British Journal of Clinical Psychology最新文献_第6页

Pleasurable emotions and internalizing psychopathology: A multi-study examination of specificity and alternative explanations 愉悦情绪与内化心理病理学：对特异性和替代解释的多项研究。

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-05-22 DOI: 10.1111/bjc.12474

Ariana Andrea Castro, Sam DeHart, Howard Berenbaum

Objectives

Past research has been inconclusive regarding the specificity of associations between discrete pleasurable emotions and internalizing symptoms. Contentment may be especially relevant to depression, whereas tranquillity may be especially relevant to worry. The goal of the current research was to clarify the mixed findings regarding the relation between pleasure deficits and internalizing psychopathology.

Methods

Participants from three samples (Total N = 757) completed alternative measures of depression and pleasurable emotions. Participants in Study 1 also completed a measure of anticipatory and consummatory pleasure, and close peers to a subset of participants (N = 64) reported their perceptions of participants' depression severity. Participants in Studies 2 and 3 also completed a measure of worry.

Results

Across the three samples, contentment was significantly negatively associated with self-reported depression. This association could not be accounted for by tranquillity, cheerfulness, anticipatory pleasure, or consummatory pleasure. Contentment was also strongly negatively associated with peer-reported depression. Contentment was more strongly associated with depression than was cheerfulness. However, the strength of the association between contentment and depression relative to the strength of the association between tranquillity and depression depended on how contentment and depression were measured. Conversely, tranquillity was more strongly associated with worry than were contentment or cheerfulness.

Conclusions

This study provides further evidence of the potential importance of the role of contentment in depression and tranquillity in worry. It may be useful to attend to contentment when assessing and treating depression and to attend to tranquillity when assessing and treating elevated worry.

研究目的过去的研究对离散的愉悦情绪与内化症状之间的特异性并无定论。满足感可能与抑郁特别相关，而宁静则可能与忧虑特别相关。本研究的目的是澄清关于愉悦感缺失与内化心理病理学之间关系的混合研究结果：来自三个样本的参与者（总人数 = 757）完成了抑郁和愉悦情绪的替代测量。研究 1 的参与者还完成了一项预期愉悦和消费愉悦的测量，参与者子集（N = 64）的亲密同伴报告了他们对参与者抑郁严重程度的看法。研究 2 和研究 3 的参与者还完成了一项担忧测量：结果：在三个样本中，知足与自我报告的抑郁呈显著负相关。这种关联无法用宁静、开朗、预期愉悦或消耗性愉悦来解释。知足也与同伴报告的抑郁呈显著负相关。与开朗相比，知足与抑郁的关系更为密切。然而，相对于宁静与抑郁之间的关联强度，知足与抑郁之间的关联强度取决于如何测量知足和抑郁。相反，宁静比知足或开朗与忧虑的关联性更强：本研究进一步证明了知足对抑郁和宁静对忧虑的潜在重要性。在评估和治疗抑郁时关注满足感，在评估和治疗升高的担忧时关注宁静感，可能会有所帮助。

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引用次数: 0

How etiological beliefs contribute to the structure of depression symptom networks 病因信念是如何促成抑郁症状网络结构的？

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-05-21 DOI: 10.1111/bjc.12476

Michael R. Gallagher, Amanda C. Collins, Sonora Goldman, Jessica S. Bryant, E. Samuel Winer

Objectives

Each person possesses a unique view surrounding depressive symptomology and etiology that is shaped by idiosyncratic experiences. However, the influence that subjective etiological beliefs regarding a person's depressive symptoms have on actual symptom presentation and organization is seldom considered.

Methods

The current study employed network analytic techniques to examine how subjective views surrounding the cause of depressive symptoms altered actual symptom presentation networks. Additionally, the interaction between depressive symptoms and various etiological beliefs was examined.

