Cardiac-disease-induced PTSD and Fear of illness progression: Capturing the unique nature of disease-related PTSD
Cardiac-disease-induced PTSD and Fear of illness progression: Capturing the unique nature of disease-related PTSD
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DOI：
10.1016/j.genhosppsych.2018.02.011
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发表时间：
2018-07-01
影响因子：
7
通讯作者：
Matetzky, Shlomi
中科院分区：
文献类型：
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作者：
Fait, Keren;Vilchinsky, Noa;Matetzky, Shlomi
根据Edmondson的急性危及生命的医疗事件引起的创伤后应激障碍的持续躯体威胁（EST）模型，疾病背景下的创伤后应激障碍的性质可能与“传统”创伤后应激障碍的性质不同，因为它包括面向未来的以及与过去相关的侵入性思想。然而，迄今为止几乎没有实证研究评估心血管疾病诱发的创伤后应激障碍（CDI-PTSD）的推定的面向未来的质量。在当前的研究中，我们评估了CDI-PTSD与疾病进展恐惧（FoP）之间的假设关联——疾病进展恐惧是患者未来相关焦虑的一种新的理论概念。我们假设FoP与CDI-PTSD呈正相关，特别是与侵入性思想的特定项目相关。患者（N = 112）在住院后三个月接受急性冠状动脉事件访谈，使用PSS-SR-5（评估PTSD症状）、FoP-Q-SF（评估疾病进展的恐惧）和HADS（评估焦虑和抑郁水平）。结果显示CDI-PTSD和FoP之间存在强烈的正相关，即使在控制焦虑和抑郁的情况下也是如此。正如假设的那样，CDI-PTSD的概念和对疾病进展的恐惧在集群水平和具体项目水平上都是密切相关的。目前的研究为EST模型提供了初步的经验验证，特别是关于急性心血管疾病导致的创伤后应激障碍的未来导向性质。
According to Edmondson's Enduring Somatic Threat (EST) Model of PTSD Due to Acute Life-Threatening Medical Events, the nature of PTSD in the context of illness may differ from the nature of "traditional" PTSD in that it includes future-oriented alongside past-related intrusive thoughts. Yet almost no empirical studies to date have assessed the putative future-oriented quality of cardiac-disease-induced PTSD (CDI-PTSD). In the current study, we assessed the hypothesized associations between CDI-PTSD and fear of illness progression (FoP) - a novel theoretical conceptualization of patients' future-related anxieties. We hypothesized that FoP would be positively associated with CDI-PTSD, and especially with its specific items of intrusive thoughts. Patients (N = 112) were interviewed three months post-hospitalization for an acute coronary event via use of the PSS-SR-5 (to assess PTSD symptomatology), the FoP-Q-SF (to assess fear of illness progression), and the HADS (to assess anxiety and depression levels). Results indicated a strong positive association between CDI-PTSD and FoP, even when controlling for anxiety and depression. As hypothesized, the concepts of CDI-PTSD and fear of illness progression were strongly associated both at the level of the clusters as well as at the level of the specific items. The current study provides an initial empirical validation of the EST Model, especially regarding the future-oriented nature of PTSD resulting from acute cardiovascular disease.