Positive and Negative Affect in the Daily Life of World Trade Center Responders With PTSD: An Ecological Momentary Assessment Study
Positive and Negative Affect in the Daily Life of World Trade Center Responders With PTSD: An Ecological Momentary Assessment Study
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DOI：
10.1037/tra0000429
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发表时间：
2020-01-01
影响因子：
6.3
通讯作者：
Kotov, Roman
中科院分区：
文献类型：
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作者：
Dornbach-Bender, Allison;Ruggero, Camilo J.;Kotov, Roman
目的：体验积极情感（PA）的能力具有临床和生活质量影响，特别是对于遭受创伤的救灾人员等弱势群体。低 PA 被纳入创伤后应激障碍 (PTSD) 的诊断标准中，但 PTSD 中 PA 降低的证据不一。相比之下，人们一直发现患有创伤后应激障碍 (PTSD) 的人的负面情绪 (NA) 较高。多日生态瞬时评估（EMA）可以提供有关情感体验的更生态有效的证据；然而，迄今为止，尚未对患有创伤后应激障碍（PTSD）的创伤患者进行此类研究。方法：从世贸中心健康计划中招募了世贸中心 (WTC) 响应者 (N = 202)，对是否存在 PTSD 进行过抽样。参与者在基线时接受了 DSM-IV 的结构化临床访谈和 DSM-5 的 PTSD 检查表，然后连续 7 天每天完成 4 次 EMA 影响调查。结果：当前患有 PTSD 的参与者（占样本的 19.3%）与没有 PTSD 的参与者相比，每日 NA 水平显着更高。然而，日常 PA 没有组间差异，PA 也与 PTSD 的维度测量无关。结论：结果表明，对于救灾人员中的慢性创伤后应激障碍（PTSD）来说，日常生活中的积极情绪并没有受到抑制。这些发现进一步证明 PA 减少可能与 PTSD 没有诊断相关性，而 NA 仍然是治疗干预的重要目标。此外，结果表明，WTC 响应者可以体验到积极情绪并从中受益，即使他们仍然存在 PTSD 症状。临床影响声明患有创伤后应激障碍 (PTSD) 的第一响应者每天所经历的积极情绪水平与未患该疾病的人相似。鉴于与体验积极情感的能力相关的众多健康益处，研究结果表明，即使在经历重大创伤后，患有创伤后应激障碍的救灾人员仍然可以从促进积极情感的干预措施中受益。此外，结果强调了如何在治疗 PTSD 时预测和解决影响的昼夜节律模式。
Objective: The ability to experience positive affect (PA) has clinical and quality of life implications, particularly in vulnerable populations such as trauma-exposed disaster responders. Low PA is included in the diagnostic criteria for posttraumatic stress disorder (PTSD), however evidence for PA reduction in PTSD has been mixed. In contrast, negative affect (NA) has consistently been found to be elevated among individuals with PTSD. Multiday, ecological momentary assessment (EMA) can provide more ecologically valid evidence about experiences of affect; however, no such studies have been conducted in traumatized individuals with PTSD to date. Method: World Trade Center (WTC) responders (N = 202) oversampled for the presence of PTSD were recruited from the WTC Health Program. Participants were administrated the Structured Clinical Interview for DSM-IV and the PTSD Checklist for DSM-5 at baseline, then completed EMA surveys of affect four times a day over seven consecutive days. Results: Participants with current PTSD (19.3% of the sample) showed significantly higher levels of daily NA compared with those without PTSD. However, there was no group difference in daily PA, nor was PA associated with a dimensional measure of PTSD. Conclusion: Results suggest that for chronic PTSD among disaster responders, positive emotions are not inhibited across daily living. Such findings add to evidence suggesting that PA reduction may not be diagnostically relevant to PTSD, whereas NA remains an important target for therapeutic interventions. Moreover, results show that WTC responders can experience and benefit from positive emotion, even if they continue to have PTSD symptoms.Clinical Impact StatementFirst responders with posttraumatic stress disorder (PTSD) experience daily levels of positive affect that are similar to those without the disorder. Given the numerous health benefits associated with the ability to experience positive affect, findings suggest that even after experiencing significant trauma, disaster responders with PTSD can nevertheless benefit from interventions that promote positive affect. Moreover, results underscore how circadian patterns of affect can be anticipated and addressed in treatment of PTSD.