اثر تجربی ناشی از نشخوار فکری در مقابل حواس پرتی بر روی آنالوگ علائم استرس پس از سانحه

Rumination has been suggested to be an important factor maintaining posttraumatic stress disorder (PTSD). Using an analogue design, this study aimed to experimentally test the hypothesis that trauma-related rumination maintains PTSD symptoms. Fifty-one participants were first asked to give a detailed narrative of a negative life event and were then randomly assigned to a rumination or distraction condition. In line with the hypotheses, rumination about the event resulted in the maintenance of negative mood and intrusive memories immediately after the manipulation whereas distraction resulted in symptom reduction. However, this effect was reversed during a subsequent symptom provocation task, in which distraction led to a greater increase in some of the symptoms than rumination. Results are in line with the idea that rumination is involved in the maintenance of PTSD but may suggest a complex relationship between rumination and posttraumatic stress symptoms.

Epidemiological data show that a large group of trauma survivors experiences acute stress symptoms immediately following traumatic events but that only a minority develop a chronic emotional disorder, such as posttraumatic stress disorder (PTSD) (McFarlane, 2000). Based on these findings, a number of authors have emphasized the importance of focusing not just on variables that predict the onset of PTSD following trauma, but also on factors that are involved in the maintenance of the disorder (e.g., Ehlers and Clark, 2000 and Schnurr et al., 2004). In their cognitive model of PTSD, Ehlers and Clark (2000) suggest that, among other variables, excessive and repeated rumination related to the trauma is an important maintaining factor (for a similar idea see Joseph, Williams, & Yule, 1997). According to Ehlers and Clark, trauma-related rumination is thought to contribute to the maintenance of PTSD by preventing the elaboration and contextualization of the trauma memory as well as by strengthening trauma-related negative appraisals and directly triggering negative emotions and arousal. Supporting evidence comes from studies showing that rumination is significantly and substantially correlated with PTSD symptom severity cross-sectionally as well as prospectively, even when initial symptom levels are controlled (e.g., Ehring et al., 2008, Ehlers et al., 1998 and Michael et al., 2007).