Momentary assessment of PTSD symptoms and sexual risk behavior in male OEF/OIF/OND Veterans
Momentary assessment of PTSD symptoms and sexual risk behavior in male OEF/OIF/OND Veterans
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DOI：
10.1016/j.jad.2015.10.039
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发表时间：
2016-01-15
影响因子：
6.6
通讯作者：
Rosen, Marc I.
中科院分区：
文献类型：
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作者：
Black, Anne C.;Cooney, Ned L.;Rosen, Marc I.
背景：退伍军人中的创伤后应激障碍(PTSD)与性危险行为的增加有关，但这种联系的性质尚不清楚。典型的创伤后应激障碍测量得出一段时间内症状严重程度的汇总估计，排除了关于症状变异性的推断，以及症状严重度的瞬时变化是否可以预测危险行为。方法：我们评估了使用生态瞬时评估(EMA)测量退伍军人日常创伤后应激障碍症状、药物使用和高危性行为的可行性。可行性指标是调查完成率、创伤后应激障碍症状变异性以及药物使用率和性危险行为变异性。9名男性退伍军人在28天内每天3次通过手机完成网络问卷调查。结果：日内调查完成率中位数保持在90%左右，创伤后应激障碍症状表现出高度的人内变异性，在80分量表上最高可达59分。六名退伍军人报告使用酒精或物质，物质使用者报告使用一种以上药物。8名退伍军人报告了1至28次高危性行为。与创伤后应激障碍相关的负面情绪和外化行为在高危性事件发生之前增加。在28天内有多个性伴与PTSD症状的不稳定性较大。限制：这些结果是初步的，考虑到这个小样本量和多次比较，应该在更大的退伍军人样本中进行验证。结论：结果支持使用EMA来更好地了解退伍军人PTSD症状和性危险行为之间的关系的可行性和实用性。特定的先期风险行为模式为有针对性的临床干预提供了希望。爱思唯尔出版公司(Elsevier B.V.)
Background: Post-traumatic stress disorder (PTSD) in Veterans is associated with increased sexual risk behaviors, but the nature of this association is not well understood. Typical PTSD measurement deriving a summary estimate of symptom severity over a period of time precludes inferences about symptom variability, and whether momentary changes in symptom severity predict risk behavior.Methods: We assessed the feasibility of measuring daily PTSD symptoms, substance use, and high-risk sexual behavior in Veterans using ecological momentary assessment (EMA). Feasibility indicators were survey completion, PTSD symptom variability, and variability in rates of substance use and sexual risk behavior. Nine male Veterans completed web-based questionnaires by cell phone three times per day for 28 days.Results: Median within-day survey completion rates maintained near 90%, and PTSD symptoms showed high within-person variability, ranging up to 59 points on the 80-point scale. Six Veterans reported alcohol or substance use, and substance users reported use of more than one drug. Eight Veterans reported 1 to 28 high-risk sexual events. Heightened PTSD-related negative affect and externalizing behaviors preceded high-risk sexual events. Greater PTSD symptom instability was associated with having multiple sexual partners in the 28-day period.Limitations: These results are preliminary, given this small sample size, and multiple comparisons, and should be verified with larger Veteran samples.Conclusions: Results support the feasibility and utility of using of EMA to better understand the relationship between PTSD symptoms and sexual risk behavior in Veterans. Specific antecedent-risk behavior patterns provide promise for focused clinical interventions. Published by Elsevier B.V.