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情绪调节障碍的各个方面均能预测创伤后抑郁和 PTSD 症状的严重程度。

Facets of emotion dysregulation differentially predict depression and PTSD symptom severity following traumatic injury.

机构信息

Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.

Department of Psychology, University of Wisconsin, Milwaukee, WI, USA.

出版信息

Eur J Psychotraumatol. 2023;14(2):2193524. doi: 10.1080/20008066.2023.2193524.

Abstract

Emotion dysregulation is a hallmark characteristic of psychopathology following trauma. Yet, emotion dysregulation is multifaceted, and little is known about which aspects of emotion dysregulation predict depression and posttraumatic stress disorder (PTSD) symptom severity following traumatic injury. The aim of this longitudinal study was to evaluate how facets of dysregulation differentially predicted the severity of PTSD symptom clusters and depressive symptoms six months after a traumatic injury requiring medical treatment. Traumatically injured adults ( = 99) presenting to a Level 1 trauma centre completed a measure of emotion dysregulation 2 weeks post-injury, and PTSD and depression were assessed at 2-weeks and 6 months later. Using stepwise regressions controlling for baseline symptoms, age, gender, race, and injury severity, results showed baseline emotion dysregulation significantly predicted the four symptom clusters of PTSD 6 months post-injury. Notably, hyperarousal symptoms and negative alterations in mood and cognition were predicted by a lack of clarity. On the other hand, depressive symptoms were significantly predicted by difficulty accessing emotion regulation strategies. Results highlight that specific facets of emotion dysregulation predict PTSD and depression symptom severity differentially after injury. Indeed, lack of emotional clarity appears to predict PTSD symptomatology, suggesting a potential mechanism driving worsening symptoms. Lack of clarity could also be detrimental to engagement in PTSD treatment. Conversely, lack of regulation strategies may represent a sense of helplessness in managing depression after trauma. As such, future research should elucidate whether interventions targeting aspects of emotion dysregulation based on symptom presentations are useful in treating PTSD and depression following injury.

摘要

情绪失调是创伤后精神病理学的一个显著特征。然而,情绪失调是多方面的,对于哪些情绪失调方面可以预测创伤后抑郁和创伤后应激障碍(PTSD)症状的严重程度,我们知之甚少。本纵向研究的目的是评估在需要医疗治疗的创伤后 2 周内,情绪失调的各个方面如何不同地预测 PTSD 症状群和抑郁症状的严重程度。99 名创伤性受伤的成年人( = 99)在一级创伤中心就诊,在受伤后 2 周内完成了情绪失调量表的测量,在 2 周和 6 个月后评估 PTSD 和抑郁症状。通过逐步回归控制基线症状、年龄、性别、种族和损伤严重程度,结果表明基线情绪失调显著预测了创伤后 6 个月的 PTSD 的四个症状群。值得注意的是,清晰度不足预测了警觉过度和情绪和认知的负性改变。另一方面,抑郁症状显著预测了难以获得情绪调节策略。结果突出了情绪失调的特定方面在受伤后不同程度地预测 PTSD 和抑郁症状的严重程度。事实上,情绪清晰度不足似乎预测了 PTSD 症状,这表明一种潜在的驱动症状恶化的机制。缺乏清晰度也可能对 PTSD 治疗的参与产生不利影响。相反,缺乏调节策略可能代表在创伤后管理抑郁时的无助感。因此,未来的研究应该阐明基于症状表现针对情绪失调方面的干预措施是否对治疗创伤后 PTSD 和抑郁有用。

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