Results

The results revealed that characterological beliefs, representing the idea that depression is caused by an internal sense of self, are strongly connected to a negative view of self, as well as a saddened mood. Additionally, the characterological beliefs node exhibited the greatest node predictability in its respective network, as well as in an omnibus network consisting of all depression symptoms and potential etiological beliefs. Whereas an achievement-based view of depression has a strong connection with concentration difficulties, a physical view of depression tends to form strong connections with physically based depressive symptoms.

Conclusion

Subjective views regarding the cause of depression have the potential to influence symptom presentation and organization within a network, which may influence a person's willingness to engage in treatment or specific treatment preferences.

目的：每个人对抑郁症状和病因都有自己独特的看法，这种看法是由其特殊经历形成的。然而，关于抑郁症状的主观病因信念对实际症状表现和组织的影响却很少被考虑：本研究采用了网络分析技术来研究围绕抑郁症状成因的主观观点是如何改变实际症状表现网络的。此外，还研究了抑郁症状与各种病因信念之间的相互作用：结果发现，代表抑郁症是由内在自我意识引起的观点的性格信念与消极的自我观以及悲伤的情绪密切相关。此外，在其各自的网络中，以及在由所有抑郁症状和潜在病因信念组成的综合网络中，性格信念节点表现出最大的节点可预测性。基于成就的抑郁观点与注意力不集中有密切联系，而基于身体的抑郁观点往往与基于身体的抑郁症状有密切联系：结论：对抑郁症病因的主观看法有可能影响症状的表现和网络中的组织，这可能会影响一个人接受治疗的意愿或具体的治疗偏好。

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引用次数: 0

Specificity of cost and probability biases in social anxiety: Comparing status and belongingness threats 社交焦虑中成本和概率偏差的特异性：比较地位威胁和归属威胁

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-05-08 DOI: 10.1111/bjc.12472

Roy Azoulay, Eva Gilboa-Schechtman

Background

Social anxiety (SA) is characterized by concerns about the expected occurrence (probability) and anticipated distress (cost) of social threats. Unclear is whether SA correlates specifically with biased expectations of belongingness or status threats.

Aims

We aimed to discern if SA is uniquely tied to biased expectancies of either belongingness or status threats.

Materials and Methods

We assessed 757 participants' perceptions of exclusion and put-down scenarios, analysing associations between SA and threat perceptions.

Discussion

Our findings support the status-sensitivity hypothesis, suggesting individuals with high SA are particularly attuned to the perceived cost of status threats, potentially informing treatment approaches.

Conclusion

Understanding SA's link to status concerns enhances therapeutic strategies, emphasizing the need to address status-related situations, cognitions, and emotions in interventions.

背景：社交焦虑（SA）的特征是对社交威胁的预期发生（概率）和预期痛苦（代价）的担忧。目的：我们的目的是了解社交焦虑是否与对归属感或地位威胁的偏差预期有独特联系：我们评估了757名参与者对排斥和贬低情景的感知，分析了SA与威胁感知之间的关联：讨论：我们的研究结果支持地位敏感性假说，表明高自闭症患者对地位威胁的感知成本尤为敏感，这有可能为治疗方法提供参考：结论：了解SA与地位问题之间的联系可以加强治疗策略，强调在干预过程中需要解决与地位相关的情况、认知和情绪问题。

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引用次数: 0

Threat, safety, safeness and social safeness 30 years on: Fundamental dimensions and distinctions for mental health and well-being 威胁、安全、安全和社会安全 30 年后的今天：心理健康与幸福的基本维度和区别

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-05-03 DOI: 10.1111/bjc.12466

