Predicting PTSD severity from experiences of trauma and heterosexism in lesbian and bisexual women: A longitudinal study of cognitive mediators.
Predicting PTSD severity from experiences of trauma and heterosexism in lesbian and bisexual women: A longitudinal study of cognitive mediators.
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DOI：
10.1037/cou0000287
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发表时间：
2018-04
影响因子：
3.9
通讯作者：
Kaysen D
中科院分区：
文献类型：
--
作者：
Dworkin ER;Gilmore AK;Bedard-Gilligan M;Lehavot K;Guttmannova K;Kaysen D
性少数女性（SMW）处于创伤暴露的高风险中，随后发展为创伤后应激障碍（PTSD）。我们将解释少数群体精神障碍风险较高的理论模型扩展到年轻成年SMW中创伤后应激障碍症状的维持和加剧。这项研究使用了348名18-25岁的创伤暴露者的纵向观察数据，这些人在出生时被分配为女性，他们被确定为双性恋（60.1%）或女同性恋（39.9%），并符合PTSD的筛选标准。参与者被确定为白色（82.8%）、西班牙裔/拉丁裔（12.4%）、美洲印第安人/阿拉斯加原住民（13.5%）、黑人/非裔美国人（13.8%）和/或亚洲人/亚裔美国人（4.9%）。我们调查了远端应激源（即，标准A创伤性事件，异性恋的日常经历）产生近端压力源（即，创伤相关的认知，内化的异性恋），维持或加重PTSD症状。研究结果表明，日常异性恋纵向预测创伤相关的认知（即，与自我、世界和自责有关的认知）。内化异性恋和自我认知纵向预测PTSD症状严重程度。此外，日常异性恋和PTSD症状之间通过自我相关的创伤后认知有显着的间接影响。这些研究结果表明，暴露于少数民族特定的远端压力似乎促进非少数民族特定的认知过程，反过来，可能会维持或加剧创伤后应激障碍的年轻成年SMW暴露于创伤。临床医生应考虑解决日常异性恋在年轻成人SMW与创伤后应激障碍，并评估这些经验如何可能促进客户的全球，对自己的负面看法。公共意义声明：这项研究表明，遭受创伤的性少数群体妇女的日常歧视经历可能会导致她们对自己产生消极的信念，反过来，这可能会维持或恶化创伤后应激障碍的症状。这些发现突出了临床医生探索寻求创伤后应激障碍治疗的性少数女性的潜在领域。
Sexual minority women (SMW) are at high risk of trauma exposure and, subsequently, the development of posttraumatic stress disorder (PTSD). We extended a theoretical model explaining the higher risk of mental disorders in minority populations to the maintenance and exacerbation of PTSD symptoms among young adult SMW specifically. This study used observational longitudinal data from a sample of 348 trauma-exposed 18–25-year-old individuals assigned female sex at birth who identified as either bisexual (60.1%) or lesbian (39.9%) and met screening criteria for PTSD. Participants identified as White (82.8%), Hispanic/Latina (12.4%), American Indian/Alaska Native (13.5%), Black/African American (13.8%), and/or Asian/Asian American (4.9%). We investigated whether distal stressors (i.e., criterion A traumatic events, daily experiences of heterosexism) produced proximal stressors (i.e., trauma-related cognitions, internalized heterosexism) that maintained or exacerbated PTSD symptoms. Findings indicated that daily heterosexism longitudinally predicted trauma-related cognitions (i.e., cognitions related to the self, world, and self-blame). Internalized heterosexism and cognitions about the self longitudinally predicted PTSD symptom severity. In addition, a significant indirect effect was identified between daily heterosexism and PTSD symptoms via self-related posttraumatic cognitions. These findings suggest that exposure to minority-specific distal stressors appears to promote non-minority-specific cognitive processes that, in turn, may maintain or exacerbate PTSD among young adult SMW exposed to trauma. Clinicians should consider addressing daily heterosexism in young adult SMW presenting with PTSD and evaluate how these experiences might promote clients’ global, negative views regarding themselves. Public significance statement: This study suggests that trauma-exposed sexual minority women’s day-to-day experiences of discrimination may lead them to develop negative beliefs about themselves which, in turn, could maintain or worsen symptoms of posttraumatic stress disorder. These findings highlight potential areas for clinicians to explore with sexual minority women seeking treatment for posttraumatic stress disorder.
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影响因子：
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作者：
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