患有创伤后应激障碍的战斗人员的睡眠质量和回避行为

D.I. Boiko, O.V. Mats, O. I. Shkidchenko
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引用次数: 0

摘要

简介创伤后应激障碍(PTSD)通常以各种症状为特征,这些症状会导致患者的行为发生变化,其中睡眠障碍和回避行为是常见的症状。然而,尽管有证据表明情绪和睡眠之间存在复杂的双边关系,但只有少数研究探讨了创伤后应激障碍中睡眠障碍和回避行为之间的关联。本研究旨在评估创伤后应激障碍患者的回避行为和失眠的严重程度。材料和方法。我们对 45 名战斗人员进行了临床研究,他们被分为两组:第一组(24 人)包括患有创伤后应激障碍的战斗人员;第二组(21 人)包括未患有创伤后应激障碍的战斗人员。采用匹兹堡睡眠质量问卷分析睡眠质量,即主观睡眠质量、睡眠潜伏期、睡眠持续时间、睡眠效率、睡眠障碍、睡眠药物使用和日常功能障碍。回避行为采用多维经验回避问卷进行测量。结果显示我们发现,第一组的主观睡眠质量更差(p=0.002),睡眠潜伏期更长(p<0.001),睡眠效率更低(p=0.019),睡眠障碍更严重(p<0.001)。在睡眠时间、服用安眠药的严重程度和日常功能障碍方面,组间差异无统计学意义。与第二组相比,第一组患者睡眠质量障碍的总体严重程度更高(P<0.001)。与第二组相比,第一组的回避行为(p=0.007)以及压抑和否认(p<0.001)更为明显。同时,第一组的压力耐受力较低(p<0.001)。第 1 组的整体经验回避水平高于第 2 组(P<0.001)。睡眠质量特征与体验性回避之间也存在许多关联。结论研究显示,患有创伤后应激障碍的战斗人员有更明显的行为回避、压抑和否认表现,压力耐受水平也更低。与此同时,患有创伤后应激障碍的战斗人员的主观睡眠质量下降,睡眠效率降低,睡眠障碍的严重程度增加。研究发现,战斗员的回避行为与睡眠质量的特征有许多联系,可作为改善心理治疗干预的潜在因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
SLEEP QUALITY AND AVOIDANCE BEHAVIOR IN COMBATANTS WITH POST-TRAUMATIC STRESS DISORDER
Introduction. Post-traumatic stress disorder (PTSD) is often characterized by various symptoms that result in behavioral changes in patients, among which sleep disturbances and avoidant behavior are commonly observed. However, despite evidence indicating a complex bilateral relationship between emotions and sleep, only few studies have explored the associations between sleep disturbances and avoidant behavior in the context of PTSD. The aim of the study is to assess the severity of avoidant behaviour and insomnia in combatants with posttraumatic stress disorder. Materials and methods. We conducted a clinical study of 45 combatants who were divided into 2 groups: group 1 (n=24) included combatants with PTSD; group 2 (n=21) consisted of combatants without PTSD. The Pittsburgh Sleep Quality Questionnaire was used to analyse sleep quality, namely subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbances, sleep medication use, and daily dysfunction. Avoidance behavior was measured using a multidimensional experience avoidance questionnaire. Results. We found that group 1 demonstrated worse subjective sleep quality (p=0.002), longer sleep latency (p<0.001), lower sleep efficiency (p=0.019) and more severe sleep disturbances (p<0.001). There were no statistically significant differences between the groups in terms of sleep duration, severity of sleeping pills use, and daily dysfunction. The overall severity of sleep quality disorders was higher in group 1 compared to group 2 (p<0.001). Avoidance behavior (p=0.007) and repression and denial (p<0.001) were more pronounced in group 1 compared to group 2. At the same time, group 1 had lower stress endurance (p<0.001). The overall level of experiental avoidance in group 1 was higher than in group 2 (p<0.001). Numerous associations between sleep quality characteristics and experiental avoidance were found as well. Conclusions. The study has revealed that combatants with PTSD have more pronounced manifestations of behavioural avoidance, repression and denial, as well as a lower level of stress endurance. At the same time, combatants with PTSD demonstrate a deterioration in the subjective quality of sleep, a decrease in its effectiveness and an increase in the severity of its disturbances. It has been found that avoidance behavior in combatants has numerous connections with the characteristics of sleep quality that may be suggested as a potential factor for improving psychotherapeutic interventions.
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