Prevalence and predictors of hyperglycemia-related posttraumatic stress in adults wtih type 1 diabetes.

摘要

Recent research has investigated the prevalence of posttaumatic stress disorder (PTSD) and significant contributors to posttraumatic stress (PTS) symptomatology, regarding hypoglycemia experiences, among individuals with type 1 diabetes (DM1; Myers, Boyer, Herbert, Barakat, & Scheiner, 2007). However, no study has examined PTS symptomatology in relation to hyperglycemia experiences in this population. The current study investigated the prevalence of hyperglycemia-related PTSD and PTS severity in 239 individuals with DM1, using the posttraumatic stress diagnostic scale (PDS: Foa, 1995). PDS was subjected to two symptom cluster scorings (Standard PDS scoring according, and more conservative scoring requiring greater symptomatology to meet item significance). Additionally, this study aimed to identify whether diabetes-related complications, hyperglycemia experiences, cognitive appraisals, self-care, and glycemic control (HbAlc) predicted PTSD/PTS. Over 30% of participants met criteria for current PTSD related to hyperglycemia experiences with standard symptom cluster scoring, and over 10% with more conservative scoring. Hierarchical multiple regression analyses identified that perceived helplessness (Partial R = .237, p = .012) and HbAlc (Partial R = .228, p =.016) significantly predicted PTSD with standard scoring; while perceived death threat (Partial R= .29; p =.002), helplessness (Partial R =.224, p = .016), and self-care (Partial R = -.184, p =.049) significantly predicted PTSD with more conservative scoring, and perceived death threat (Partial R =.346, p < .001), helplessness (Partial R =.417; p <.001), and HbAlc (Partial R = .280 , p = .002) predicted PTS severity. Diabetes-related complications, hyperglycemia-related fear, and hyperglycemia-related experiences (e.g., number of hyperglycemic episodes; hospital, ER, and ICU visits due to hyperglycemic episode) did not predict PTSD or PTS severity. Implications for self-management interventions and future research directions will be suggested.