Cognitive factors involved in the onset and maintenance of posttraumatic stress disorder (PTSD) after physical or sexual assault
Cognitive factors involved in the onset and maintenance of posttraumatic stress disorder (PTSD) after physical or sexual assault
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DOI：
10.1016/s0005-7967(98)00181-8
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发表时间：
1999-09-01
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
对影响创伤后应激障碍发展和维持的认知因素进行了研究。92名袭击受害者完成了评估一系列认知变量的问卷。通过比较患有创伤后应激障碍和未患创伤后应激障碍的患者，调查与创伤后应激障碍发病相关的因素。与创伤后应激障碍的发病和维持相关的认知因素包括：对攻击本身各方面的评估(精神挫败、精神困惑、情绪评估)；对攻击的后遗症的评估(对症状的评估、对他人的负面反应、永久性改变)；功能失调的策略(回避/寻求安全)和受攻击影响的全球信念。只与创伤后应激障碍的发病相关的认知因素是：攻击过程中的冷漠；失败；从他人那里感受到积极的反应和精神上的崩溃。认知变量和创伤后应激障碍之间的关系仍然显著，当感知和客观攻击严重程度的差异被统计控制时。研究中确定的认知因素可能通过产生持续威胁感直接导致创伤后应激障碍，或通过激发阻止康复的认知和行为策略间接导致创伤后应激障碍，或通过影响创伤记忆的性质。(C)1999爱思唯尔科学有限公司。保留所有权利。
Cognitive factors hypothesised to influence the development and maintenance of PTSD were investigated. 92 assault victims completed questionnaires assessing a range of cognitive variables. Factors relating to onset of PTSD were investigated by comparing victims who did and who did not suffer PTSD. Factors relating to maintenance of PTSD,were investigated by comparing victims who had recovered from PTSD with victims who had persistent PTSD.Cognitive factors associated with both onset and maintenance of PTSD were: appraisal of aspects of the assault itself (mental defeat, mental confusion, appraisal of emotions); appraisal of the sequelae of the assault (appraisal of symptoms, perceived negative responses of others, permanent change); dysfunctional strategies (avoidance/safety seeking) and global beliefs impacted by assault. Cognitive factors that were associated only with the onset of PTSD were: detachment during assault; failure; to perceive positive responses from others and mental undoing. Relationships between the cognitive variables and PTSD remained significant when variations in perceived and objective assault severity were statistically controlled. The cognitive factors identified in the study may contribute to PTSD directly, by generating a sense of ongoing threat, or indirectly, by motivating cognitive and behavioural strategies that prevent recovery, or by affecting the nature of the traumatic memory. (C) 1999 Elsevier Science Ltd. All rights reserved.