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创伤暴露消防员的创伤后应激障碍症状严重程度、疼痛强度及疼痛相关残疾:正念的调节作用

PTSD Symptom Severity, Pain Intensity, and Pain-Related Disability Among Trauma-Exposed Firefighters: the Moderating Role of Mindfulness.

作者信息

Lebeaut Antoine, Zegel Maya, Healy Nathaniel A, Rogers Andrew H, Buser Samuel J, Vujanovic Anka A

机构信息

Department of Psychology, Trauma and Stress Studies Center, University of Houston, 3695 Cullen Boulevard - 126 Heyne Building, Houston, TX 77204, USA.

Houston Fire Department, Houston, TX, USA.

出版信息

Mindfulness (N Y). 2022 Mar;13(3):786-798. doi: 10.1007/s12671-022-01836-4. Epub 2022 Feb 5.

Abstract

OBJECTIVES

Firefighters are regularly exposed to potentially traumatic and injurious events and are at increased risk for developing posttraumatic stress disorder (PTSD) symptoms, pain, and pain-related disability. Mindfulness (i.e., present-oriented awareness and nonjudgmental acceptance of cognitions and bodily sensations) may influence PTSD-pain relations in firefighter populations and inform mutual maintenance models. The current cross-sectional study sought to examine the moderating role of mindfulness on the associations between PTSD symptom severity and pain-related disability and intensity among trauma-exposed firefighters.

METHODS

Firefighters ( = 266; = 40.48, = 9.70; 92.5% male) were recruited from a large, southwestern metropolitan area and voluntarily completed an online, self-report survey advertised throughout the fire department.

RESULTS

Accounting for covariates (i.e., age, years in the fire service, trauma load), a significant interactive effect of PTSD symptom severity and mindfulness on pain-related disability (Δ = 0.05, = - 0.16, < .001), but not pain intensity, emerged. Simple slope analyses revealed that PTSD symptom severity was associated with pain-related disability for those with low, but not high mindfulness. Post hoc analyses examining mindfulness facets revealed significant main effects of acting with awareness, non-judging of inner experience, and nonreactivity to inner experience on pain-related disability. Significant interactive effects of observing, describing, and nonreactivity to inner experience with PTSD symptom severity on pain-related disability emerged.

CONCLUSIONS

Mindfulness moderates PTSD symptom severity and pain-related disability associations in trauma-exposed firefighters. Future work should further examine these associations among first responders, using experimental and/or longitudinal methodologies.

摘要

目的

消防员经常接触潜在的创伤性和伤害性事件,患创伤后应激障碍(PTSD)症状、疼痛及与疼痛相关的残疾的风险增加。正念(即对当下的认知和身体感觉的关注以及不加评判的接纳)可能会影响消防员群体中PTSD与疼痛的关系,并为相互维持模型提供信息。本横断面研究旨在检验正念在创伤暴露消防员中PTSD症状严重程度与疼痛相关残疾及强度之间关联的调节作用。

方法

从西南部一个大都市地区招募消防员(n = 266;M = 40.48,SD = 9.70;92.5%为男性),他们自愿完成了在整个消防部门宣传的在线自我报告调查。

结果

在考虑协变量(即年龄、消防工作年限、创伤负荷)后,PTSD症状严重程度与正念对疼痛相关残疾有显著的交互作用(ΔR² = 0.05,β = - 0.16,p <.001),但对疼痛强度没有交互作用。简单斜率分析显示,对于低正念而非高正念的个体,PTSD症状严重程度与疼痛相关残疾有关。事后分析考察正念的各个方面发现,有意识行动、不对内心体验进行评判以及对内心体验不反应对疼痛相关残疾有显著的主效应。观察、描述以及对内心体验不反应与PTSD症状严重程度对疼痛相关残疾有显著的交互作用。

结论

正念调节创伤暴露消防员中PTSD症状严重程度与疼痛相关残疾的关联。未来的研究应使用实验和/或纵向方法,进一步研究急救人员中的这些关联。

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