农村青少年创伤经历及创伤后应激障碍流行特征
|
摘要
基于《精神障碍诊断与统计手册》(第五版)的诊断标准,考察了农村青少年创伤经历、创伤后应激障碍流行情况及其与人口学特征、创伤经历之间的关系。研究采用《加州大学洛杉矶分校儿童青少年创伤后应激障碍反应指数》和《创伤后应激障碍检查表第五版》,对1781名乡镇初级中学学生进行了调查。结果显示,(1) 60%的农村青少年至少经历过1件创伤性事件,发生频率最高的创伤性事件为曾有亲近的人去世(42.6%);(2)有创伤经历的农村青少年的PTSD检出率为9.7%,与PTSD有关的人口学特征为男性、独生子女以及父母在外打工;(3)最易引发创伤后应激障碍的创伤经历为遭受或目睹家庭暴力。本研究呈现了农村青少年群体创伤相关心理健康现状,并初步识别了一些该群体罹患PTSD的风险因素,这将有助于在临床实践中针对PTSD易感人群进行及时、有效的筛查和干预。
The present study was aimed to investigate the trauma experiences, the prevalence of PTSD based on DSM-5 criteria, and the relationships between PTSD and demographics and traumatic events. A sample of 1781 middle school students living in rural areas was assessed by the UCLA PTSD Reaction Index for Children/Adolescents and the PTSD Checklist for DSM-5. The results revealed that 60% of participants experienced at least one traumatic event. The most frequent traumatic event was the death of someone close to you(42.6%). The caseness rate of PTSD among trauma-exposed participants was 9.7%. Male sex, being the only child, and parental labor migration were associated with PTSD diagnosis. The most likely trauma trigger for PTSD was experiencing/witnessing domestic violence. This study provided an presentation of the current status of rural adolescents' trauma-related mental health, and primarily identified some risk factors for PTSD in this population, which would contribute to the timely and efficient screening and intervention for vulnerable individuals in clinical practice.
The present study was aimed to investigate the trauma experiences, the prevalence of PTSD based on DSM-5 criteria, and the relationships between PTSD and demographics and traumatic events. A sample of 1781 middle school students living in rural areas was assessed by the UCLA PTSD Reaction Index for Children/Adolescents and the PTSD Checklist for DSM-5. The results revealed that 60% of participants experienced at least one traumatic event. The most frequent traumatic event was the death of someone close to you(42.6%). The caseness rate of PTSD among trauma-exposed participants was 9.7%. Male sex, being the only child, and parental labor migration were associated with PTSD diagnosis. The most likely trauma trigger for PTSD was experiencing/witnessing domestic violence. This study provided an presentation of the current status of rural adolescents' trauma-related mental health, and primarily identified some risk factors for PTSD in this population, which would contribute to the timely and efficient screening and intervention for vulnerable individuals in clinical practice.
引文
高静,梁贞贞,杨森焙,王友洁,杜玉开,沈敏.(2014).儿童期不良生活事件与创伤后应激障碍的相关性研究.中国妇幼保健,29,4272-4277.
江琴普,栗克清,崔利军,崔泽,李建峰,孙秀丽,…吕华.(2008).河北省创伤后应激障碍的流行病学调查.中国心理卫生杂志,22,16,doi:10.3321/j.issn:1000-6729.2008.01.005.
苏静,陈静,万宇辉,钟超,胡晓,陶芳标,…陈英.(2015).童年期虐待经历与中学生自伤行为的关联性.中国学校卫生,36,1326-1329.
唐光政,郭兰婷,黄雪竹.(2005).成都市区11~18岁青少年人群心理问题调查.中华流行病学杂志,26,878-881,doi:10.3760/j.issn:0254-6450.2005.11.012.
王维宇,周家骥,顾海根.(2005).上海市初中生生活事件、社会支持与应对方式对创伤后应激障碍的影响研究.社会心理科学,20(1),87-90,100.
吴垠,陈雪军.(2010).广州市初中生经历创伤事件调查--以越秀区某中学为例.山西师大学报(社会科学版),37,138-140.
