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创伤相关羞耻感的变化是否能预测 PTSD 症状学的变化?

Does change in trauma-related shame predict change in PTSD symptomatology?

机构信息

Rogers Behavioral Health.

Department of Counselor Education and Counseling Psychology, Marquette University.

出版信息

Psychol Trauma. 2024 Jul;16(5):711-721. doi: 10.1037/tra0001454. Epub 2023 Apr 13.

DOI:10.1037/tra0001454
PMID:37053404
Abstract

OBJECTIVE

Trauma-related shame (TR-shame) is associated with Posttraumatic Stress Disorder (PTSD) symptoms. However, research findings are inconsistent regarding the role of TR-shame in PTSD treatment. The purpose of this study was to examine if change in TR-shame predicted change in PTSD symptoms in treatment.

METHOD

A sample of 462 adults who received PTSD treatment at a Partial Hospitalization Program completed questionnaires measuring TR-shame (i.e., Trauma-Related Shame Inventory; TRSI) and PTSD symptoms (PTSD Checklist for DSM-5; PCL-5). Latent growth curve models were estimated to examine if the rate of change in TRSI predicted the rate of change in PCL-5 by using structural equation modeling. Furthermore, a latent regression model was estimated to predict the intercept and slope of the PCL-5.

RESULTS

Model fits for the PCL-5 and the TRSI linear models were acceptable and both linear slopes were significant. On average, PCL-5 scores reduced 22.18 points from admission to discharge, while TRSI scores reduced 21.9 points from admission to discharge. The results of latent curve regression model suggested that the TRSI linear slope and intercept predicted the PCL-5 linear slope and intercept, respectively. Additionally, post-hoc analyses suggested that the variance in PCL-5 factors at discharge that were explained by TRSI intercept and linear slope ranged from 18.6% to 34.9%.

CONCLUSIONS

The results of this study indicated that the rate of change in TR-shame predicted the rate of change in PTSD symptoms. Given the negative impact of TR-shame on PTSD symptoms, TR-shame should be a target in treatment for PTSD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

摘要

目的

与创伤后应激障碍(PTSD)症状相关的创伤相关羞耻感(TR-shame)。然而,关于 TR-shame 在 PTSD 治疗中的作用,研究结果并不一致。本研究的目的是检验治疗中 TR-shame 的变化是否预测 PTSD 症状的变化。

方法

一个接受部分住院治疗的 PTSD 治疗的 462 名成年人的样本完成了问卷,这些问卷测量了 TR-shame(即创伤相关羞耻感量表;TRSI)和 PTSD 症状(DSM-5 PTSD 检查表;PCL-5)。使用结构方程建模来估计潜在增长曲线模型,以检验 TRSI 的变化率是否预测 PCL-5 的变化率。此外,还估计了一个潜在的回归模型,以预测 PCL-5 的截距和斜率。

结果

PCL-5 和 TRSI 线性模型的模型拟合度可以接受,并且两个线性斜率都是显著的。平均而言,PCL-5 分数从入院到出院减少了 22.18 分,而 TRSI 分数从入院到出院减少了 21.9 分。潜在曲线回归模型的结果表明,TRSI 线性斜率和截距分别预测了 PCL-5 线性斜率和截距。此外,事后分析表明,TRSI 截距和线性斜率解释了出院时 PCL-5 因子的方差范围从 18.6%到 34.9%。

结论

本研究的结果表明,TR-shame 的变化率预测了 PTSD 症状的变化率。鉴于 TR-shame 对 PTSD 症状的负面影响,TR-shame 应该成为 PTSD 治疗的目标。

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