关于创伤后应激障碍与创伤后成长的辩证认识——基于整合-比较的视角

Dialectical Understanding Posttraumatic Stress Disorder and Posttraumatic Growth:A Perspective of Integration and Comparison

经历创伤事件的个体不仅会出现创伤后应激障碍(PTSD),而且也会体验到创伤后成长(PTG)。作为创伤后两种性质不同的心理反应,PTSD与PTG之间并不是彼此无关的,它们往往共存于创伤后的人群之中。从整合-比较的视角对两者的关系、影响因素及其机制进行探讨,可以发现在创伤后的短时间内,PTG作为一种策略,可以缓解PTSD;在创伤后的长时间内,PTG作为一种结果,可以由PTSD转化。PTSD与PTG既分享着诸如创伤暴露、核心信念挑战和恐惧等共同的因素,也可能被诸如侵入性反刍和主动反刍等因素所影响,甚至社会支持对两者也可能产生"双刃剑"的作用。从PTSD与PTG的影响机制角度看,两者产生的认知机制不同,但是两者产生的情绪机制类似;社会支持通过认知活动可以缓解PTSD,并促进PTG;社会支持通过降低情绪的表达抑制能有效地缓解PTSD,但不能促进PTG。

Following traumatic events, traumatized individuals not only reported posttraumatic stress disorder （PTSD）, but also perceived positive psychological changes such as posttraumatic growth （PTG）. As contrast valance psychological re- actions, PTSD and PTG may co exist in traumatized individuals. Based on the perspective of integration and comparison, this study discussed the relation between PTSD and PTG, the predictors as well as their underlying mechanism. This re- search demonstrated that shortly after the trauma, PTG, as a strategy, might relieve the severity of PTSD, but PTG, as a long-term consequence, might exist after the trauma, which was precipitated by PTSD. Trauma exposure, core belief chal- lenge, and fear were common factors leading to PTSD and PTG, intrusive rumination and deliberated rumination not only re- sults in PTSD, but also lead to PTG, and social support could be a two-side sword to PTSD and PTG. In addition, PTSD and PTG had unique underlying cognitive mechanism but common emotive mechanism, and social support could relieve PTSD and lead to PTG by the indirect effect of cognitive activities. However, social support can only relieve PTSD but cannot im- prove PTG by suppressing emotion.