Peritraumatic dissociation mediates the relationship between acute panic and chronic posttraumatic stress disorder
Peritraumatic dissociation mediates the relationship between acute panic and chronic posttraumatic stress disorder
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DOI：
10.1016/j.brat.2011.03.003
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发表时间：
2011-05-01
影响因子：
4.1
通讯作者：
McFarlane, Alexander C.
中科院分区：
文献类型：
--
作者：
Bryant, Richard A.;Brooks, Robert;McFarlane, Alexander C.
虽然创伤周围分离可以预测随后的创伤后应激障碍（PTSD），但对这种关系的机制知之甚少。本研究旨在探讨创伤期间的恐慌在创伤周围分离和随后的PTSD之间的关系中的作用。在澳大利亚4家主要创伤医院（n = 244）的随机合格入院患者在入院期间和创伤暴露后1个月内评估恐慌，创伤周围分离和PTSD症状，随后在初始评估后3个月重新评估PTSD（n = 208）。20例（9.6%）患者在伤后3个月时符合PTSD标准。结构方程模型支持这一命题，即创伤周围现实障碍（解离的一个子集）介导的创伤和随后的PTSD症状期间的恐慌反应的影响。中介模型表明，恐慌反应与随后的PTSD的严重程度通过现实分离，表明一个显着的间接关系。创伤周围现实障碍与慢性PTSD症状相关，这种关系受到初始急性惊恐反应的影响。(C)2011爱思唯尔有限公司保留所有权利。
Although peritraumatic dissociation predicts subsequent posttraumatic stress disorder (PTSD), little is understood about the mechanism of this relationship. This study examines the role of panic during trauma in the relationship between peritraumatic dissociation and subsequent PTSD. Randomized eligible admissions to 4 major trauma hospitals across Australia (n = 244) were assessed during hospital admission and within one month of trauma exposure for panic, peritraumatic dissociation and PTSD symptoms, and subsequently re-assessed for PTSD three months after the initial assessment (n = 208). Twenty (9.6%) patients met criteria for PTSD at 3-months post injury. Structural equation modeling supported the proposition that peritraumatic derealization (a subset of dissociation) mediated the effect of panic reactions during trauma and subsequent PTSD symptoms. The mediation model indicated that panic reactions are linked to severity of subsequent PTSD via derealization, indicating a significant indirect relationship. Whereas peritraumatic derealization is associated with chronic PTSD symptoms, this relationship is influenced by initial acute panic responses. (C) 2011 Elsevier Ltd. All rights reserved.