Paul Gilbert

In 1993, the British Journal of Clinical Psychology published my paper titled ‘Defence and safety: Their function in social behaviour and psychopathology’. The paper highlights that to understand people's sensitivity to threat, we also need to understand their ability to identify what is safe. This paper offers an update on these concepts, highlighting distinctions that were implicit but not clearly defined at the time. Hence, the paper seeks to clarify distinctions between: (i) threat detection and response, (ii) safety and safety seeking, (iii) safeness and (iv) their social and non-social functions and forms. Threat detection and response are to prevent or minimize harm (e.g., run from a predator or fire). Safety checking relates to monitoring for the absence and avoidance of threat, while safety seeking links to the destination of the defensive behaviour (e.g., running home). Safety seeking also relates to maintaining vigilance to the appearance of potential harms and doing things believed to avoid harm. Threat-defending and safety checking and seeking are regulated primarily through evolved threat processing systems that monitor the nature, presence, controllability and/or absence of threat (e.g., amygdala and sympathetic nervous system). Safeness uses different monitoring systems via different psychophysiological systems (e.g., prefrontal cortex, parasympathetic system) for the presence of internal and external resources that support threat-coping, risk-taking, resource exploration. Creating brain states that recruit safeness processing can impact how standard evidence-based therapies (e.g., exposure, distress tolerance and reappraisal) are experienced and produce long-term change.

1993 年，《英国临床心理学杂志》发表了我的论文《防御与安全：它们在社会行为和精神病理学中的功能》。该论文强调，要了解人们对威胁的敏感性，我们还需要了解他们识别安全事物的能力。本文对这些概念进行了更新，强调了当时隐含但未明确定义的区别。因此，本文试图厘清以下概念之间的区别：(i) 威胁侦测与应对；(ii) 安全与寻求安全；(iii) 安全性；(iv) 它们的社会和非社会功能与形式。威胁探测和反应是为了防止或尽量减少伤害（例如，逃离捕食者或火灾）。安全检查与监测是否存在威胁和避免威胁有关，而寻求安全则与防卫行为的目的地有关（如跑回家）。寻求安全也是指对潜在伤害的出现保持警惕，并做一些认为可以避免伤害的事情。威胁防御、安全检查和寻求主要通过进化的威胁处理系统来调节，这些系统监测威胁的性质、存在、可控性和/或不存在（如杏仁核和交感神经系统）。安全感则通过不同的心理生理系统（如前额叶皮层、副交感神经系统）使用不同的监控系统，以监控支持威胁应对、冒险和资源探索的内部和外部资源的存在。创造能够促进安全处理的大脑状态，可以影响标准循证疗法（如暴露疗法、痛苦耐受疗法和重新评估疗法）的体验方式，并产生长期的改变。

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引用次数: 0

Interpersonal sensitivity predicts slower change and less change in anxiety symptoms in cognitive behavioural therapy 人际关系敏感性可预测认知行为疗法中焦虑症状的缓慢变化和较小变化

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-04-29 DOI: 10.1111/bjc.12470

Jiyoung Song, Genevieve Freedman, Letian Li, Jacqueline B. Persons

Objectives

Patients in cognitive behavioural therapy (CBT) who are high in interpersonal sensitivity may have difficulty fully engaging in treatment because therapy sessions require intimate interpersonal interactions that are especially uncomfortable for these individuals. The current study tests the hypotheses that patients who are high in interpersonal sensitivity benefit less from CBT for symptoms of depression and anxiety, show a slower rate of change in those symptoms, and are more likely to drop out of treatment.

Methods

Participants were 832 outpatients who received naturalistic CBT. We assessed interpersonal sensitivity before treatment began and depression and anxiety symptoms at every therapy session. We assessed early, premature, and uncollaborative termination after treatment ended. We constructed multilevel linear regression models and logistic regression models to assess the effects of baseline interpersonal sensitivity on the treatment outcome, the slope of change in depression and anxiety symptoms, and each type of dropout.

Results

Higher baseline interpersonal sensitivity was associated with a slower rate of change and less overall change in anxiety but not depressive symptoms. Baseline interpersonal sensitivity was not a predictor of dropout.

Conclusions

Interpersonal sensitivity at baseline predicts less change and a slower rate of change in anxiety symptoms. Early detection of elevated interpersonal sensitivity can help therapists take action to address these barriers to successful treatment and help scientists build decision support tools that accurately predict the trajectory of change in anxiety symptoms for these patients.

