Department of Psychology, Yale University, New Haven, CT, USA.
Department of Anesthesiology, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Psychol Med. 2022 Jul;52(10):1934-1947. doi: 10.1017/S0033291720003773. Epub 2020 Oct 29.
This is the first report on the association between trauma exposure and depression from the dvancing nderstanding of ecvery afte traum(AURORA) multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience.
We focus on participants presenting at EDs after a motor vehicle collision (MVC), which characterizes most AURORA participants, and examine associations of participant socio-demographics and MVC characteristics with 8-week depression as mediated through peritraumatic symptoms and 2-week depression.
Eight-week depression prevalence was relatively high (27.8%) and associated with several MVC characteristics (being passenger driver; injuries to other people). Peritraumatic distress was associated with 2-week but not 8-week depression. Most of these associations held when controlling for peritraumatic symptoms and, to a lesser degree, depressive symptoms at 2-weeks post-trauma.
These observations, coupled with substantial variation in the relative strength of the mediating pathways across predictors, raises the possibility of diverse and potentially complex underlying biological and psychological processes that remain to be elucidated in more in-depth analyses of the rich and evolving AURORA database to find new targets for intervention and new tools for risk-based stratification following trauma exposure.
这是 ADVANCING UNDERSTANDING OF EVERYTHING AFTER TRAUMA(AURORA)多中心纵向研究中关于创伤后不良神经精神后果(APNS)的首份报告,该研究调查了创伤后生活经历后到急诊就诊的参与者中创伤暴露与抑郁之间的关系。
我们重点关注在机动车碰撞(MVC)后到急诊就诊的参与者,这是 AURORA 参与者的主要特征,并通过创伤前症状和 2 周抑郁来检查参与者的社会人口统计学特征和 MVC 特征与 8 周抑郁之间的关联。
8 周抑郁的患病率相对较高(27.8%),与几个 MVC 特征(乘客/司机;其他人受伤)有关。创伤前痛苦与 2 周抑郁有关,但与 8 周抑郁无关。在控制创伤前症状以及在较小程度上控制创伤后 2 周的抑郁症状时,这些关联仍然存在。
这些观察结果,加上预测因素中介途径的相对强度存在很大差异,这表明存在不同的且可能复杂的潜在生物学和心理过程,这些过程有待在对丰富且不断发展的 AURORA 数据库进行更深入的分析中阐明,以找到创伤暴露后干预的新目标和基于风险分层的新工具。