The Association Between Cognitive Coping Strategies and Treatment Outcomes in Smokers With PTSD
The Association Between Cognitive Coping Strategies and Treatment Outcomes in Smokers With PTSD
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吸烟者创伤后应激障碍认知应对策略与治疗效果的关系
DOI：
10.1037/tra0000473
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发表时间：
2020-01-01
影响因子：
6.3
通讯作者：
Foa, Edna B.
中科院分区：
文献类型：
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作者：
Asnaani, Anu;Kaczkurkin, Antonia N.;Foa, Edna B.
目的：许多研究人员表明，某些应对方式（例如，适应不良的认知应对策略）会干扰从创伤经历中恢复，并导致创伤后应激障碍（PTSD）的发作/持续。此外，鉴于患有 PTSD 的个体吸烟率很高（例如，Mahaffey 等人，2016），并且适应不良的应对策略通常与较低的戒烟率相关，因此使用适应不良的认知应对策略对于患有 PTSD 的吸烟者的康复可能尤其成问题。本研究探讨了特定的认知应对策略是否与患有 PTSD 的吸烟者在对这两种疾病进行综合治疗后较差的结果相关。方法：患有慢性 PTSD 和尼古丁依赖的患者 (N = 142) 接受了多达 12 次戒烟咨询联合伐尼克兰或综合长期暴露疗法和戒烟咨询联合伐尼克兰。我们假设基线时较大的适应不良和较低的适应性认知应对策略将在随访期间适度改善吸烟和创伤后应激障碍（PTSD）结果。结果：多层次模型显示，在研究过程中，适应不良或适应性认知应对策略均不会调节戒烟结果 (ps >= .271)。然而，在基线时更多地使用灾难性描述和较少地使用积极的重新评估与研究过程中过度警觉性 PTSD 症状群的改善较少相关（ps
Objective: Numerous researchers have suggested that certain coping styles (e.g., maladaptive cognitive coping strategies) interfere with recovery from traumatic experiences and contribute to the onset/maintenance of posttraumatic stress disorder (PTSD). Further, given that individuals with PTSD have a high rate of smoking (e.g., Mahaffey et al., 2016) and that maladaptive coping strategies in general are associated with lower smoking quit rates, it is possible that use of maladaptive cognitive coping strategies are particularly problematic for the recovery of smokers with PTSD. The present study examined whether specific cognitive coping strategies are associated with poorer outcome among smokers with PTSD following an integrated treatment for both disorders. Method: Patients with chronic PTSD and nicotine dependence (N = 142) received up to 12 sessions of smoking cessation counseling combined with varenicline or integrated prolonged exposure therapy and cessation counseling combined with varenicline. We hypothesized that greater maladaptive, and lower adaptive, cognitive coping strategies at baseline would moderate degree of improvement in smoking and PTSD outcomes through to follow-up. Results: Multilevel modeling revealed that neither maladaptive nor adaptive cognitive coping strategies moderated smoking abstinence outcomes over the course of the study (ps >= .271). However, greater use of catastrophizing and lower use of positive reappraisal at baseline were associated with less improvement in the hyperarousal PTSD symptom cluster over the course of the study (ps