Predictors of somatic symptom severity: The role of cumulative history of trauma and adversity in a diverse community sample.
Predictors of somatic symptom severity: The role of cumulative history of trauma and adversity in a diverse community sample.
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DOI：
10.1037/tra0000334
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发表时间：
2018-09
期刊：
影响因子：
--
通讯作者：
Aswad Y
中科院分区：
文献类型：
--
作者：
Loeb TB;Joseph NT;Wyatt GE;Zhang M;Chin D;Thames A;Aswad Y
据报道，创伤受害者经常出现躯体症状，这给初级保健保健提供者带来了重大负担。我们考察了创伤和逆境的终生历史，包括以前没有研究过的方面(即感知到的歧视)与躯体症状之间的关系，以及创伤后应激症状(PTSS)和抑郁症状的中介作用。一个由500名男性和女性参与者(230名非裔美国人和270名拉丁裔)组成的多种族社区样本完成了人口统计特征、加州大学洛杉矶分校终身不良筛查(LADS)、抑郁症状、PTSS和躯体症状的测量。控制了年龄、性别和种族/民族的普通最小二乘回归分析表明，一生中遭遇的逆境和创伤程度越高，躯体症状越严重，b=6.95，p<；0.0001。正式中介检验显示LADS通过PTSS和抑郁症状对躯体症状有显著的间接效应，间接效应分别为2.64(95%CI：1.2~4.1)和2.19(95%CI：1.3~3.3)。即使在考虑了PTSS和抑郁症状后，LAD仍然与躯体症状显著相关，b=2.13，p<；05，建议部分调解。暴露于创伤和不良事件(LADS)与躯体症状严重程度相关。此外，尽管PTSS和抑郁症状部分解释了LAD和躯体症状之间的联系，但LAD仍然显著，这表明暴露在创伤和逆境中以及由此导致的PTSS和抑郁症状的发展影响躯体症状的发展。
Somatic symptoms are often reported among victims of trauma, and place a significant burden on primary care health providers. We examined the relationship between lifetime histories of trauma and adversity, including aspects not previously studied (i.e., perceived discrimination), and somatic symptoms, as well as the mediating role of post-traumatic stress symptoms (PTSS) and depressive symptoms. A multi-ethnic community sample of 500 male and female participants (230 African American and 270 Latino) completed measures of demographic characteristics, the UCLA Lifetime Adversities Screener (LADS), depressive symptoms, PTSS, and somatic symptoms. An ordinary least squares regression analysis controlling for age, gender, and race/ethnicity indicated that higher levels of lifetime adversity and trauma were significantly associated with more severe somatic symptoms, b = 6.95, p < .0001. Formal mediation tests indicated that there was a significant indirect effect of LADS on somatic symptoms via PTSS and depressive symptoms, indirect effect = 2.64 (95% CI: 1.2–4.1) and 2.19 (95% CI: 1.3–3.3), respectively. Even after PTSS and depressive symptoms were taken into account, the LADS remained significantly associated with somatic symptoms, b = 2.13, p <. 05, suggesting partial mediation. Exposure to traumatic and adverse events (the LADS) was associated with somatic symptom severity. Further, although PTSS and depressive symptoms partially accounted for the association between the LADS and somatic symptoms, the LADS remained significant, suggesting that both exposure to trauma and adversity and the resultant development of PTSS and depressive symptoms influence the development of somatic symptoms.
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影响因子：
3.7
作者：
Adam EK;Heissel JA;Zeiders KH;Richeson JA;Ross EC;Ehrlich KB;Levy DJ;Kemeny M;Brodish AB;Malanchuk O;Peck SC;Fuller-Rowell TE;Eccles JS
通讯作者：
Eccles JS
影响因子：
3.1
作者：
Edwards, Robert R.
通讯作者：
Edwards, Robert R.
影响因子：
2.4
作者：
Chen, Angela Chia-Chen;Szalacha, Laura A.;Menon, Usha
通讯作者：
Menon, Usha
影响因子：
3.3
作者：
Allen, Vincent C., Jr.;Myers, Hector F.;Williams, John K.
通讯作者：
Williams, John K.
影响因子：
3.8
作者：
Cusack, KJ;Frueh, BC;Brady, KT
通讯作者：
Brady, KT