Departamento de Fisiologia e Farmacologia, Instituto Biomédico, Universidade Federal Fluminense, Rua Hernani Pires de Mello, 101, São Domingos, Niterói, RJ 24210-130, Brazil; Programa de Pós-graduação em Ciências Biomédicas (Fisiologia e Farmacologia), Universidade Federal Fluminense, Niterói, RJ Brazil.
Departamento de Fisiologia e Farmacologia, Instituto Biomédico, Universidade Federal Fluminense, Rua Hernani Pires de Mello, 101, São Domingos, Niterói, RJ 24210-130, Brazil.
J Anxiety Disord. 2024 Jul;105:102894. doi: 10.1016/j.janxdis.2024.102894. Epub 2024 Jun 24.
During the COVID-19 pandemic healthcare workers were repeatedly exposed to traumatic experiences. Facing life-threatening events and repeated exposure to traumatic duty-related situations may cause posttraumatic stress disorder (PTSD). While tonic immobility has been considered a key vulnerability factor for PTSD, little is known about this relationship in the long term. In this study, we aimed to determine whether peritraumatic tonic immobility triggered by COVID-19-related trauma predicts PTSD symptom severity six to twelve months later. We conducted an online longitudinal survey using the PTSD Checklist for the DSM-5 (PCL-5) and the Tonic Immobility Scale to assess PTSD symptoms and the tonic immobility response, respectively. Multivariate regression models revealed a significant association between tonic immobility and PTSD symptoms. Each one-unit increase in the tonic immobility score was associated with a 1.5 % increase in the average PTSD symptom score six to twelve months after the traumatic event that triggered the tonic immobility. Furthermore, participants who showed significant or extreme levels of tonic immobility were 3.5 times or 7.3 times more likely to have a probable PTSD diagnosis, respectively. Hence, peritraumatic tonic immobility seems to have a lasting deleterious effect on mental health. Psychological treatment for health care professionals is urgent, and psychoeducation about the involuntary, biological nature of tonic immobility is essential to reduce suffering.
在 COVID-19 大流行期间，医护人员反复接触创伤性经历。面对危及生命的事件和反复接触与创伤相关的职责情况，可能会导致创伤后应激障碍（PTSD）。虽然强直不动被认为是 PTSD 的一个关键脆弱性因素，但对于这种关系的长期影响知之甚少。在这项研究中，我们旨在确定 COVID-19 相关创伤引发的围创伤强直不动是否预测创伤后六个月至十二个月后 PTSD 症状的严重程度。我们使用创伤后应激障碍检查表第五版（PCL-5）和强直不动量表进行了在线纵向调查，分别评估 PTSD 症状和强直不动反应。多变量回归模型显示强直不动与 PTSD 症状之间存在显著关联。强直不动评分每增加一个单位，与创伤事件引发的强直不动后六个月至十二个月平均 PTSD 症状评分增加 1.5%相关。此外，表现出显著或极端强直不动水平的参与者分别有 3.5 倍或 7.3 倍更可能被诊断为可能的 PTSD。因此，围创伤强直不动似乎对心理健康有持久的不良影响。医护人员的心理治疗迫在眉睫，关于强直不动的无意识、生物性质的心理教育对于减轻痛苦至关重要。
