Maladaptive Cognitive Appraisals Mediate the Evolution of Posttraumatic Stress Reactions: A 6-Month Follow-Up of Child and Adolescent Assault and Motor Vehicle Accident Survivors
Maladaptive Cognitive Appraisals Mediate the Evolution of Posttraumatic Stress Reactions: A 6-Month Follow-Up of Child and Adolescent Assault and Motor Vehicle Accident Survivors
复制标题
DOI：
10.1037/a0016945
复制
发表时间：
2009-11-01
影响因子：
4.6
通讯作者：
Smith, Patrick
中科院分区：
文献类型：
--
作者：
Meiser-Stedman, Richard;Dalgleish, Tim;Smith, Patrick
一项对身体攻击和机动车事故的儿童和青少年幸存者的前瞻性纵向随访研究(n=59)评估了认知过程是否预示着该年龄组创伤后6个月的创伤后应激症状(PTSS)。特别是，这项研究评估了不适应的创伤后评估是否在最初和后来的创伤后应激之间起到了中介作用。创伤后2-4周和6个月完成PTSS、适应不良评估和其他认知过程的自我报告测量，以及评估急性应激障碍和创伤后应激障碍(PTSD)的结构化访谈。6个月时的创伤后应激障碍和创伤后应激障碍与不良适应评估和其他认知过程有关，但与人口统计学或客观创伤严重程度变量无关。只有适应不良评估在分离初始症状/诊断后与PTSS/PTSD相关，并在初始和后来的PTSS之间起中介作用。有人认为，在此基础上，随着时间的推移，适应不良评估参与了创伤后应激障碍的发展和维持，而其他认知过程(如主观威胁、记忆过程)可能只在急性阶段产生影响。讨论了这项研究对青少年PTSS治疗的意义。
A prospective longitudinal follow-up study (n = 59) of child and adolescent survivors of physical assaults and motor vehicle accidents assessed whether cognitive processes predicted posttraumatic stress symptomatology (PTSS) at 6 months posttrauma in this age group. In particular, the study assessed whether maladaptive posttraumatic appraisals mediated the relationship between initial and later posttraumatic stress. Self-report measures of PTSS, maladaptive appraisals, and other cognitive processes, as well as structured interviews assessing for acute stress disorder and posttraumatic stress disorder (PTSD), were completed at 2-4 weeks and 6 months posttrauma. PTSS and PTSD at 6 months were associated with maladaptive appraisals and other cognitive processes but not demographic or objective trauma severity variables. Only maladaptive appraisals were found to associate with PTSS/PTSD after partialing out initial symptoms/diagnosis and to mediate between initial and later PTSS. It was argued that, on this basis, maladaptive appraisals are involved in the development and maintenance of PTSS over time, whereas other cognitive processes (e.g., subjective threat, memory processes) may have an effect only in the acute phase. The implications of this study for the treatment of PTSS in youths are discussed.