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创伤后成年人的情绪反应失调:述情障碍的影响。

Emotion response disconcordance among trauma-exposed adults: the impact of alexithymia.

机构信息

Department of Psychiatry, Phoenix Australia Centre for Posttraumatic Mental Health, University of Melbourne, Parkville, VIC, Australia.

Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia.

出版信息

Psychol Med. 2023 Sep;53(12):5442-5448. doi: 10.1017/S0033291722002586. Epub 2022 Aug 17.

Abstract

BACKGROUND

Emotion processing deficits have been identified as a critical transdiagnostic factor that facilitates distress after trauma exposure. Limited skills in identifying and labelling emotional states (i.e. alexithymia) may present on the more automated (less conscious) end of the spectrum of emotional awareness and clarity. Individuals with alexithymia tend to exhibit a disconcordance between subjective experience and autonomic activity (e.g. where high levels of subjective emotional intensity are associated with low physiological arousal), which may exacerbate distress. Although there is a robust link between alexithymia and trauma exposure, no work to date has explored whether alexithymia is associated with emotional response disconcordance among trauma-exposed adults.

METHOD

Using a validated trauma script paradigm, the present study explored the impact of alexithymia on emotion response concordance [skin conductance (Galvanic Skin Response, GSR) and Total Mood Disturbance (TMD)] among 74 trauma-exposed adults recruited via a posttraumatic stress disorder (PTSD) treatment clinic and student research programme.

RESULTS

Unlike posttraumatic symptom severity, age, sex, participant type and mood (which showed no effect on emotion response concordance), alexithymia was associated with heightened emotion response disconcordance between GSR and TMD [ = 8.93, = 0.006], with low GSR being associated with high TMD. Observed effects of the trauma script were entirely accounted for by the interaction with alexithymia, such that those with alexithymia showed a negligible association between subjective and physiological states.

CONCLUSION

This finding is paramount as it shows that a large proportion of trauma-exposed adults have a divergent emotion engagement profile.

摘要

背景

情绪处理缺陷已被确定为创伤暴露后痛苦加剧的关键跨诊断因素。识别和标记情绪状态的能力有限(即述情障碍)可能出现在情绪意识和清晰度的更自动化(无意识程度较低)端。述情障碍个体往往表现出主观体验与自主活动之间的不协调(例如,主观情绪强度高与生理唤醒低相关),这可能会加剧痛苦。尽管述情障碍与创伤暴露之间存在很强的联系,但迄今为止尚无研究探讨述情障碍是否与创伤暴露成年人的情绪反应不协调有关。

方法

本研究使用经过验证的创伤脚本范式,探讨了述情障碍对 74 名创伤暴露成年人(通过创伤后应激障碍(PTSD)治疗诊所和学生研究计划招募)的情绪反应一致性(皮肤电导(皮肤电反应,GSR)和总情绪障碍(TMD))的影响。

结果

与创伤后症状严重程度、年龄、性别、参与者类型和情绪(对情绪反应一致性没有影响)不同,述情障碍与 GSR 和 TMD 之间的情绪反应不协调高度相关[ = 8.93, = 0.006],GSR 较低与 TMD 较高相关。观察到的创伤脚本效应完全由与述情障碍的相互作用解释,因此述情障碍个体在主观和生理状态之间表现出微不足道的关联。

结论

这一发现至关重要,因为它表明相当一部分创伤暴露成年人具有不同的情绪参与特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2592/10482720/a24a784fd3e1/S0033291722002586_fig1.jpg

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