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创伤前韧性和在 COVID-19 大流行期间的应对。

Prior resilience to trauma & coping during the COVID-19 pandemic.

机构信息

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.

Department of Natural and Applied Sciences, Bentley University, Waltham, Massachusetts, United States of America.

出版信息

PLoS One. 2024 May 7;19(5):e0297169. doi: 10.1371/journal.pone.0297169. eCollection 2024.

Abstract

BACKGROUND AND OBJECTIVE

This study examined the potential influence of pre-pandemic psychological resilience on use of approach or avoidant coping styles and strategies to manage stress during the COVID-19 pandemic. We hypothesized that higher resilience would be associated with more approach coping and less avoidant coping.

DESIGN AND METHODS

Longitudinal cohort data were from the Nurses' Health Study II, including 13,143 female current and former healthcare professionals with pre-pandemic lifetime trauma. Pre-pandemic resilience was assessed between 2018-2019 and current coping during the outbreak of the pandemic in the United States (May-August 2020). Multiple linear regression model results identified associations between continuous pre-pandemic resilience scores and use of approach and avoidant coping styles, as well as individual coping strategies, adjusting for relevant covariates.

RESULTS

Greater resilience was associated with higher use of approach coping (ß = 0.06, 95% CI 0.05, 0.08) and lower use of avoidant coping styles (ß = -0.39, 95% CI -0.41, -0.38). Higher pre-pandemic resilience was also associated with use of eight (distraction [ß = -0.18, 95% CI -0.20, -0.16], substance use [ß = -0.15, 95% CI -0.17, -0.13], behavioral disengagement [ß = -0.29, 95% CI -0.30, -0.27], self-blame [ß = -0.44, 95% CI -0.45, -0.42], emotional support (ß = 0.03, 95% CI 0.01, 0.05), positive reframing [ß = 0.13, 95% CI 0.12, 0.15], humor [ß = 0.03, 95% CI 0.01, 0.05] and religion [ß = 0.06, 95% CI 0.04, 0.08]) of the nine coping strategies in expected directions.

CONCLUSION

Findings have important implications for intervention or even prevention efforts to support vulnerable groups, such as women with prior trauma histories, during this and other immensely stressful times. Supporting or building psychological resilience following trauma may promote effective coping in times of future stress.

摘要

背景与目的

本研究旨在探讨新冠疫情大流行前的心理韧性对采用趋近或回避应对方式和管理压力策略的潜在影响。我们假设较高的韧性与更多的趋近应对和较少的回避应对有关。

方法

纵向队列数据来自护士健康研究 II,包括 13143 名有既往创伤史的当前和前医疗保健专业人员的女性。在新冠疫情在美国爆发期间(2020 年 5 月至 8 月),对疫情前的韧性进行了评估。使用多元线性回归模型,根据相关协变量,确定了连续的疫情前韧性评分与采用趋近和回避应对方式以及个体应对策略之间的关联。

结果

更高的韧性与更高的趋近应对(β=0.06,95%置信区间为 0.05,0.08)和更低的回避应对方式(β=-0.39,95%置信区间为-0.41,-0.38)有关。较高的疫情前韧性也与使用八种应对策略有关(分心[β=-0.18,95%置信区间为-0.20,-0.16]、物质使用[β=-0.15,95%置信区间为-0.17,-0.13]、行为脱离[β=-0.29,95%置信区间为-0.30,-0.27]、自责[β=-0.44,95%置信区间为-0.45,-0.42]、情感支持[β=0.03,95%置信区间为 0.01,0.05]、积极重新构建[β=0.13,95%置信区间为 0.12,0.15]、幽默[β=0.03,95%置信区间为 0.01,0.05]和宗教[β=0.06,95%置信区间为 0.04,0.08]),这与预期的方向一致。

结论

这些发现对于在这个和其他极具压力的时期支持弱势群体(如有既往创伤史的女性)的干预甚至预防措施具有重要意义。在创伤后支持或建立心理韧性可能会促进未来应对压力时的有效应对。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a31f/11075842/acae04942b7c/pone.0297169.g001.jpg

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