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围生期创伤后应激障碍和强迫症症状的面板网络分析。

A panel network analysis of posttraumatic stress disorder and obsessive-compulsive disorder symptoms across the perinatal period.

机构信息

Department of Psychological and Brain Sciences, University of Iowa.

Department of Psychology, University of Minnesota Twin Cities.

出版信息

J Psychopathol Clin Sci. 2024 Aug;133(6):445-455. doi: 10.1037/abn0000916. Epub 2024 May 30.

Abstract

The perinatal period is marked by a higher risk of experiencing depressive, anxiety, and/or trauma-related symptoms, a phenomenon that affects millions of individuals each year. Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) symptoms commonly co-occur but have rarely been examined together beyond prevalence estimates in the perinatal period. Our study aimed to explore patterns of associations among OCD and PTSD symptoms to elucidate within- and between-person effects and how these effects may change over time. Participants ( = 270) were recruited during pregnancy from an academic medical center affiliated with a midwestern university. PTSD, OCD, and depressive symptoms were assessed at pregnancy, 4, 8, and 12 weeks postpartum. A panel graphical vector autoregression model was used to estimate networks. The temporal network provided information regarding directed predictive effects between symptoms, and hyperarousal, neutralizing, and ordering were the most stable and predictive symptoms across time. The contemporaneous network, which yields undirected partial correlations between symptoms at a given moment, indicated that there were positive associations between intrusions and avoidance, hyperarousal and negative alterations in cognitions and mood, as well as between hyperarousal and dysphoria. This study identified hyperarousal and neutralizing as the PTSD and OCD symptoms with the strongest stability, predictive power, and association with other symptoms. Clinically, this indicates that screening for hyperarousal and neutralizing symptoms may identify individuals who could maximally benefit from treatment in the perinatal period. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

摘要

围产期的抑郁、焦虑和/或创伤相关症状风险较高,这一现象每年影响着数百万人。强迫症(OCD)和创伤后应激障碍(PTSD)症状通常同时出现,但在围产期,除了流行率估计之外,很少对它们进行联合研究。我们的研究旨在探索 OCD 和 PTSD 症状之间的关联模式,以阐明个体内和个体间的效应,以及这些效应如何随时间变化。参与者(n=270)在怀孕时从中西部一所大学附属医院的学术医疗中心招募。在怀孕、产后 4、8 和 12 周时评估 PTSD、OCD 和抑郁症状。采用面板图形向量自回归模型来估计网络。时间网络提供了关于症状之间有向预测效应的信息,过度警觉、中和和有序是整个时间最稳定和具有预测性的症状。同时网络在特定时刻提供症状之间的无向部分相关,表明侵入和回避、过度警觉和认知与情绪的负性改变、以及过度警觉和苦恼之间存在正相关。本研究确定了过度警觉和中和是 PTSD 和 OCD 症状中最稳定、最具预测性、与其他症状关联最强的症状。从临床角度来看,这表明筛查过度警觉和中和症状可以识别出在围产期最能受益于治疗的个体。(PsycInfo 数据库记录(c)2024 APA,保留所有权利)。

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本文引用的文献

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A model of risk for perinatal posttraumatic stress symptoms.围产期创伤后应激症状的风险模型。
Arch Womens Ment Health. 2021 Apr;24(2):259-270. doi: 10.1007/s00737-020-01068-2. Epub 2020 Sep 30.

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