Mental Health Service, Ralph H. Johnson VA Healthcare System, Charleston, South Carolina, USA.
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
J Clin Psychol. 2024 Feb;80(2):291-305. doi: 10.1002/jclp.23610. Epub 2023 Oct 18.
Interventions in post-disaster environments may be accelerated by identifying protective behavioral factors adding incremental value to models of psychopathology using longitudinal methods. One protective behavior applicable to post-disaster contexts is behavioral activation (BA). BA is defined here as a behavioral pattern involving presence of valued activity engagement. While relevant post-disaster, the incremental value of BA behaviors in predicting longitudinal post-disaster outcomes is not well understood. We hypothesized that higher baseline engagement in behaviors consistent with a BA framework would predict decreased posttraumatic stress disorder (PTSD) symptom severity, depression symptom severity, and sleep disturbance approximately 3, 6, and 12 months after hurricane survivors completed baseline measures.
The current study is a secondary analysis from a randomized controlled trial of a disaster mental health digital intervention. Participants completed surveys at baseline and approximately 3, 6, and 12 months post-enrollment. Correlations and hierarchical regression analyses were calculated following data screening to predict PTSD symptom severity, depression symptom severity, and sleep disturbances.
Controlling for alcohol use, prior trauma, displacement, and intervention condition, higher baseline BA consistently predicted less PTSD symptom severity, depression symptom severity, and sleep disturbances.
Results suggest that post-disaster interventions should consider addressing BA. The study provides evidence that BA is potentially an important protective factor longitudinally predicting sleep disturbances and psychopathology after natural disasters.
通过使用纵向方法识别对精神病理学模型具有附加价值的保护性行为因素,可以加速灾后环境中的干预措施。一种适用于灾后环境的保护性行为是行为激活(BA)。这里将 BA 定义为一种涉及参与有价值的活动的行为模式。虽然与灾后情况相关,但 BA 行为在预测纵向灾后结果方面的附加价值尚不清楚。我们假设,在基线时更积极地参与与 BA 框架一致的行为,将预测创伤后应激障碍(PTSD)症状严重程度、抑郁症状严重程度和睡眠障碍大约在飓风幸存者完成基线测量后的 3、6 和 12 个月时降低。
本研究是对灾难心理健康数字干预的随机对照试验的二次分析。参与者在基线和大约 3、6 和 12 个月后完成调查。在进行数据筛选后,计算了相关性和层次回归分析,以预测 PTSD 症状严重程度、抑郁症状严重程度和睡眠障碍。
在控制酒精使用、先前的创伤、流离失所和干预条件后,基线时更高的 BA 始终预测 PTSD 症状严重程度、抑郁症状严重程度和睡眠障碍较少。
结果表明,灾后干预措施应考虑解决 BA。该研究提供了证据表明,BA 是一种潜在的重要保护因素,可以纵向预测自然灾害后的睡眠障碍和精神病理学。