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与部署相关的创伤后应激障碍症状学及社会功能:探究情绪调节和心理化在门诊退伍军人样本中的中介作用

Deployment-related PTSD symptomatology and social functioning: Probing the mediating roles of emotion regulation and mentalization in an outpatient veteran sample.

作者信息

Janssen Petrus G J, Stoltz Sabine, Cillessen Antonius H N, van Ee Elisa

机构信息

Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands; Psychotraumacentrum Zuid Nederland, Reinier van Arkel, 's-Hertogenbosch, The Netherlands.

Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.

出版信息

J Psychiatr Res. 2022 Dec;156:444-450. doi: 10.1016/j.jpsychires.2022.10.050. Epub 2022 Oct 20.

Abstract

Deployment-related posttraumatic stress disorder (PTSD) impacts social functioning in families. Therefore, it is important to examine the factors that contribute to social functioning in families that are confronted with deployment-related PTSD. The goal of this study was to assess the association between PTSD symptom severity and social functioning using self-report questionnaires in an outpatient veteran sample and to test the mediating roles of emotion regulation (Study 1, N = 100) and mentalization (Study 2, N = 38). Study 1 demonstrated that emotion regulation problems fully mediated PTSD associated family dysfunctioning. Study 2 did not demonstrate a mediation role of mentalization, but also did not demonstrate an association between PTSD and social dysfunctioning. Maladaptive mentalization was associated with poor child adjustment. Critically, a between-study comparison revealed that PTSD symptom severity was significantly higher in Study 1 than in Study 2. Overall, our findings suggest that social dysfunctioning may only appear when a given severity threshold of PTSD is reached, in which emotion regulation might be a key clinical factor. Maladaptive mentalization may be critical for post-deployment child adjustment. Future research should further examine social functioning in samples with different PTSD severity profiles and include the role of mentalization. Longitudinal data are needed to gain further insight into the causal relationships among the factors considered and the etiological pathways that lead to developing social dysfunction over time.

摘要

与部署相关的创伤后应激障碍(PTSD)会影响家庭中的社会功能。因此,研究导致面临与部署相关PTSD的家庭中社会功能的因素非常重要。本研究的目的是在门诊退伍军人样本中使用自我报告问卷评估PTSD症状严重程度与社会功能之间的关联,并测试情绪调节(研究1,N = 100)和心理化(研究2,N = 38)的中介作用。研究1表明,情绪调节问题完全介导了与PTSD相关的家庭功能失调。研究2未证明心理化的中介作用,但也未证明PTSD与社会功能失调之间的关联。适应不良的心理化与儿童适应不良有关。至关重要的是,研究间比较显示,研究1中的PTSD症状严重程度显著高于研究2。总体而言,我们的研究结果表明,只有当达到特定的PTSD严重程度阈值时,社会功能失调才可能出现,其中情绪调节可能是一个关键的临床因素。适应不良的心理化可能对部署后儿童的适应至关重要。未来的研究应进一步检查不同PTSD严重程度特征样本中的社会功能,并纳入心理化的作用。需要纵向数据以进一步深入了解所考虑因素之间的因果关系以及随着时间推移导致社会功能失调的病因途径。

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