目的认知行为疗法（CBT）中人际关系敏感度高的患者可能很难完全投入治疗，因为治疗过程需要亲密的人际互动，而这对这些人来说特别不舒服。本研究验证了以下假设：人际关系敏感度高的患者在抑郁和焦虑症状方面从 CBT 治疗中获益较少，这些症状的变化速度较慢，并且更有可能放弃治疗。我们在治疗开始前对人际关系敏感性进行了评估，并在每次治疗过程中对抑郁和焦虑症状进行了评估。在治疗结束后，我们对早期终止、过早终止和不合作终止进行了评估。我们建立了多层次线性回归模型和逻辑回归模型，以评估基线人际关系敏感性对治疗结果、抑郁和焦虑症状变化斜率以及各种辍学类型的影响。结果基线人际关系敏感性越高，焦虑症状的变化速度越慢，总体变化越小，但抑郁症状却没有变化。结论基线人际关系敏感度可预测焦虑症状的较小变化和较慢的变化速度。人际关系敏感性升高的早期检测可以帮助治疗师采取行动解决这些阻碍成功治疗的问题，并帮助科学家建立决策支持工具，准确预测这些患者焦虑症状的变化轨迹。

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引用次数: 0

Different self-damaging behaviours, similar motives? Testing measurement invariance of motives for nonsuicidal self-injury, disordered eating and substance misuse 不同的自我损害行为，相似的动机？测试非自杀性自伤、饮食失调和药物滥用动机的测量不变性

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-04-16 DOI: 10.1111/bjc.12467

Christina L. Robillard, Gabriel J. Merrin, Nicole K. Legg, Megan E. Ames, Brianna J. Turner

Objectives

Theory and research suggest that distinct self-damaging behaviours (SDBs; e.g., nonsuicidal self-injury [NSSI], restrictive eating, binge eating, drug misuse, alcohol misuse) share similar motives. However, few studies have used a common self-report inventory to investigate the shared relevance and relative salience of motives for SDBs. Accordingly, the present study: (1) examined whether self-report scales assessing intrapersonal motives (i.e., relieving negative emotions, enhancing positive emotions, punishing oneself) and interpersonal motives (i.e., bonding with others, conforming with others, communicating distress, communicating strength, reducing demands) have invariant factor structures across SDBs; and (2) compared the salience of these motives across SDBs.

Methods

1018 adults (54.6% men, M_age = 35.41 years) with a history of SDBs were allocated to the following groups: NSSI (n = 213), restrictive eating (n = 200), binge eating (n = 200), drug misuse (n = 200) or alcohol misuse (n = 205). Participants reported on their motives for engaging in their allocated SDB. Measurement invariance analyses compared the factor structures and latent means of the motive scales across SDBs.

Results

The motive scales had comparable factor structures across SDBs. Intrapersonal motives were most strongly endorsed for NSSI and drug misuse. Interpersonal motives were most strongly endorsed for drug and alcohol misuse. All motives were least salient to restrictive eating.

Conclusions

Results suggest that common motives underlie distinct SDBs and that they can be adequately assessed using a single self-report inventory. However, certain motives are more relevant to some SDBs than others, with restrictive eating being the most motivationally distinct SDB. This knowledge can inform transdiagnostic models and interventions for SDBs.

理论和研究表明，不同的自我损害行为（SDBs；例如，非自杀性自伤[NSSI]、限制性饮食、暴饮暴食、药物滥用、酒精滥用）具有相似的动机。然而，很少有研究使用通用的自我报告清单来调查SDBs动机的共同相关性和相对显著性。因此，本研究：(1) 检验了评估人内动机（即缓解消极情绪、增强积极情绪、惩罚自己）和人际动机（即与他人建立联系、与他人保持一致、传达痛苦、传达力量、减少需求）的自我报告量表在不同的 SDB 中是否具有不变的因子结构；(2) 比较了这些动机在不同 SDB 中的显著性。

