在 SARS-CoV-2（COVID-19）大流行期间，医护人员和公共安全人员的创伤与物质使用之间的关联：分离和情绪调节障碍的中介作用。
Associations between trauma and substance use among healthcare workers and public safety personnel during the SARS-CoV-2 (COVID-19) pandemic: the mediating roles of dissociation and emotion dysregulation.
机构信息
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.
Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Canada.
出版信息
Eur J Psychotraumatol. 2023;14(1):2180706. doi: 10.1080/20008066.2023.2180706.
BACKGROUND
Given the highly stressful environment surrounding the SARS-CoV-2 pandemic, healthcare workers (HCW) and public safety personnel (PSP) are at an elevated risk for adverse psychological outcomes, including posttraumatic stress disorder (PTSD) and alcohol/substance use problems. As such, the study aimed to identify associations between PTSD severity, related dissociation and emotion dysregulation symptoms, and alcohol/substance use problems among HCWs and PSP.
METHODS
A subset of data (= 498; HCWs = 299; PSP = 199) was extracted from a larger study examining psychological variables among Canadian HCWs and PSP during the pandemic. Structural equation modelling assessed associations between PTSD symptoms and alcohol/substance use-related problems with dissociation and emotion dysregulation as mediators.
RESULTS
Among HCWs, dissociation fully mediated the relation between PTSD and alcohol-related problems (indirect effect = .133, = .03) and emotion dysregulation partially mediated the relation between PTSD and substance-related problems (indirect effect = .151, = .046). In PSP, emotion dysregulation fully mediated the relation between PTSD and alcohol-related problems (indirect effects = .184, = .005). For substance-related problems among PSP, neither emotion dysregulation nor dissociation (s >.05) had any effects.
CONCLUSION
To our knowledge, this is the first study examining associations between PTSD severity and alcohol/substance use-related problems via mediating impacts of emotion dysregulation and dissociation among HCWs and PSP during the SARS-CoV-2 pandemic. These findings highlight dissociation and emotion dysregulation as important therapeutic targets for structured interventions aimed at reducing the burden of PTSD and/or SUD among Canadian HCWs or PSP suffering from the adverse mental health impacts of the SARS-CoV-2 pandemic.
背景
由于 SARS-CoV-2 大流行带来的高度紧张环境，医护人员（HCW）和公共安全人员（PSP）面临着更高的不良心理后果风险，包括创伤后应激障碍（PTSD）和酒精/物质使用问题。因此，本研究旨在确定 PTSD 严重程度、相关解离和情绪调节障碍症状与 HCW 和 PSP 之间的酒精/物质使用问题之间的关联。
方法
从一项更大的研究中提取了与 SARS-CoV-2 大流行期间加拿大 HCW 和 PSP 的心理变量有关的数据子集（=498；HCW=299；PSP=199）。结构方程模型评估了 PTSD 症状与酒精/物质使用相关问题之间的关联，将解离和情绪调节障碍作为中介。
结果
在 HCW 中，解离完全介导了 PTSD 与酒精相关问题之间的关系（间接效应=0.133，=0.03），情绪调节障碍部分介导了 PTSD 与物质相关问题之间的关系（间接效应=0.151，=0.046）。在 PSP 中，情绪调节障碍完全介导了 PTSD 与酒精相关问题之间的关系（间接效应=0.184，=0.005）。对于 PSP 中的物质相关问题，情绪调节障碍和解离都没有影响（s>0.05）。
结论
据我们所知，这是第一项研究，通过在 SARS-CoV-2 大流行期间对 HCW 和 PSP 中情绪调节障碍和解离的中介影响，研究 PTSD 严重程度与酒精/物质使用相关问题之间的关联。这些发现强调了在 SARS-CoV-2 大流行期间，对遭受 PTSD 和/或 SUD 不良心理健康影响的加拿大 HCW 或 PSP ，解离和情绪调节障碍是重要的治疗目标。
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