杨梦竹.(2003).上海市青少年PTSD状况调查及分析(硕士学位论文),上海师范大学.
American Psychiatric Association.(1994).Diagnostic and statistical manual of mental disorders(4th ed.).Washington,DC:American Psychiatric Association.
American Psychiatric Association.(2013).Diagnostic and statistical manual of mental disorders(5th ed.).Washington,DC:American Psychiatric Association.
Copeland-Linder N.(2008).Posttraumatic stress disorder.Pediatrics in Review,29,103-104,doi:10.1542/pir.29-3-103.
Ford,J.D.,Elhai,J.D.,Connor,D.F.,&Frueh,B.C.(2010).Polyvictimization and risk of posttraumatic,depressive,and substance use disorders and involvement in delinquency in a national sample of adolescents.Journal of Adolescent Health,46,545-552,doi:10.1016/j.jadohealth.2009.11.212.
Hunt,K.L.,Martens,P.M.,&Belcher,H.M.E.(2011).Risky business:Trauma exposure and rate of posttraumatic stress disorder in African American children and adolescents.Journal of Traumatic Stress,24,365-369,doi:10.1002/jts.20648.
Keane,T.M.,Marshall,A.D.,&Taft,C.T.(2006).Posttraumatic stress disorder:Etiology,epidemiology,and treatment outcome.Annual Review of Clinical Psychology,2,161-197,doi:10.1146/annurev.clinpsy.2.022305.095305.
Lancaster,S.L.,Melka,S.E.,Rodriguez,B.F.,&Bryant,A.R.(2014).PTSD symptom patterns following traumatic and nontraumatic events.Journal of Aggression,Maltreatment&Trauma,23,414-429.
Liu,L.Y.,Wang,L.,Cao,C.Q.,Qing,Y.L.,&Armour,C.(2016).Testing the dimensional structure of DSM-5 posttraumatic stress disorder symptoms in a nonclinical trauma-exposed adolescent sample.Journal of Child Psychology and Psychiatry,57,204-212,doi:10.1111/jcpp.12462.
Phillips,M.R.,Zhang,J.X.,Shi,Q.C.,Song,Z.Q.,Ding,Z.J.,Pang,S.T.,…Wang,Z.Q.(2009).Prevalence,treatment,and associated disability of mental disorders in four provinces in China during2001-05:An epidemiological survey.The Lancet,373,2041-2053,doi:10.1016/S0140-6736(09)60660-7.
Pynoos,R.S.,&Steinberg,A.M.(2013).UCLA PTSD Reaction Index for Children/Adolescents-DSM-5.http://www.nctsn.org/nctsn_assets/pdfs/mediasite/ptsd-training.pdf.
Spitzer,R.L.,First,M.B.,&Wakefield,J.C.(2007).Saving PTSD from itself in DSM-V.Journal of Anxiety Disorders,21,233-241,doi:10.1016/j.janxdis.2006.09.006.
Tolin,D.F.,&Foa,E.B.(2006).Sex differences in trauma and posttraumatic stress disorder:A quantitative review of 25 years of research.Psychological Bulletin,132,959-992,doi:10.1037/0033-2909.132.6.959.
Ward,J.H.,Jr.(1963).Hierarchical grouping to optimize an objective function.Journal of the American Statistical Association,58,236-244,doi:10.1080/01621459.1963.10500845.
Weathers,F.W.,Litz,B.T.,Keane,T.M.,Palmieri,P.A.,Marx,B.P.,&Schnurr,P.P.(2013).The PTSD checklist for DSM-5(PCL-5).Scale available from the National Center for PTSD website:http://www.ptsd.va.gov.
江琴普,栗克清,崔利军,崔泽,李建峰,孙秀丽,…吕华.(2008).河北省创伤后应激障碍的流行病学调查.中国心理卫生杂志,22,16,doi:10.3321/j.issn:1000-6729.2008.01.005.
苏静,陈静,万宇辉,钟超,胡晓,陶芳标,…陈英.(2015).童年期虐待经历与中学生自伤行为的关联性.中国学校卫生,36,1326-1329.
