Rachel C. Blain, Colleen E. Martin, Carolina C. Ehlinger, Kathleen M. Chard
{"title":"创伤后应激障碍的循证治疗通过减少退伍军人在门诊项目中的感知负担来减少自杀意念。","authors":"Rachel C. Blain, Colleen E. Martin, Carolina C. Ehlinger, Kathleen M. Chard","doi":"10.1002/jts.23004","DOIUrl":null,"url":null,"abstract":"<p>Evidenced-based posttraumatic stress disorder (PTSD) treatments generally reduce suicidal ideation (SI), and the interpersonal theory of suicide (ITS) may theoretically account for this finding. The ITS posits that SI stems from feeling like a burden (i.e., perceived burdensomeness) and a lack of belonging (i.e., thwarted belongingness). Previous research suggests that change in PTSD severity has a significant indirect effect on change in SI through changes in perceived burdensomeness, but not thwarted belongingness, among patients receiving residential PTSD treatment in a Veterans Affairs (VA) medical center; however, no research has investigated these associations in an outpatient VA setting with fewer confounding factors that might affect ITS constructs. Therefore, the current sample included veterans (<i>N</i> = 126) who completed PTSD treatment and pre- and posttreatment assessments in a VA outpatient clinic. Results from parallel models of multiple indirect effects suggest that change in PTSD severity was indirectly associated with change in SI through changes in perceived burdensomeness, <i>B =</i> 0.35, <i>p</i> < .001; β = .36, <i>p</i> < .001, <i>SE</i> = .10, 95% CI [.15, .54], but not thwarted belongingness, <i>B</i> = 0.14, <i>p</i> = .146; β = .14, <i>p</i> = .161, <i>SE</i> = .10, 95% CI [−.05, .33]. Additional models were examined using PTSD cluster scores for exploratory purposes. The results indicate that PTSD treatment reduces the perceived and objective burden of PTSD to decrease SI. Study findings support the importance of access to evidence-based care to treat PTSD and alleviate burdensomeness for suicide prevention.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":null,"pages":null},"PeriodicalIF":2.4000,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jts.23004","citationCount":"0","resultStr":"{\"title\":\"Evidence-based treatment for posttraumatic stress disorder decreases suicidal ideation by reducing perceived burdensomeness among veterans in an outpatient program\",\"authors\":\"Rachel C. Blain, Colleen E. Martin, Carolina C. Ehlinger, Kathleen M. 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引用次数: 0
摘要
基于证据的创伤后应激障碍(PTSD)治疗通常会减少自杀意念(SI),而人际自杀理论(ITS)理论上可以解释这一发现。ITS认为,SI源于感觉自己是一种负担(即,感知到的负担)和缺乏归属感(即,受挫的归属感)。先前的研究表明,在退伍军人事务(VA)医疗中心接受创伤后应激障碍住院治疗的患者中,创伤后应激障碍严重程度的变化通过感知负担的变化对创伤后应激障碍的改变有显著的间接影响,但不影响受挫的归属感;然而,没有研究调查这些关联在门诊VA设置较少的混杂因素可能影响ITS结构。因此,目前的样本包括退伍军人(N = 126),他们在VA门诊诊所完成了PTSD治疗和治疗前和治疗后的评估。多重间接效应的平行模型结果表明,PTSD严重程度的变化通过感知负担的变化与SI的变化间接相关,B = 0.35, p < 0.001;β = .36, p < .001, SE = .10, 95% CI[。][15, .54],但不妨碍归属感,B = 0.14, p = .146;β = 0.14, p = 0.161, SE = 0.10, 95% CI[-]。05年,.33]。为了探索性目的,使用PTSD聚类评分对其他模型进行检查。结果表明,创伤后应激障碍治疗可减轻创伤后应激障碍的感知负担和客观负担,从而减少自伤。研究结果支持了获得循证护理对治疗PTSD和减轻自杀预防负担的重要性。
Evidence-based treatment for posttraumatic stress disorder decreases suicidal ideation by reducing perceived burdensomeness among veterans in an outpatient program
Evidenced-based posttraumatic stress disorder (PTSD) treatments generally reduce suicidal ideation (SI), and the interpersonal theory of suicide (ITS) may theoretically account for this finding. The ITS posits that SI stems from feeling like a burden (i.e., perceived burdensomeness) and a lack of belonging (i.e., thwarted belongingness). Previous research suggests that change in PTSD severity has a significant indirect effect on change in SI through changes in perceived burdensomeness, but not thwarted belongingness, among patients receiving residential PTSD treatment in a Veterans Affairs (VA) medical center; however, no research has investigated these associations in an outpatient VA setting with fewer confounding factors that might affect ITS constructs. Therefore, the current sample included veterans (N = 126) who completed PTSD treatment and pre- and posttreatment assessments in a VA outpatient clinic. Results from parallel models of multiple indirect effects suggest that change in PTSD severity was indirectly associated with change in SI through changes in perceived burdensomeness, B = 0.35, p < .001; β = .36, p < .001, SE = .10, 95% CI [.15, .54], but not thwarted belongingness, B = 0.14, p = .146; β = .14, p = .161, SE = .10, 95% CI [−.05, .33]. Additional models were examined using PTSD cluster scores for exploratory purposes. The results indicate that PTSD treatment reduces the perceived and objective burden of PTSD to decrease SI. Study findings support the importance of access to evidence-based care to treat PTSD and alleviate burdensomeness for suicide prevention.
期刊介绍:
Journal of Traumatic Stress (JTS) is published for the International Society for Traumatic Stress Studies. Journal of Traumatic Stress , the official publication for the International Society for Traumatic Stress Studies, is an interdisciplinary forum for the publication of peer-reviewed original papers on biopsychosocial aspects of trauma. Papers focus on theoretical formulations, research, treatment, prevention education/training, and legal and policy concerns. Journal of Traumatic Stress serves as a primary reference for professionals who study and treat people exposed to highly stressful and traumatic events (directly or through their occupational roles), such as war, disaster, accident, violence or abuse (criminal or familial), hostage-taking, or life-threatening illness. The journal publishes original articles, brief reports, review papers, commentaries, and, from time to time, special issues devoted to a single topic.