Pre- to Posttreatment Changes in Trauma-Cued Negative Emotion Mediate Improvement in Posttraumatic Stress Disorder, Depression, and Impulsivity.
Pre- to Posttreatment Changes in Trauma-Cued Negative Emotion Mediate Improvement in Posttraumatic Stress Disorder, Depression, and Impulsivity.
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DOI：
10.1037/trm0000258
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发表时间：
2020-12
期刊：
影响因子：
3.2
通讯作者：
Connolly KM
中科院分区：
文献类型：
--
作者：
McGuire AP;Anderson LM;Frankfurt SB;Connolly KM
创伤后应激障碍（PTSD）的特征是强烈的负面情绪，通常是对创伤线索或提醒的反应。随后的情绪调节策略影响创伤后应激障碍症状的维持和其他创伤相关的结果（抑郁，物质使用）。本研究旨在研究一系列创伤情绪，以增强我们对治疗后变化的理解，以及它们在改善相关结果方面的潜在作用。参与者包括67名被诊断患有创伤后应激障碍和物质使用障碍的退伍军人，他们完成了使用认知处理疗法的双重诊断住院项目。在治疗前和治疗后，我们测量了创伤回忆和创伤后应激障碍症状后的8种消极情绪，抑郁症状和消极紧迫性（消极情绪后的冲动性）作为治疗结果。我们使用t检验来评估治疗后的变化，并使用受试者内部中介分析来测试创伤情绪的变化是否介导了治疗结果。参与者报告治疗后5种情绪有中度显著的下降：对自己的愤怒、对自己的厌恶、恐惧、内疚和悲伤（d≥0.50），而对他人的愤怒、对他人的厌恶和羞耻没有显著的变化。调解分析表明创伤性悲伤的减少对创伤后应激障碍症状、抑郁症状和消极紧迫感的改善有显著的间接影响。自我厌恶和恐惧的减少也显示出对抑郁症状改善的显著间接影响。在这个双重诊断项目中，退伍军人报告了一些（但不是全部）创伤情绪的显著减少，并且只有部分情绪的改善才占相关治疗结果改善的重要部分。
Posttraumatic stress disorder (PTSD) is characterized by strong negative emotions, often in response to trauma cues or reminders. Subsequent emotion regulation strategies impact the maintenance of PTSD symptoms and other trauma-related outcomes (depression, substance use). This study aimed to examine a range of trauma-cued emotions to enhance our understanding of changes following treatment and their potential role in improving relevant outcomes. Participants included 67 veterans diagnosed with PTSD and a substance use disorder who completed a dual diagnosis residential program that used cognitive processing therapy. At pre- and posttreatment, we measured 8 negative emotions following a trauma recall and PTSD symptoms, depressive symptoms, and negative urgency (impulsivity following negative emotions) as treatment outcomes. We used t-tests to assess changes at posttreatment and a within-subjects mediational analysis to test whether changes in trauma-cued emotions mediated treatment outcomes. Participants reported moderate, significant decreases for 5 emotions at posttreatment: anger at self, disgust at self, fear, guilt, and sadness (d ≥ 0.50), whereas nonsignificant changes were found for anger at others, disgust at others, and shame. Mediation analyses indicated greater reductions in trauma-cued sadness had a significant indirect effect on improvement in PTSD symptoms, depressive symptoms, and negative urgency. Reductions in disgust at self and fear also demonstrated a significant indirect effect on depressive symptom improvement. In this dual diagnosis program, veterans reported a significant reduction in some, but not all, trauma-cued emotions, and improvements in only select emotions accounted for a significant portion of improvement in relevant treatment outcomes.
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影响因子：
4.7
作者：
Frankfurt SB;DeBeer BB;Morissette SB;Kimbrel NA;La Bash H;Meyer EC
通讯作者：
Meyer EC
影响因子：
7
作者：
Judd, CM;Kenny, DA;McClelland, GH
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McClelland, GH
影响因子：
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Ranieri, WF
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影响因子：
10.3
作者：
Bardeen, Joseph R.;Kumpula, Mandy J.;Orcutt, Holly K.
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