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引用次数: 0

Exploring the roles of compassion and post-traumatic stress disorder on global distress after sexual trauma 探索同情心和创伤后应激障碍对性创伤后整体痛苦的影响。

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-04-02 DOI: 10.1111/bjc.12465

Runa Dawood, Jane Vosper, Chris Irons, Stuart Gibson, Gary Brown

Objectives

Recovery from sexual trauma can be complex and multi-faceted. Most current psychological treatment protocols for trauma use a cognitive model of post-traumatic stress disorder (PTSD). However, sexual trauma may include specific complexities beyond that of a cognitive model of PTSD, such as relational factors. The distress experienced after sexual abuse may involve variables not exclusive to a PTSD model. Compassion focused therapy (CFT) is an approach that incorporates evolutionary, relational and social perspectives. This study explored the relationships between variables associated with CFT, PTSD and distress in survivors of sexual abuse to determine the role of CFT-related variables.

Methods

155 adults who had experienced sexual abuse or any unwanted sexual experience at any point in their lives completed online questionnaires pertaining to various CFT variables (self-compassion, receiving compassion from others, having a fear of compassion from others, having a fear of compassion from the self, shame and self-criticism) and questionnaires measuring global distress as the outcome of sexual abuse and PTSD symptoms.

Results

An exploratory model involving CFT-related variables explained significantly more of the variance (4.4%) in global distress than PTSD symptomology alone. Self-criticism was found to be the variable with significant contribution.

Conclusions

That CFT treatments, targeting self-criticism, should be developed alongside the standard cognitive model of PTSD based treatments for survivors of sexual abuse was supported. Future research may explore experimental designs utilizing CFT in this population, as well as further investigations on the roles of these specific CFT variables.

目标：性创伤的康复可能是复杂和多方面的。目前，大多数创伤心理治疗方案都采用创伤后应激障碍（PTSD）的认知模式。然而，性创伤可能包含超越创伤后应激障碍认知模式的特定复杂性，例如关系因素。性虐待后所经历的痛苦可能涉及创伤后应激障碍模型之外的变量。同情焦点疗法（CFT）是一种融合了进化、关系和社会视角的方法。本研究探讨了性虐待幸存者中与慈悲为怀疗法、创伤后应激障碍和痛苦相关的变量之间的关系，以确定慈悲为怀疗法相关变量的作用。方法：155 名曾在生命的任何阶段经历过性虐待或任何不想要的性经历的成年人填写了有关各种 CFT 变量（自我同情、接受他人同情、害怕他人同情、害怕自我同情、羞耻感和自我批评）的在线问卷，以及测量作为性虐待和创伤后应激障碍症状结果的整体痛苦的问卷：与单纯的创伤后应激障碍症状相比，涉及 CFT 相关变量的探索性模型能解释更多的总体痛苦方差（4.4%）。结论：以自我批判为目标的创伤后应激障碍治疗方法对创伤后应激障碍的治疗有重要意义：以自我批判为目标的创伤后应激障碍治疗应与基于创伤后应激障碍标准认知模式的性虐待幸存者治疗同时进行，这一点得到了支持。未来的研究可能会探索在这一人群中使用 CFT 的实验设计，并进一步调查这些特定 CFT 变量的作用。

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引用次数: 0

Recognizing and coping with suicidal thoughts: A mixed-methods investigation of digital safety plan content 认识和应对自杀念头：数字安全计划内容的混合方法调查。

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-03-26 DOI: 10.1111/bjc.12460

Christopher Rainbow, Ruth Tatnell, Grant Blashki, Glenn A. Melvin

Objectives

Suicide safety plans are a personalized means of documenting how a person at risk of suicide recognizes and intends to cope with emerging suicidal thoughts. This study aimed to understand how users of digital suicide safety plans describe their warning signs, methods of coping and any relationships between these that may emerge.

Methods

A sample comprising 150 users of the Australian suicide safety planning smartphone app Beyond Now consented to share the content of their safety plans. Reflexive thematic analysis was used to identify themes in overall plan content. Most participants identified as women (61%), had a history of at least one suicide attempt (61%) and completed their plans by themselves (84%).

