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痛苦容忍度可以减轻创伤后应激障碍、创伤性脑损伤和爆炸暴露对精神健康和身体健康结果的影响。

Distress tolerance mitigates effects of posttraumatic stress, traumatic brain injury, and blast exposure on psychiatric and health outcomes.

机构信息

Research & Academic Affairs Service Line, W. G. (Bill) Hefner VA Healthcare System.

Department of Psychology, University of Houston.

出版信息

Rehabil Psychol. 2023 Nov;68(4):385-395. doi: 10.1037/rep0000502. Epub 2023 May 22.

Abstract

BACKGROUND

Exposure to blasts is common among service members and history of these exposures has been associated with chronic psychiatric and health outcomes. Evidence suggests that distress tolerance (DT) may moderate this relationship and be a valuable treatment target in this population. The purpose of this manuscript was to evaluate DT as a modifying factor in the association between posttraumatic stress disorder (PTSD), mild traumatic brain injury (TBI), blast exposure, and functional indicators.

METHOD

Participants were 275 (86.55% male) combat veterans who served in Iraq or Afghanistan after September 11, 2001. Clinical interviews for PTSD diagnosis, TBI history, and blast exposure were administered, and participants completed self-report questionnaires (DT, PTSD symptom severity, depressive symptom severity, neurobehavioral symptom severity, sleep quality, pain interference, and quality of life).

RESULTS

DT was significantly associated with all functional indicators beyond PTSD diagnosis, mild TBI, and blast severity. There were significant interaction effects between DT and PTSD diagnosis for posttraumatic stress symptom severity, sleep quality, and quality of life. Specifically, there were significant differences in these reported functional indicators between individuals with and without a PTSD diagnosis as DT increases, such that reported symptoms were lower (quality of life better) for individuals without PTSD as DT improved.

CONCLUSION

Our results demonstrate that DT might be a key factor in postdeployment function for military service members. Treatments targeting DT may be particularly effective in individuals who attribute psychiatric symptoms to history of blast exposure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

摘要

背景

爆炸暴露在军人中很常见,这些暴露的历史与慢性精神和健康结果有关。有证据表明,痛苦耐受力(DT)可能会调节这种关系,并成为该人群中一个有价值的治疗靶点。本文的目的是评估 DT 在创伤后应激障碍(PTSD)、轻度创伤性脑损伤(TBI)、爆炸暴露与功能指标之间的关系中作为调节因素的作用。

方法

参与者为 275 名(86.55%为男性)在 2001 年 9 月 11 日之后在伊拉克或阿富汗服役的参战老兵。进行了 PTSD 诊断、TBI 病史和爆炸暴露的临床访谈,参与者完成了自我报告问卷(DT、PTSD 症状严重程度、抑郁症状严重程度、神经行为症状严重程度、睡眠质量、疼痛干扰和生活质量)。

结果

DT 与 PTSD 诊断、轻度 TBI 和爆炸严重程度以外的所有功能指标均显著相关。DT 与 PTSD 诊断之间存在显著的交互效应,这些交互效应与创伤后应激症状严重程度、睡眠质量和生活质量有关。具体来说,在 PTSD 诊断的个体之间,DT 增加与 PTSD 诊断的个体之间,在这些报告的功能指标上存在显著差异,例如,在没有 PTSD 的个体中,随着 DT 的改善,报告的症状较低(生活质量较好)。

结论

我们的研究结果表明,DT 可能是军事人员部署后功能的关键因素。针对 DT 的治疗可能对将精神症状归因于爆炸暴露史的个体特别有效。(PsycInfo 数据库记录(c)2023 APA,保留所有权利)。

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