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分娩创伤记忆与产妇产后创伤后应激障碍有关。

Traumatic memories of childbirth relate to maternal postpartum posttraumatic stress disorder.

机构信息

Department of Psychiatry, Massachusetts General Hospital, Charlestown Navy Yard, 120 2nd Ave, Charlestown, MA 02129, USA.

Department of Psychiatry, Massachusetts General Hospital, Charlestown Navy Yard, 120 2nd Ave, Charlestown, MA 02129, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.

出版信息

J Anxiety Disord. 2021 Jan;77:102342. doi: 10.1016/j.janxdis.2020.102342. Epub 2020 Nov 26.

Abstract

The trauma memory is a crucial feature of PTSD etiology and maintenance. Nonetheless, the nature of memories associated with childbirth-related posttraumatic stress disorder (CB-PTSD) requires explication. The present study, as part of a larger project on psychological outcomes of childbirth, utilized a multi-method approach to characterize childbirth memories in relation to CB-PTSD symptoms. We here assessed 413 women who completed self-report measures pertaining to CB-PTSD, postpartum depression, and childbirth memories. Additionally, a subset of 209 women provided written childbirth narratives, analyzed using Linguistic Inquiry and Word Count software. Women endorsing CB-PTSD symptoms on the PTSD-Checklist (PCL)-5 reported more incoherent childbirth memories with more emotional and sensory details, and more frequent involuntary recall and reliving of the memory. They also indicated the childbirth experience was more central to their identity. Written narratives in those with probable CB-PTSD were characterized by less (positive) affective processes, and more cognitive processes. We infer that childbirth memories in women who endorse symptoms of CB-PTSD in the early postpartum period resemble those described in the general PTSD literature. This suggests that childbirth may be experienced as traumatic and evoke a traumatic memory, implicated in symptom endorsement. Opportunities for therapeutic interventions modifying traumatic memories of childbirth in women at risk for CB-PTSD need to be investigated. Future research examining characteristics of traumatic childbirth memories is needed to advance our understanding of this overlooked postpartum condition.

摘要

创伤记忆是创伤后应激障碍(PTSD)发病和维持的一个关键特征。然而,与产后创伤后应激障碍(CB-PTSD)相关的记忆的性质需要加以说明。本研究作为一项关于分娩相关心理后果的更大项目的一部分,采用多方法的方法来描述与 CB-PTSD 症状相关的分娩记忆。我们在此评估了 413 名完成了与 CB-PTSD、产后抑郁和分娩记忆相关的自我报告措施的女性。此外,还对 209 名女性进行了书面分娩叙述,使用语言探究和词汇计数软件进行了分析。在 PTSD 检查表(PCL-5)上对 CB-PTSD 症状表示认可的女性报告了更多不连贯的分娩记忆,这些记忆具有更多的情感和感官细节,并且更频繁地不由自主地回忆和重温记忆。她们还表示分娩经历对她们的身份更为重要。在可能患有 CB-PTSD 的女性中,书面叙述的特点是较少(积极)的情感过程,更多的认知过程。我们推断,在产后早期对 CB-PTSD 症状表示认可的女性的分娩记忆与一般 PTSD 文献中描述的记忆相似。这表明分娩可能被视为创伤性的,并引起创伤性记忆,这与症状的出现有关。需要研究对有患 CB-PTSD 风险的女性进行分娩创伤记忆的治疗干预的机会。需要进一步研究创伤性分娩记忆的特征,以增进我们对这种被忽视的产后疾病的理解。

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