Results

Three major themes emerged: (1) interpersonal challenges and complexity; (2) matching coping strategies to warning signs; and (3) helpful and harmful digital technology use. Most plans appeared to demonstrate high self-awareness of warning signs and available supports.

Conclusions

Safety plan content provides a window into the thought process underlying the recognition of suicidal thoughts and the attempts to manage them. An opportunity exists for practitioners and support persons to use this content when collaboratively supporting a safety plan user to improve their coping strategies and support networks.

目的：自杀安全计划是一种个性化手段，用于记录有自杀风险的人如何认识到并打算应对新出现的自杀念头。本研究旨在了解数字自杀安全计划的用户如何描述他们的警示信号、应对方法以及这些因素之间可能出现的任何关系：150名澳大利亚自杀安全计划智能手机应用程序 "Beyond Now "的用户同意分享他们的安全计划内容。我们采用了反思性主题分析法来确定总体计划内容的主题。大多数参与者都认为自己是女性（61%），有过至少一次自杀未遂史（61%），并且自己完成了计划（84%）：结果：出现了三大主题：(1) 人际关系的挑战和复杂性；(2) 应对策略与警告信号的匹配；(3) 有用和有害数字技术的使用。大多数计划似乎都表现出对警示信号和可用支持的高度自我意识：安全计划的内容提供了一个窗口，让人们了解认识到自杀念头和试图控制这些念头的思维过程。从业人员和支持人员在共同支持安全计划使用者改善其应对策略和支持网络时，有机会使用这些内容。

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引用次数: 0

Acknowledging religion in cognitive behavioural therapy: The effect on alliance, treatment expectations and credibility in a video-vignette study 在认知行为疗法中承认宗教：在视频短片研究中对联盟、治疗期望和可信度的影响。

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-03-25 DOI: 10.1111/bjc.12464

Hibah Hassan, Sarah Lack, Paul M. Salkovskis, Graham R. Thew

Objectives

Developing mental health services which are accessible and acceptable to those from minority backgrounds continues to be a priority. In the United Kingdom, individuals who identify with a religion are underrepresented in Talking Therapies services as compared to those with no religion. This necessitates an understanding of how therapy is perceived. This online study explored the impact of explicitly acknowledging religion on anticipated alliance, treatment credibility and expectations of therapy in a non-clinical sample of British Muslims.

Methods

A video-vignette experimental design was used in which participants who self-reported as either high or low in religiosity were randomly allocated to receiving information about cognitive behavioural therapy either with or without an explicit mention of religion as a value in the therapeutic process.

Results

One hundred twenty-nine British Muslim adults aged 18–70+ years from various ethnic backgrounds participated in the study. Between-subjects ANOVAs showed that scores on the perceived credibility of therapy and treatment expectations were significantly higher when religion was explicitly mentioned by the ‘therapist’, but that acknowledging religion did not impact upon anticipated alliance.

Conclusions

These findings suggest that mentioning religion as a value to be considered in therapy has some positive impacts upon how therapy is perceived by British Muslims. Although video vignettes do not provide insight into the complexity of actual therapeutic encounters, acknowledging religion in mental health services more broadly remains an important consideration for improving equity of access and may bear relevance to other minoritized groups.

目标：发展少数群体背景的人能够获得和接受的心理健康服务仍然是一个优先事项。在英国，与无宗教信仰的人相比，有宗教信仰的人在谈话治疗服务中所占的比例较低。这就需要了解人们是如何看待治疗的。这项在线研究探讨了在英国穆斯林非临床样本中，明确承认宗教对预期联盟、治疗可信度和治疗期望的影响：方法：采用视频插图实验设计，将自称宗教信仰较高或较低的参与者随机分配到接受认知行为疗法的信息中，在治疗过程中明确提及或不明确提及宗教信仰的价值：129 名年龄在 18-70 岁以上、具有不同种族背景的英国穆斯林成年人参与了这项研究。研究对象间方差分析显示，当 "治疗师 "明确提及宗教时，治疗可信度和治疗期望值的得分明显较高，但承认宗教并不会影响预期联盟：这些研究结果表明，将宗教作为治疗中需要考虑的价值之一会对英国穆斯林如何看待治疗产生一些积极影响。虽然视频片段无法让人深入了解实际治疗过程的复杂性，但从更广泛的角度来看，在心理健康服务中承认宗教信仰仍然是改善公平就医的一个重要考虑因素，而且可能与其他少数群体相关。

