Department of Psychology, Harvard University, United States; Department of Psychology, University of Amsterdam, the Netherlands.
Department of Psychology, Harvard University, United States; Department of Psychology, University of Kaiserslautern-Landau (RPTU), Germany.
J Anxiety Disord. 2024 Aug;106:102896. doi: 10.1016/j.janxdis.2024.102896. Epub 2024 Jul 7.
PTSD has been associated with negative long-term consequences, including social and occupational impairments. Yet, a nuanced understanding of the interplay between PTSD symptoms and distinct domains of impairments on a short-term basis (weeks/ months) at the within-person level remains underexplored. In a large sample (n = 1096, n = 304) of UK healthcare workers assessed across seven assessment waves during the COVID-19 pandemic (spaced 6 weeks apart), we employed exploratory graphical vector autoregression models (GVAR) models to discern within-person temporal (across time) and contemporaneous (within same time window) dynamics between PTSD symptoms and functional impairment domains. The contemporaneous network highlighted strong co-occurrences between different symptoms and impairments. The temporal network revealed a mutually reinforcing cycle between intrusion and avoidance symptoms. Intrusion symptoms showed the highest out-strength (i.e., most predictive symptom), predicting avoidance symptoms, elevated sense of current threat, and various functional impairments. Avoidance symptoms, elevated after increased levels of intrusions, predicted work impairments that in turn were associated with difficulties in fulfilling other obligations. Our findings underscore the dynamics between perceived threat and intrusions, and the role intrusions may play in predicting a cascade of adverse effects. Targeted interventions aimed at mitigating intrusions may disrupt this negative cycle.
创伤后应激障碍与负面的长期后果有关，包括社交和职业障碍。然而，人们对 PTSD 症状与短期（数周/数月）内在个体水平上不同障碍领域之间的相互作用的细微理解仍未得到充分探索。在一项针对英国医疗保健工作者的大型样本（n = 1096，n = 304）的研究中，这些工作者在 COVID-19 大流行期间（每隔 6 周评估一次）接受了七次评估，我们采用探索性图形向量自回归模型（GVAR）模型来辨别 PTSD 症状和功能障碍领域之间的内在个体时间（随时间）和同期（在同一时间窗口内）动态。同期网络突出了不同症状和障碍之间的强共存。时间网络揭示了入侵和回避症状之间的相互增强循环。入侵症状表现出最高的外向强度（即最具预测性的症状），可预测回避症状、当前威胁感升高以及各种功能障碍。回避症状在入侵症状增加后升高，可预测工作障碍，进而与履行其他义务的困难有关。我们的研究结果强调了感知威胁和入侵之间的动态关系，以及入侵在预测一连串不良影响中的作用。旨在减轻入侵的有针对性干预措施可能会打破这种负面循环。
