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在寻求与军事性创伤相关治疗的退伍军人中,担忧以不同方式介导创伤后认知与创伤后应激症状之间的关系。

Worry differentially mediates posttraumatic cognition and posttraumatic stress symptom relationships among veterans seeking treatment associated with military sexual trauma.

作者信息

Vuper Tessa C, Lass Alisson N S, Paulson Julia L, Rogers Travis A, Porter Katherine E, Rauch Sheila A M, Sexton Minden B

机构信息

VA Ann Arbor Healthcare System.

Joseph Maxwell Cleland Atlanta VA Medical Center.

出版信息

Psychol Serv. 2024 Nov;21(4):840-848. doi: 10.1037/ser0000855. Epub 2024 Mar 28.

DOI:10.1037/ser0000855
PMID:38546607
Abstract

Research has established negative posttraumatic cognitions (NPC) affect the development and course of posttraumatic stress symptoms (PTSS) following trauma exposure (L. A. Brown et al., 2019). Previous studies in civilian and combat veteran populations also suggest positive associations among worry, NPC (Beck et al., 2004; Bennett et al., 2009), and PTSS (Fergus & Bardeen, 2017). However, little research has investigated the prevalence of worry in veterans who have experienced military sexual trauma (MST), and no research has examined the role of worry in the relation between NPC and PTSS among veterans seeking treatment associated with MST. This project examined the prevalence of worry in a MST sample and whether worry mediated NPC-PTSS associations. Veterans ( = 91) seeking MST-related treatment presented to a Veterans Affairs Posttraumatic Stress Disorder specialty clinic for assessment and treatment recommendations. Veterans completed questionnaires assessing NPC, worry, and PTSS. Bootstrapped mediation analyses examined NPC-PTSS associations. Veterans reported similar levels of worry as nonveterans seeking treatment associated with generalized anxiety disorder. Mediation analyses showed worry significantly mediated NPC-PTSS relationships for beliefs about the world, self-blame, and coping competence but not for beliefs about the self or global NPC severity. Further, the degree of mediation differed by NPC type. Though a limitation of this study is the use of cross-sectional data, these results inform the use of clinical intervention strategies targeting worry in trauma-focused interventions and necessitate further research on whether trauma-focused interventions ameliorate co-occurring worry among veterans exposed to MST. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

摘要

研究表明,创伤后消极认知(NPC)会影响创伤暴露后创伤后应激症状(PTSS)的发展和进程(L. A. 布朗等人,2019年)。此前针对平民和退伍军人的研究也表明,担忧、NPC(贝克等人,2004年;贝内特等人,2009年)和PTSS(弗格斯和巴丁,2017年)之间存在正相关。然而,很少有研究调查经历过军事性创伤(MST)的退伍军人中担忧的患病率,也没有研究考察担忧在寻求与MST相关治疗的退伍军人中NPC与PTSS关系中的作用。本项目调查了一个MST样本中担忧的患病率,以及担忧是否介导了NPC与PTSS之间的关联。寻求与MST相关治疗的退伍军人(n = 91)前往退伍军人事务部创伤后应激障碍专科诊所进行评估和治疗建议。退伍军人完成了评估NPC、担忧和PTSS的问卷。采用自抽样中介分析来检验NPC与PTSS之间的关联。退伍军人报告的担忧水平与寻求广泛性焦虑症相关治疗的非退伍军人相似。中介分析表明,担忧显著介导了关于世界的信念、自责和应对能力方面的NPC与PTSS关系,但在关于自我的信念或总体NPC严重程度方面则不然。此外,中介程度因NPC类型而异。尽管本研究的一个局限性是使用了横断面数据,但这些结果为在以创伤为重点的干预措施中使用针对担忧的临床干预策略提供了参考,并且有必要进一步研究以创伤为重点的干预措施是否能改善遭受MST的退伍军人中同时存在的担忧。(PsycInfo数据库记录(c)2024美国心理学会,保留所有权利)

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