唐光政,郭兰婷,黄雪竹.(2005).成都市区11~18岁青少年人群心理问题调查.中华流行病学杂志,26,878-881,doi:10.3760/j.issn:0254-6450.2005.11.012.
王维宇,周家骥,顾海根.(2005).上海市初中生生活事件、社会支持与应对方式对创伤后应激障碍的影响研究.社会心理科学,20(1),87-90,100.
吴垠,陈雪军.(2010).广州市初中生经历创伤事件调查--以越秀区某中学为例.山西师大学报(社会科学版),37,138-140.
杨梦竹.(2003).上海市青少年PTSD状况调查及分析(硕士学位论文),上海师范大学.
American Psychiatric Association.(1994).Diagnostic and statistical manual of mental disorders(4th ed.).Washington,DC:American Psychiatric Association.
American Psychiatric Association.(2013).Diagnostic and statistical manual of mental disorders(5th ed.).Washington,DC:American Psychiatric Association.
Copeland-Linder N.(2008).Posttraumatic stress disorder.Pediatrics in Review,29,103-104,doi:10.1542/pir.29-3-103.
Ford,J.D.,Elhai,J.D.,Connor,D.F.,&Frueh,B.C.(2010).Polyvictimization and risk of posttraumatic,depressive,and substance use disorders and involvement in delinquency in a national sample of adolescents.Journal of Adolescent Health,46,545-552,doi:10.1016/j.jadohealth.2009.11.212.
Hunt,K.L.,Martens,P.M.,&Belcher,H.M.E.(2011).Risky business:Trauma exposure and rate of posttraumatic stress disorder in African American children and adolescents.Journal of Traumatic Stress,24,365-369,doi:10.1002/jts.20648.
Keane,T.M.,Marshall,A.D.,&Taft,C.T.(2006).Posttraumatic stress disorder:Etiology,epidemiology,and treatment outcome.Annual Review of Clinical Psychology,2,161-197,doi:10.1146/annurev.clinpsy.2.022305.095305.
Lancaster,S.L.,Melka,S.E.,Rodriguez,B.F.,&Bryant,A.R.(2014).PTSD symptom patterns following traumatic and nontraumatic events.Journal of Aggression,Maltreatment&Trauma,23,414-429.
Liu,L.Y.,Wang,L.,Cao,C.Q.,Qing,Y.L.,&Armour,C.(2016).Testing the dimensional structure of DSM-5 posttraumatic stress disorder symptoms in a nonclinical trauma-exposed adolescent sample.Journal of Child Psychology and Psychiatry,57,204-212,doi:10.1111/jcpp.12462.
Phillips,M.R.,Zhang,J.X.,Shi,Q.C.,Song,Z.Q.,Ding,Z.J.,Pang,S.T.,…Wang,Z.Q.(2009).Prevalence,treatment,and associated disability of mental disorders in four provinces in China during2001-05:An epidemiological survey.The Lancet,373,2041-2053,doi:10.1016/S0140-6736(09)60660-7.
Pynoos,R.S.,&Steinberg,A.M.(2013).UCLA PTSD Reaction Index for Children/Adolescents-DSM-5.http://www.nctsn.org/nctsn_assets/pdfs/mediasite/ptsd-training.pdf.
Spitzer,R.L.,First,M.B.,&Wakefield,J.C.(2007).Saving PTSD from itself in DSM-V.Journal of Anxiety Disorders,21,233-241,doi:10.1016/j.janxdis.2006.09.006.
Tolin,D.F.,&Foa,E.B.(2006).Sex differences in trauma and posttraumatic stress disorder:A quantitative review of 25 years of research.Psychological Bulletin,132,959-992,doi:10.1037/0033-2909.132.6.959.
Ward,J.H.,Jr.(1963).Hierarchical grouping to optimize an objective function.Journal of the American Statistical Association,58,236-244,doi:10.1080/01621459.1963.10500845.
Weathers,F.W.,Litz,B.T.,Keane,T.M.,Palmieri,P.A.,Marx,B.P.,&Schnurr,P.P.(2013).The PTSD checklist for DSM-5(PCL-5).Scale available from the National Center for PTSD website:http://www.ptsd.va.gov.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |