Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Australia.
College of Health and Medicine, University of Tasmania, Sydney Campus, Australia; National Burns Center, Sheba Medical Center, Israel.
Burns. 2019 Sep;45(6):1359-1366. doi: 10.1016/j.burns.2019.03.011. Epub 2019 Jun 1.
Research into recovery and adjustment after burn injury has indicated a link between psychopathological symptoms including traumatic stress, distress, depression and anxiety, and worse psychosocial and physical outcomes. The severity of psychological symptoms does not always correlate with that of the burn injury, and symptoms can be ongoing in certain patients for extensive periods, leading to a need for early screening in burns patients for psychological vulnerabilities. One potential factor influencing recovery from the psychological impact of burn injury is adult attachment style, specifically secure and insecure attachment, as this describes how an individual organizes their stress regulation. This cross-sectional study measured: (a) attachment style (via the Relationship Questionnaire [RQ]): (b) negative psychological symptoms (via the Depression Anxiety and Stress Scale [DASS]); and, (c) post-traumatic symptoms (via the Davidson Trauma Scale [DTS]) in a cohort of burns patients (n = 104, 51 analysed) in a severe burns unit in Australia during the acute phase of their recovery. Secure attachment style was inversely related to psychopathological symptoms. Secure participants scored significantly lower scores on the DASS (M = 17.63, SD = 17.07) compared to self-rated insecure participants [(M = 42.38, SD = 34.69), p < .01] and on the DTS (M = 14.22, SD = 15.42) compared to insecure participants [(M = 40.54, SD = 35.72), p < .01]. Similar results were found in analyses controlling for covariates of gender, age and burn severity as potential confounders. This research suggests attachment style may play an important role in psychosocial recovery from severe burn injury.
烧伤后康复和调整的研究表明,心理病理学症状(包括创伤后应激、痛苦、抑郁和焦虑)与较差的心理社会和身体结果之间存在关联。心理症状的严重程度并不总是与烧伤的严重程度相关,某些患者的症状可能会持续很长时间,因此需要对烧伤患者进行早期心理脆弱性筛查。影响烧伤后心理影响康复的一个潜在因素是成人依恋风格,特别是安全型和不安全型依恋,因为它描述了个体如何组织其压力调节。这项横断面研究在澳大利亚一家严重烧伤病房的急性康复期间,对烧伤患者(n=104,51 人分析)进行了以下测量:(a)依恋风格(通过关系问卷[RQ]):(b)负面心理症状(通过抑郁、焦虑和压力量表[DASS]);(c)创伤后症状(通过戴维森创伤量表[DTS])。安全型依恋与心理病理学症状呈负相关。安全型参与者在 DASS 上的得分显著低于自我评定的不安全型参与者[(M=17.63,SD=17.07),(M=42.38,SD=34.69),p<0.01],在 DTS 上的得分也显著低于不安全型参与者[(M=14.22,SD=15.42),(M=40.54,SD=35.72),p<0.01]。在控制性别、年龄和烧伤严重程度等潜在混杂因素的分析中,也得到了类似的结果。这项研究表明,依恋风格可能在严重烧伤后从心理社会方面的康复中起着重要作用。