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为什么 COVID-19 大流行是一个创伤性压力源。

Why the COVID-19 pandemic is a traumatic stressor.

机构信息

College of Education, Psychology & Social Work, Flinders University, Adelaide, South Australia, Australia.

Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia.

出版信息

PLoS One. 2021 Jan 11;16(1):e0240146. doi: 10.1371/journal.pone.0240146. eCollection 2021.

Abstract

The COVID-19 pandemic does not fit into prevailing Post-traumatic Stress Disorder (PTSD) models, or diagnostic criteria, yet emerging research shows traumatic stress symptoms as a result of this ongoing global stressor. Current pathogenic event models focus on past, and largely direct, trauma exposure to certain kinds of life-threatening events. Yet, traumatic stress reactions to future, indirect trauma exposure, and non-Criterion A events exist, suggesting COVID-19 is also a traumatic stressor which could lead to PTSD symptomology. To examine this idea, we asked a sample of online participants (N = 1,040), in five western countries, to indicate the COVID-19 events they had been directly exposed to, events they anticipated would happen in the future, and other forms of indirect exposure such as through media coverage. We then asked participants to complete the Posttraumatic Stress Disorder Checklist-5, adapted to measure pre/peri/post-traumatic reactions in relation to COVID-19. We also measured general emotional reactions (e.g., angry, anxious, helpless), well-being, psychosocial functioning, and depression, anxiety, and stress symptoms. We found participants had PTSD-like symptoms for events that had not happened and when participants had been directly (e.g., contact with virus) or indirectly exposed to COVID-19 (e.g., via media). Moreover, 13.2% of our sample were likely PTSD-positive, despite types of COVID-19 "exposure" (e.g., lockdown) not fitting DSM-5 criteria. The emotional impact of "worst" experienced/anticipated events best predicted PTSD-like symptoms. Taken together, our findings support emerging research that COVID-19 can be understood as a traumatic stressor event capable of eliciting PTSD-like responses and exacerbating other related mental health problems (e.g., anxiety, depression, psychosocial functioning, etc.). Our findings add to existing literature supporting a pathogenic event memory model of traumatic stress.

摘要

新冠疫情不符合现行的创伤后应激障碍 (PTSD) 模型或诊断标准,但新兴研究表明,由于这种持续的全球压力源,出现了创伤性应激症状。目前的发病事件模型主要集中在过去,并且主要直接针对某些危及生命的事件的创伤暴露。然而,对于未来的间接创伤暴露和非 A 类事件,也存在创伤性应激反应,这表明新冠疫情也是一种创伤性应激源,可能导致 PTSD 症状。为了检验这一观点,我们在五个西方国家的在线参与者样本中(N = 1,040),要求他们指出自己直接接触过的新冠疫情事件、预计未来会发生的事件以及通过媒体报道等其他形式的间接接触。然后,我们让参与者完成创伤后应激障碍检查表 5 版,该版本旨在测量与新冠疫情相关的创伤前/中/后反应。我们还测量了一般情绪反应(例如,愤怒、焦虑、无助)、幸福感、心理社会功能和抑郁、焦虑和压力症状。我们发现,参与者对尚未发生的事件和直接(例如接触病毒)或间接(例如通过媒体)接触新冠疫情的事件出现了类似 PTSD 的症状。此外,尽管新冠疫情“暴露”(例如封锁)不符合 DSM-5 标准,但我们样本中的 13.2%可能存在 PTSD 阳性。“最严重”经历/预期事件的情绪影响最能预测类似 PTSD 的症状。总的来说,我们的研究结果支持了新兴研究,即新冠疫情可被理解为一种创伤性应激源事件,能够引发类似 PTSD 的反应,并加重其他相关心理健康问题(例如,焦虑、抑郁、心理社会功能等)。我们的研究结果增加了支持创伤性应激的发病事件记忆模型的现有文献。

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