Peritraumatic panic attacks and health outcomes two years after psychological trauma: Implications for intervention and research

PSYCHIATRY RESEARCH

卷:167

Article

Boscarino, Joseph A.^1,2,3  Adams, Richard E.^3,4 

[1] Geisinger Med Clin, Ctr Hlth Res, Danville, PA 17822 USA

[2] Mt Sinai Sch Med, Dept Gen Internal Med, New York, NY USA

[3] Mt Sinai Sch Med, Dept Pediat, New York, NY USA

[4] Kent State Univ, Dept Sociol, Kent, OH 44242 USA

关键词: Peritraumatic;    Panic attack;    Posttraumatic stress disorder;    Depression;    Anxiety;    Disaster;    Alcohol use;    Mental health treatment;   

DOI  :  10.1016/j.psychres.2008.03.019

来源: Elsevier

【 摘 要 】

Several studies have suggested that experiencing a peritraumatic panic attack (PPA) during a traumatic event predicts future mental health status. Some investigators have suggested that this finding has psychotherapeutic significance. We assessed the hypothesis that PPA was not related to longer-term health status after event exposure, once background confounders were controlled. In our study we assessed exposure to the World Trade Center disaster (WTCD) and other negative life events, demographic factors, social support, self-esteem, and panic attack onset in predicting health outcome among 1681 New York City residents 2 years after the attack. Initial bivariate results indicated that a PPA was related to a number of adverse outcomes 2 years after the WTCD, including posttraumatic stress disorder, depression, poor physical health, anxiety, binge drinking, and mental health treatment seeking. However, when multivariate (MV) models were estimated adjusting for potential confounders, most of these associations were either non-significant or substantially reduced. Contrary to previous predictions, these MV models revealed that recent negative life events and current self-esteem at follow-up were the best predictors of health outcomes, not PPA. Although post-trauma interventions may target individuals who experienced PPA after traumatic exposures, reducing the long-term health consequences following such exposures based on PPA alone may be problematic. Modifications of psychopathology constructs based on the reported correlation between PPA and post-trauma outcomes may be premature. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

Free