A Longitudinal Study Of Related Factors Of Posttraumatic Stress Disorder Symptom And Posttraumatic Growth In Patients With Acute Myocardial Infarction

Objective:The aim was to explore the role of attachment, alexithymia, childhood trauma in the experience of posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) for patients with acute myocardial infarction.Methods:A questionnaire survey and a follow-up questionnaire survey were carried out in patients with acute myocardial infarction in China during hospitalization. There were two stages in this study. The first stage was a face to face questionnaire survey conducted in107patients with97valid questionnaires after5days-2weeks since attack, the valid return rate was90.65%. The second stage was a telephone follow-up questionnaire survey conducted in44of97patients after8weeks since attack. The valid follow-up rate was45.36%. PTG was measured by the Posttraumatic Growth Inventory (PTGI), PTSD symptoms by the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), Attachment by the Experiences in Close Relationship (ECR). Alexithymia by the The20-item Toronto Alexithymia Scale (TAS-20), Childhood Trauma by the Childhood Trauma Questionnaire (CTQ).Results:1. In T1,25.77%patients reported positive PTSD symptoms, with a mean PCL-C total score of31.42(SD=10.79);71.13%patients reported positive PTG, with a mean PTGI total score of62.93(SD=15.59).2.t-test analysis revealed significant differences in PTSD symptoms based on demographic variables such as education level of patients and medical payment methods.But, it did’t found the significant differences in PTG based on demogra-phic variables.3. There were significant differences of scores on attachment anxiety and TAS-20among patients met the criteria of PTSD symptoms and failed to meet the criteria (P＜0.01). Meanwhile, there were significant differences of scores on attachment anxiety and CTQ among patients met the criteria of PTG and those who met the criteria (P＜0.01).4. The scores of PCL-C was significantly and positively related to the scores of attachment avoidance, attachment anxiety and TAS-20(P＜0.01). The scores of PTGI were significantly and positively related to the scores of attachment anxiety. On the contrary, there were significant and negative correlation between scores on PTGI and scores on attachment avoidance and scores on physical abuse of CTQ.5. Hierarchical multiple regression analysis indicated that attachment anxiety and alexithymia had significant predictive effects on PTSD symptoms, meanwhile,attachment avoidance and attachment anxiety had significant predictive effects on PTG By controlled demographics variables,23.7%variance of PTSD symptoms was explained by attachment avoidance, attachment anxiety, alexithymia, childhood trauma. Moreover,19.7%variance of PTG was explained by attachment avoidance, attachment anxiety, alexithymia, childhood trauma, and PTSD symptoms.6. Both the scores on PCL-C and PTGI were significantly different (P＜0.01) between T1and T2stages. PTGI and PCL-C scores in T2stage were significantly lower than those in T1stage.7. Among44follow-up patients, PTSD symptoms and PTG cumulative po sitive rate was34.88%and74.42%in T2stages respectively, slightly higher th an the rates in T1stage.8. Among44follow-up patients, attachment anxiety score in T1stage significantly predicted the T2stage PCL-C total score (P＜0.05); PTGI total score inT1significantly predicted PTGI total score in T2stage (P＜0.05).Conclusions: 1. Patients with acute myocardial infarction had certain level of PTSD symptoms and PTG, with a positive rate of25.77%and71.13%.2. There were significant differences in PTSD symptoms among patients with different education level and medical payment methods. High levels of education, health care and publicly funded patients were not prone to PTSD symptoms; PTG levels were not significantly different in different demographic data of patients with AMI.3. The secure attachment patients had lowest level of PTSD symptoms. Patients with the higher score of attachment avoidance were prone to higher levels of PTSD symptoms and lower levels of PTG. Attachment anxiety is the common positive predictor of both PTSD symptoms and PTG.4. Patients with alexithymia were more prone to PTSD symptoms.5. Both the level of PTSD symptoms and PTG reduced significantly in T2compared to T1. Attachment anxiety in T1significantly and positively predicted PTSD symptoms of T2stage. PTG in T1had a significant and positive predictive effect on PTG level in T2stage.