Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Landau, Germany.
Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany.
Eur J Psychotraumatol. 2023;14(1):2165025. doi: 10.1080/20008066.2023.2165025.
Previous research has shown that multiple traumatic experiences cumulatively increase the risk for the development of severe symptoms of posttraumatic stress disorder (PTSD). Yet, little is known about the specific psychological mechanism through which this increased risk comes about. In the present study, we examined a possible cognitive link between multiple traumatic events and PTSD symptom severity through dysfunctional cognitions and expectations. A sample of patients with a diagnosed PTSD (= 70; = 42.06; 82% female) and high symptom burden (IES-R = 79.24) was examined. On average, patients had experienced 5.31 different traumatic events. In a structural equation model, we tested the hypothesis that the relationship between multiple traumatic experiences and PTSD symptom severity is mediated through dysfunctional general cognitions and dysfunctional situation-specific expectations. General trauma-related cognitions were assessed with the Posttraumatic Cognition Inventory (PTCI) and trauma-related situational expectations were assessed with the Posttraumatic Expectations Scale (PTES). The direct effect of the number of traumatic events on PTSD symptom severity was non-significant. Instead, as hypothesised, there was evidence for a significant indirect effect via dysfunctional general cognitions and situation-specific expectations. The current results further specify the cognitive model of PTSD by indicating that the relationship between the number of traumatic events and PTSD symptom severity is mediated through dysfunctional cognitions and expectations. These findings emphasise the importance of focused cognitive treatment approaches that seek to modify dysfunctional cognitions and expectations in people with multiple traumatic experiences.
先前的研究表明，多次创伤经历会累积增加出现严重创伤后应激障碍（PTSD）症状的风险。然而，人们对于导致这种风险增加的具体心理机制知之甚少。在本研究中，我们通过认知扭曲和预期，研究了多次创伤事件与 PTSD 症状严重程度之间可能存在的认知联系。对患有 PTSD 诊断的患者样本（= 70；= 42.06；82%为女性）和高症状负担（IES-R = 79.24）进行了检查。平均而言，患者经历了 5.31 次不同的创伤事件。在结构方程模型中，我们检验了这样一个假设，即多次创伤经历与 PTSD 症状严重程度之间的关系是通过认知扭曲和特定情境的预期来介导的。使用创伤后认知清单（PTCI）评估一般创伤相关认知，使用创伤后预期量表（PTES）评估与创伤相关的情境预期。创伤事件数量对 PTSD 症状严重程度的直接影响不显著。相反，正如假设的那样，通过认知扭曲和特定情境的预期，存在显著的间接影响。目前的结果通过表明创伤事件数量与 PTSD 症状严重程度之间的关系是通过认知扭曲和预期来介导的，进一步明确了 PTSD 的认知模型。这些发现强调了针对具有多次创伤经历的人群进行有针对性的认知治疗方法的重要性，这种方法旨在改变认知扭曲和预期。
