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应对韧性变化与创伤后应激障碍症状之间的关联。

Associations between changes in resilient coping and posttraumatic stress disorder symptoms.

机构信息

Vanderbilt University School of Nursing, Nashville, Tennessee.

出版信息

Res Nurs Health. 2020 Jun;43(3):255-262. doi: 10.1002/nur.22014. Epub 2020 Feb 17.

Abstract

The pervasive, damaging nature of posttraumatic stress disorder (PTSD) presents enormous clinical challenges. Understanding the relationship between patients' perceptions of PTSD symptoms and resilient coping strategies may prompt investigation of clinical interventions that improve adaptive, resilient coping skills. In this study, we examined whether changes in resilient coping were related to changes over time in the PTSD symptoms of intrusion and avoidance. A secondary analysis was conducted using longitudinal data from the community-based Washington State Twin Registry. Participants completed the four-item Brief Resilient Coping Scale (BRCS) and the Avoidance and Intrusion subscales of the Impact of Events Scale (IES) at two points in time that were at least 2 years apart. To limit analyses to participants reporting PTSD symptoms at baseline, an initial value of at least 1.0 on either Avoidance (n = 1,337) or Intrusion (n = 1,206) was required for inclusion in the sample. Using linear regression, we assessed associations of change in BRCS with a change in IES scores, controlling for the respective initial scores on each measure. Controlling for initial BRCS and IES-Intrusion values, we observed a small, statistically significant association between change in BRCS and change in IES-Intrusion scores (b* = -0.07; p = .003). There was no statistically significant association between change in BRCS and change in IES-Avoidance (b* < 0.01; p = .869). In this large, longitudinal sample, increases in resilient coping were related to decreases in intrusive thoughts over time. Because coping patterns can be taught, these results warrant further investigations into adaptive coping patterns associated with diminishing PTSD symptoms.

摘要

创伤后应激障碍(PTSD)普遍存在且具有破坏性,这给临床带来了巨大挑战。了解患者对 PTSD 症状的认知与弹性应对策略之间的关系,可能会促使人们探索改善适应性、弹性应对技能的临床干预措施。在这项研究中,我们考察了弹性应对的变化是否与 PTSD 症状中的侵入和回避症状随时间的变化有关。我们对基于社区的华盛顿州双胞胎登记处的纵向数据进行了二次分析。参与者在至少相隔 2 年的两个时间点完成了四项简短的弹性应对量表(BRCS)和事件影响量表(IES)的回避和侵入分量表。为了将分析限制在基线时报告有 PTSD 症状的参与者中,要求样本中至少有 1 项回避(n=1337)或侵入(n=1206)的初始值为 1.0 或更高。我们使用线性回归,在控制每个测量的初始分数的情况下,评估了 BRCS 变化与 IES 分数变化之间的关联。在控制初始 BRCS 和 IES-侵入值的情况下,我们观察到 BRCS 变化与 IES-侵入分数变化之间存在较小但具有统计学意义的关联(b*=-0.07;p=0.003)。BRCS 变化与 IES-回避变化之间没有统计学意义上的关联(b*<0.01;p=0.869)。在这个大型的纵向样本中,弹性应对能力的提高与侵入性思维随时间的减少有关。由于应对模式可以被教授,因此这些结果值得进一步研究与 PTSD 症状减轻相关的适应性应对模式。

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