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The Panic Attack-Posttraumatic Stress Disorder Model: Applicability to Orthostatic Panic Among Cambodian Refugees

机译:恐慌发作-创伤后应激障碍模型:适用于柬埔寨难民中的体位性恐慌

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This article examines the ability of the panic attack-posttraumatic stress disorder (PTSD) model to predict how panic attacks are generated and how panic attacks worsen PTSD. The article does so by determining the validity of the panic attack-PTSD model in respect to one type of panic attack among traumatized Cambodian refugees: orthostatic panic (OP) attacks (i.e. panic attacks generated by moving from lying or sitting to standing). Among Cambodian refugees attending a psychiatric clinic, the authors conducted two studies to explore the validity of the panic attack-PTSD model as applied to OP patients (i.e. patients with at least one episode of OP in the previous month). In Study 1, the panic attack-PTSD model accurately indicated how OP is seemingly generated: among OP patients (N = 58), orthostasis-associated flashbacks and catastrophic cognitions predicted OP severity beyond a measure of anxious-depressive distress (Symptom Checklist-90-R subscales), and OP severity significantly mediated the effect of anxious-depressive distress on Clinician-Administered PTSD Scale severity. In Study 2, as predicted by the panic attack-PTSD model, OP had a mediational role in respect to the effect of treatment on PTSD severity: among Cambodian refugees with PTSD and comorbid OP who participated in a cognitive behavioural therapy study (N = 56), improvement in PTSD severity was partially mediated by improvement in OP severity.
机译:本文研究了惊恐发作-创伤后应激障碍(PTSD)模型预测惊恐发作的方式以及惊恐发作如何使PTSD恶化的能力。文章通过确定恐慌症发作-PTSD模型对于受过创伤的柬埔寨难民中的一种恐慌症发作的正确性来做到这一点:直立性恐慌症(OP)攻击(即从躺着或坐着到站着而产生的恐慌症发作)。在前往精神病诊所就诊的柬埔寨难民中,作者进行了两项研究,探讨了恐慌发作-PTSD模型应用于OP患者(即,上个月患有至少一次OP的患者)的有效性。在研究1中,惊恐发作-PTSD模型准确地表明了看似如何产生OP:在OP患者(N = 58)中,与矫正相关的倒叙和灾难性认知预测出OP的严重程度超出了焦虑抑郁困扰的程度(症状清单90) -R量表)和OP严重程度明显介导了焦虑抑郁困扰对临床医生管理的PTSD量表严重程度的影响。在研究2中,正如恐慌症发作-PTSD模型所预测的那样,OP在治疗对PTSD严重性的影响方面起中介作用:在参与认知行为疗法研究的患有PTSD和共病OP的柬埔寨难民中(N = 56 ),PTSD严重性的改善部分由OP严重性的改善介导。

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