Prevalence and predictors of acute stress disorder and PTSD following road traffic accidents: Thought control strategies and social support
Prevalence and predictors of acute stress disorder and PTSD following road traffic accidents: Thought control strategies and social support
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DOI：
10.1016/s0005-7894(01)80044-7
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发表时间：
2001-12-01
期刊：
影响因子：
3.7
通讯作者：
Wells, A
中科院分区：
文献类型：
--
作者：
Holeva, V;Tarrier, N;Wells, A
本研究调查了道路交通事故（rta）后急性应激障碍（ASD）和创伤后应激障碍（PTSD）的患病率，以及思想控制策略和感知到的重要他人的社会支持和批评之间的横断面和前瞻性关系。在事故发生后4周内对434例连续入院的事故和急诊诊所进行了RTA评估，并在6个月内对265例进行了重新评估。21%的人在最初评估时符合ASD的症状标准，23%的人在事故发生后4到6个月符合PTSD的标准。这些结果与其他以类似方式招募相似人群的研究结果非常吻合。在最初评估时被分类为患有ASD的受试者在随访时被分类为患有PTSD的可能性高出20倍（优势比= 20.04）。在时间1时评估的ASD病例中，72%在时间2时是PTSD病例。在横断面分析中，丧失、思想控制策略的个体差异和感知到的消极社会支持质量独立地预测了时间1的ASD和时间2的PTSD。对时间2 PTSD的预测因素分析表明，时间1的ASD、时间1使用担忧控制思想、时间1到时间2感知到的社会支持的变化、以及时间1感知到的社会支持与使用社会控制作为应对策略之间的相互作用对随后的PTSD有显著的预测作用。那些在使用社会控制和感知负面社会支持方面得分较高的人随后发展为PTSD的可能性更大（优势比= 8.2）。结果主要与预测一致，并符合创伤模型，其中持续性障碍与情绪处理的抑制有关。
The study examined the prevalence of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) following road traffic accidents (RTAs), and cross-sectional and prospective relationships with thought-control strategies and perceived social support and criticism from a key significant other. Four hundred and thirty-four consecutive admissions to accident and emergency clinics following an RTA were assessed within 4 weeks of the accident, and 265 reassessed within 6 months. Twenty-one percent met symptom criteria for ASD at initial assessment, and 23% met criteria for PTSD at 4 to 6 months post-accident. These results agree closely with other studies recruiting similar populations in a similar manner. Subjects classified as suffering ASD at initial assessment were 20 times (odds ratio = 20.04) more likely to be classified as suffering PTSD at follow-up. Of the ASD cases assessed at Time 1, 72% were PTSD cases at Time 2. Loss, individual differences in thought-control strategies, and perceived negative quality of social support independently predicted ASD at Time 1 and PTSD at Time 2 in cross-sectional analyses. Analysis of prospective predictors of PTSD at Time 2 indicated that ASD at Time 1, the use of worry to control thoughts at Time 1, a change in perceived social support from Time 1 to Time 2, and an interaction between perceived social support and the use of social control as a coping strategy at Time 1 significantly predicted subsequent PTSD. Those who rated highly on the use of social control and on perceived negative social support had greater probability of subsequently developing PTSD (odds ratio = 8.2). The results were mainly as predicted and conform to models of trauma in which persistent disorders are associated with inhibition of emotional processing.