醒线索和俄罗斯方块游戏)是否能减少创伤后的睡眠障碍。探索性分析纳入了71名参与者(平均年龄39.66岁,标准差16.32;37名女性,占52.1%),他们参与了一项之前发表的概念验证随机对照试验。参与者是在经历或目睹创伤性机动车事故后从急诊科招募的。创伤后一周内通过每日纸笔日记评估侵入性记忆,创伤后一周和一个月时通过事件影响量表修订版中的三个问题评估睡眠障碍,这三个问题分别是入睡困难、维持睡眠困难以及关于该事件的梦境。缺失数据进行了15次插补。创伤后第一周侵入性记忆的总数表明,与入睡和维持睡眠困难之间的合并相互关联较弱至中等。使用插补数据的有序回归表明干预对睡眠障碍没有影响,而仅对完成者的分析表明创伤后一周维持睡眠困难有所改善。这项探索性研究表明,早期经历侵入性记忆与睡眠障碍有关。在涉及创伤后侵入性记忆的研究中,睡眠障碍可能是一个特别重要的评估指标。

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