Posttraumatic stress disorder in daily life among World Trade Center responders: Temporal symptom cascades.
Posttraumatic stress disorder in daily life among World Trade Center responders: Temporal symptom cascades.
复制标题
世贸中心急救人员日常生活中的创伤后应激障碍：时间症状级联。
DOI：
10.1016/j.jpsychires.2021.04.002
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发表时间：
2021
影响因子：
4.8
通讯作者：
Kotov,Roman
中科院分区：
文献类型：
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作者：
Ruggero,CamiloJ;Schuler,Keke;Waszczuk,MonikaA;Callahan,JenniferL;Contractor,AtekaA;Bennett,CharlesB;Luft,BenjaminJ;Kotov,Roman
背景创伤后应激障碍（PTSD）的症状在创伤后很常见，但它是随着时间的推移，导致诊断的持续性。这种模式强调了症状维持对理解和治疗疾病的关键作用。相对较少的研究探讨了PTSD症状是否可能相互作用或相互触发以恶化和维持这种疾病，我们称之为“症状级联”。此外，很少有工作已经测试了实时如何其他维护因素，如压力，有助于这样的事件在日常生活中MethodsThe本研究在一组（N= 202）的世界贸易中心（WTC）响应者过采样的创伤后应激障碍测试日常时间之间的联系创伤后应激障碍症状的维度（即，入侵，回避，麻木，过度觉醒）和压力在一周内。结果纵向模型发现过度觉醒在给定的一天预测增加PTSD症状的第二天，与其他症状维度或日常压力相比，效果大小几乎翻了一番。相比之下，入侵几乎没有显示出前瞻性的预测效果，而是最容易受到前一天其他症状的影响。避免和麻木表现出较弱的双向effects.LimitationsFindings是从一个独特的人口和基于naturalistic observation.ConclusionsResults的想法是一致的症状级联，他们强调hyperarousal的强大作用，在预测短期增加PTSD（甚至超过压力本身），他们提出的前景高度具体的生态瞬时干预措施，有可能破坏PTSD维持在日常生活中。
BackgroundPosttraumatic stress disorder (PTSD) symptoms are common in the immediate aftermath of a trauma, but it is their persistence over time that leads to a diagnosis. This pattern highlights the critical role of symptom maintenance to understanding and treating the disorder. Relatively few studies have explored whether PTSD symptoms may be interacting or triggering one another to worsen and maintain the disorder, a dynamic we refer to as “symptom cascades.” Additionally, little work has tested in real-time how other maintenance factors, such as stress, contribute to such events in daily life.MethodsThe present study in a group (N= 202) of World Trade Center (WTC) responders oversampled for PTSD tested day-to-day temporal associations among PTSD symptom dimensions (i.e., intrusions, avoidance, numbing, and hyperarousal) and stress across one week.ResultsLongitudinal models found hyperarousal on a given day predicted increased PTSD symptoms the next day, with the effect sizes almost double compared to other symptom dimensions or daily stress. Intrusions, in contrast, showed little prospective predictive effects, but instead were most susceptible to the effects from other symptoms the day before. Avoidance and numbing showed weaker bidirectional effects.LimitationsFindings are from a unique population and based on naturalistic observation.ConclusionsResults are consistent with the idea of symptom cascades, they underscore hyperarousal's strong role in forecasting short-term increases in PTSD (even more than stress per se) and they raise the prospect of highly specific ecological momentary interventions to potentially disrupt PTSD maintenance in daily life.