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创伤反应作为俄克拉荷马城爆炸案六个月后创伤后应激障碍的预测指标。

Traumatic reactions as predictors of posttraumatic stress six months after the Oklahoma City bombing.

作者信息

Tucker P, Dickson W, Pfefferbaum B, McDonald N B, Allen G

机构信息

Department of Psychiatry and Behavioral Sciences, University of Oklahoma, Oklahoma City 73190, USA.

出版信息

Psychiatr Serv. 1997 Sep;48(9):1191-4. doi: 10.1176/ps.48.9.1191.

Abstract

OBJECTIVE

This study attempted to identify remembered reactions of Oklahoma City residents at the time of the April 1995 terrorist bombing that predicted later development of posttraumatic stress symptoms.

METHODS

Eighty-six adults who sought help for distress related to the bombing six months after it occurred completed a survey about demographic characteristics, level of exposure to the event, symptoms of grief, retrospective reports of reactions at the time of the trauma, current posttraumatic stress symptoms, and coping strategies. To identify immediate bombing reactions predictive of later distress, retrospective reports of reactions to the trauma were correlated with current posttraumatic stress symptoms. Multiple regression analysis was used to determine which reactions predicted the emergence of posttraumatic stress symptoms.

RESULTS

Reactions of being nervous and being upset by how other people acted when the bombing occurred accounted for about one-third of the total variation in posttraumatic stress symptom scores and thus were major predictors of posttraumatic stress.

CONCLUSIONS

These results differ from those of other studies in which peritraumatic dissociation, or dissociation at the time of the event, was more predictive than anxiety for developing later distress. The results suggest that persons who experience significant anxiety at the time of the traumatic event may continue to experience distress. Those who are overly concerned about others' actions may be showing diminished interpersonal trust, evidence of terrorism's ability to erode social harmony.

摘要

目的

本研究试图确定1995年4月俄克拉何马城恐怖爆炸事件发生时,俄克拉何马城居民的记忆反应,这些反应可预测创伤后应激症状的后期发展。

方法

86名成年人在爆炸事件发生6个月后因与爆炸相关的痛苦而寻求帮助,他们完成了一项关于人口统计学特征、事件暴露程度、悲伤症状、创伤发生时反应的回顾性报告、当前创伤后应激症状以及应对策略的调查。为了确定可预测后期痛苦的即时爆炸反应,将对创伤反应的回顾性报告与当前创伤后应激症状进行关联。采用多元回归分析来确定哪些反应可预测创伤后应激症状的出现。

结果

爆炸发生时因他人行为而感到紧张和心烦的反应,占创伤后应激症状评分总变异的约三分之一,因此是创伤后应激的主要预测因素。

结论

这些结果与其他研究不同,在其他研究中,创伤周围解离,即事件发生时的解离,比焦虑更能预测后期痛苦的发展。结果表明,在创伤事件发生时经历显著焦虑的人可能会持续经历痛苦。那些过度关注他人行为的人可能表现出人际信任的降低,这是恐怖主义侵蚀社会和谐能力的证据。

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