A prospective investigation of the role of cognitive factors in persistent Posttraumatic Stress Disorder (PTSD) after physical or sexual assault
A prospective investigation of the role of cognitive factors in persistent Posttraumatic Stress Disorder (PTSD) after physical or sexual assault
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DOI：
10.1016/s0005-7967(00)00088-7
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发表时间：
2001-09-01
影响因子：
4.1
通讯作者：
Ehlers, A
中科院分区：
文献类型：
--
作者：
Dunmore, E;Clark, DM;Ehlers, A
通过更好地了解维持该障碍所涉及的因素，可能会提高针对创伤后应激障碍（PTSD）的心理治疗的有效性。埃勒斯和克拉克 [持续性创伤后干细胞障碍行为的认知模型。资源。瑟尔。 38(2000)319-345]最近提出了维护的认知模型。当前的研究旨在使用前瞻性设计来调查埃勒斯和克拉克模型中强调的几个认知因素。 57 名身体或性侵犯的受害者参与了这项研究。在袭击发生后 4 个月内评估认知因素，并在袭击后 6 个月和 9 个月对受害者进行随访。在两次随访中显着预测 PTSD 严重程度的认知变量是： 袭击期间的认知处理方式（精神挫败、精神混乱、疏离）；对攻击后遗症的评估（对症状的评估、感知到的他人的负面反应、永久性的改变）、对自我和世界的负面信念；和适应不良的控制策略（回避/寻求安全）。在对性别和感知的攻击严重程度进行统计控制后，早期评估、控制策略和处理方式与随后的创伤后应激障碍严重程度之间的关系仍然显着。这些发现支持埃勒斯和克拉克提出的创伤后应激障碍的认知模型，并表明有效的治疗需要解决这些认知因素。 (C) 2001 Elsevier Science Ltd. 保留所有权利。
The effectiveness of psychological treatments for PTSD is likely to be enhanced by improved understanding of the factors involved in maintaining the disorder. Ehlers and Clark [A cognitive model of persistent posttraumatic stem disorder Behav. Res. Ther. 38 (2000) 319-345] recently proposed a cognitive model of maintenance. The current study aimed to investigate several cognitive factors highlighted in Ehlers and Clark's model using a prospective design.Fifty-seven victims of physical or sexual assault participated in the study. Cognitive factors were assessed within 4 months of assault and victims were followed-up 6 and 9 months after the assault.Cognitive variables which significantly predicted PTSD severity at both follow-ups were: cognitive processing style during assault (mental defeat, mental confusion, detachment); appraisal of assault sequelae (appraisal of symptoms, perceived negative responses of others, permanent change), negative beliefs about self and world; and maladaptive control strategies (avoidance/safety seeking). Relationships between early appraisals, control strategies, and processing styles and subsequent PTSD severity remained significant after statistically controlling for gender and perceived assault severity. These findings support the cognitive model of PTSD proposed by Ehlers and Clark and suggest that effective treatment will need to address these cognitive factors. (C) 2001 Elsevier Science Ltd. All rights reserved.