Four-symptom model of medical-related posttraumatic stress among adult cancer patients.
Four-symptom model of medical-related posttraumatic stress among adult cancer patients.
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成年癌症患者医疗相关创伤后应激的四症状模型。
DOI：
10.1037/hea0001187
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Ironson,Gail
中科院分区：
文献类型：
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作者：
Mitchell,Hannah-Rose;Kim,Youngmee;Llabre,MariaM;Ironson,Gail
目的精神障碍诊断与统计手册（DSM-5）提出了创伤后应激的四种症状（PTSS：侵入、回避、觉醒和反应性改变以及认知和情绪的消极改变）。患有慢性重大疾病的患者及其家庭护理人员通常认为疾病经历是创伤性的，但 DSM-5 标准排除了医疗疾病作为潜在的创伤性暴露。在本文中，我们讨论了这四种症状对医疗人群的适用性。方法成年结直肠癌患者（n = 130，M = 55.83岁，60.0％女性，46.9％西班牙裔）及其家庭照顾者（n = 160，M = 51.01岁，72.5％女性，49.0％西班牙裔）在癌症诊断前后完成了问卷调查和治疗开始（时间 1 [T1]），以及诊断后 1-（时间 2 [T2]）和 2-（时间 3 [T3]）年。使用事件影响量表（修订版）评估侵入、回避以及唤醒和反应性症状的改变，并使用从各种心理社会测量中选择的概念上一致的项目来量化认知和情绪的负面改变。结果验证性因素分析显示，PTSS 的四症状模型对于所有三个时间的护理人员和 T2 的患者都非常适合。四种症状的因子负荷很高，范围从。 47–。 97 和。 62–。患者和护理人员分别为 96。 结论 研究结果将四种创伤后应激症状的应用范围扩大到患有慢性重大疾病（癌症）的患者及其家庭护理人员。有必要对癌症等重大疾病引起的亚临床但严重的心理困扰进行评估和治疗。（PsycInfo 数据库记录 (c) 2022 APA，保留所有权利）
ObjectiveFour symptoms of posttraumatic stress (PTSS: intrusion, avoidance, alterations in arousal and reactivity, and negative alterations in cognitions and mood) were put forth by the Diagnostic and Statistical Manual of Mental Disorder (DSM–5). Patients with chronic major medical illness and their family caregivers often perceive the illness experience as traumatic, yet DSM–5 criteria precludes medical illness as a potential traumatic exposure. In this article, we address the applicability of the four symptoms to a medical population.MethodAdult patients with colorectal cancer (n= 130, M= 55.83 years old, 60.0% female, 46.9% Hispanic) and their family caregivers (n= 160, M= 51.01 years old, 72.5% female, 49.0% Hispanic) completed questionnaires around the time of cancer diagnosis and treatment initiation (Time 1 [T1]), and 1-(Time 2 [T2]) and 2-(Time 3 [T3]) year postdiagnosis. Intrusion, avoidance, and alterations in arousal and reactivity symptoms were assessed using the Impact of Events Scale–Revised and negative alterations in cognitions and mood were quantified with selected conceptually congruent items from various psychosocial measures.ResultsConfirmatory factor analysis revealed good fit of the four-symptom model of PTSS for caregivers at all three times and for patients at T2. Factor loadings of the four symptoms were high, ranging from. 47–. 97 and. 62–. 96 among patients and caregivers, respectively.ConclusionsFindings extend the application of the four posttraumatic stress symptoms to patients with chronic major medical illness (cancer) and their family caregivers. Assessment and treatment of subclinical, yet substantial psychological distress precipitated by major medical illness like cancer are warranted.(PsycInfo Database Record (c) 2022 APA, all rights reserved)