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引用次数: 0

Investigating the dissociative subtype of post-traumatic stress disorder in single- and multi-event trauma-exposed youth: Prevalence, course, prognosis, severity and functional impairment 调查遭受单一和多重事件创伤的青少年创伤后应激障碍的分离亚型：患病率、病程、预后、严重程度和功能障碍。

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2024-03-15 DOI: 10.1111/bjc.12461

William F. White, Aaron Burgess, Tim Dalgleish, Clare Dixon, Sarah L. Halligan, Rachel M. Hiller, Anna McKinnon, Patrick Smith, Richard Meiser-Stedman

Objectives

This study aimed, following both single- and multi-event trauma, to ascertain prevalence and course of the dissociative subtype of post-traumatic stress disorder (PTSD-DS) in youth; how well early PTSD-DS predicts later PTSD; and whether dissociation accounts for unique variance in post-traumatic stress symptoms (PTSS) and functional impairment over and above the effect of other post-trauma cognitive processing factors and PTSS respectively.

Design and Methods

This study is a secondary analysis of data from the Acute Stress Programme for Children and Teenagers study (n = 234) and the Coping in Care After Trauma study (n = 110) in which children had experienced single- and multi-event trauma respectively.

Results

PTSD-DS diagnosis was common in children with PTSD regardless of trauma experienced (>39.0%). PTSD-DS showed a similar trajectory of natural recovery to PTSD, and it was similarly predictive of later PTSD following single-event trauma. Finally, dissociation was a significant factor in PTSS and functional impairment.

Conclusions

These results should be viewed in the context of several limitations including narrow sample of participants which reduces the generalizability of results, concerns around children's ability to conceptualize challenging concepts such as dissociation and the use of self-report measures to form diagnostic groups. The PTSD-DS diagnosis may offer clinical utility to the extant PTSD diagnosis in children and adolescents, as dissociation has been shown to be a contributory factor in the maintenance of both PTSS and functional impairment. Further research is required to inform further editions of the DSM and other diagnostic systems.

研究目的本研究旨在确定单次和多次创伤后青少年创伤后应激障碍分离亚型（PTSD-DS）的患病率和病程；早期PTSD-DS对日后PTSD的预测能力；以及分离是否分别在其他创伤后认知处理因素和PTSS的影响之外，在创伤后应激症状（PTSS）和功能障碍方面造成独特的差异：本研究是对儿童和青少年急性应激方案研究（n = 234）和创伤后护理应对研究（n = 110）的数据进行的二次分析：结果：无论经历过何种创伤，PTSD-DS 诊断在患有创伤后应激障碍的儿童中都很常见（大于 39.0%）。创伤后应激障碍-DS与创伤后应激障碍的自然恢复轨迹相似，同样可以预测单次事件创伤后的创伤后应激障碍。最后，解离是导致创伤后应激障碍和功能障碍的重要因素：在看待这些结果时，应考虑到一些局限性，包括参与者样本较少，这降低了结果的普遍性；儿童对解离等高难度概念的概念化能力令人担忧；以及使用自我报告测量来形成诊断组别。创伤后应激障碍-DS 诊断可为儿童和青少年的现有创伤后应激障碍诊断提供临床实用性，因为解离已被证明是维持创伤后应激障碍和功能障碍的一个促成因素。还需要进一步的研究，以便为 DSM 和其他诊断系统的进一步版本提供信息。

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