Reexperiencing Symptoms, Dissociation, and Avoidance Behaviors in Daily Life of Patients With PTSD and Patients With Panic Disorder With Agoraphobia
Published online on July 25, 2013
Abstract
Panic attacks are frequently perceived as life threatening. Panic disorder (PD) patients may therefore experience symptoms of posttraumatic stress disorder (PTSD). The authors explored this in 28 healthy controls, 17 PTSD patients, and 24 PD patients with agoraphobia who completed electronic diaries 36 times during 1 week. Patient groups frequently reported dissociation as well as thoughts, memories, and reliving of their trauma or panic attacks. PTSD patients reported more trauma/panic attack thoughts (incidence rate ratio [IRR] = 2.9) and memories (IRR = 2.8) than PD patients. Patient groups relived their trauma or panic attacks equally frequently, and reported comparable bodily reactions and distress associated with trauma or panic attack memories. Clinical groups avoided trauma or panic attack reminders more often than healthy controls (avoidance of trauma‐ or panic attack‐related thoughts (IRR = 8.0); avoidance of things associated with the trauma or panic attack (IRR = 40.7). PD patients avoided trauma or panic attack reminders less often than PTSD patients (avoidance of trauma‐ or panic attack‐related thoughts [IRR = 2.5]; avoidance of things associated with the trauma or panic attack [IRR = 4.1]), yet these differences were nonsignificant when controlling for functional impairment. In conclusion, trauma‐like symptoms are common in PD with agoraphobia and panic attacks may be processed similarly as trauma in PTSD.
標題:創傷後壓力症病者,和恐慌症併廣場恐懼症的病者在日常生活的再經歷、解離和迴避
撮要:恐慌突襲令人有死亡的恐懼,所以恐慌症(PD)病者可能經歷創傷後壓力症(PTSD)症狀。我們研究了28名健康對照人士,17名PTSD病者,和24名PD併廣場恐懼症病者。他們在一週內寫下36篇電子日誌。病者組別經常提及創傷或恐慌突襲中的解離、想法、回憶及再經歷。PTSD病者比PD病者有更多創傷/恐慌突襲想法(病發比率﹝IRR﹞ = 2.9)及記憶(IRR = 2.8)。不同病者組別在創傷/恐慌突襲的再經歷方面都有相似密度,及與創傷/恐慌突襲回憶有關的相類似身體反應和困擾。臨床組別對比健康對照人士較多迴避創傷/恐慌突襲的提示(迴避創傷/恐慌突襲想法:IRR = 8.0;迴避創傷/恐慌突襲相關事物:IRR = 40.7)。PD病人比PTSD病人較少迴避創傷/恐慌突襲的提示(迴避創傷/恐慌突襲想法:IRR = 2.5;迴避創傷/恐慌突襲相關事物:IRR = 4.1),但這些差異在功能障礙受控後並不顯著。結論是:創傷症狀在PD併廣場恐懼症的病人中是常見的,而恐慌突襲則可能與PTSD的創傷有相同整理過程。
标题:创伤后压力症病患,和恐慌症并广场恐惧症的病患在日常生活的再经历、解离和回避
撮要:恐慌突袭令人有死亡的恐惧,所以恐慌症(PD)病患可能经历创伤后压力症(PTSD)症状。我们研究了28名健康对照人士,17名PTSD病患,和24名PD并广场恐惧症病患。他们在一周内写下36篇电子日志。病患组别经常提及创伤或恐慌突袭中的解离、想法、回忆及再经历。PTSD病患比PD病患有更多创伤/恐慌突袭想法(病发比率﹝IRR﹞ = 2.9)及记忆(IRR = 2.8)。不同病患组别在创伤/恐慌突袭的再经历方面都有相似密度,及与创伤/恐慌突袭回忆有关的相类似身体反应和困扰。临床组别对比健康对照人士较多回避创伤/恐慌突袭的提示(回避创伤/恐慌突袭想法:IRR = 8.0;回避创伤/恐慌突袭相关事物:IRR = 40.7)。PD病患比PTSD病患较少回避创伤/恐慌突袭的提示(回避创伤/恐慌突袭想法:IRR = 2.5;回避创伤/恐慌突袭相关事物:IRR = 4.1),但这些差异在功能障碍受控后并不显着。结论是:创伤症状在PD并广场恐惧症的病患中是常见的,而恐慌突袭则可能与PTSD的创伤有相同整理过程。