The experience of chronic illness and post-traumatic stress disorder: the consequences of cumulative adversity
The experience of chronic illness and post-traumatic stress disorder: the consequences of cumulative adversity
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DOI：
10.1016/s0277-9536(99)00399-8
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发表时间：
2000-05-01
影响因子：
5.4
通讯作者：
Alonzo, AA
中科院分区：
文献类型：
--
作者：
Alonzo, AA
本研究以慢性病患者为研究对象，探讨创伤后应激障碍（PTSD）、累积性逆境负担和创伤谱系障碍对患者后续疾病和应对行为的影响。经历慢性疾病的个体已经研究了抑郁症，焦虑症和各种应对不良适应，但忽略了对慢性疾病在生命过程中的PTSD潜力的关注。然而，越来越多的证据表明，慢性疾病的潜在创伤性，一些突然和意外的发病，以及生活环境的创伤性变化，可能会产生适应不良的疾病应对在生命过程中。更重要的是，需要关注共病生活事件的累加效应和侵入性医学治疗的创伤潜力。考虑创伤后应激障碍和一个连续的累积逆境提供了一个更复杂和充分的理解周围的情况下慢性疾病的应对和原因适应不良的应对后侵入性治疗和疾病轨迹的变化。产生慢性疾病的病理生理学并不是从症状发作时就开始开始的，而科普慢性疾病的社会心理策略，无论是有效的还是适应不良的，也不是从症状发作时就开始开始的，而是在整个生命过程中发展的。(C)2000爱思唯尔科技有限公司版权所有。
In this paper the experiences of the chronically ill are examined to explore the impact of post-traumatic stress disorder (PTSD), accumulated burden of adversity and trauma spectrum disorder on subsequent illness and coping behaviors. Individuals experiencing chronic diseases have been studied with regard to depression, anxiety and a variety of coping maladaptions, but negligible attention has been given to the PTSD potential of chronic disease over the life course. Yet, growing evidence suggests that the traumatogenic potential of chronic diseases, some sudden and unexpected onsets, and the traumatogenic changes in life circumstance, may produce maladaptive illness coping over the life course. More importantly, attention needs to focus on the additive effect of co-morbid life events and the traumatic potential of invasive medical therapies. Consideration of PTSD and a continuum of cumulative adversity provide a more complex and fully drawn understanding of the circumstances surrounding chronic illness coping and reasons for maladaptive coping following invasive therapies and changes in the disease trajectory. The pathophysiology that produces a chronic diseases does not begin at symptom onset, and the psychosocial strategies to cope with a chronic illness, whether efficacious or maladaptive, also do not begin at symptom onset, but develops over the life course. (C) 2000 Elsevier Science Ltd. All rights reserved.