汶川地震后2年救灾官兵创伤后应激障碍的发生率及其影响因素
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摘要
目的了解汶川地震后2年参加救灾官兵心理创伤后应激障碍(PTSD)的发生率及其影响因素,为救灾后官兵心理防护提供依据,并为减少救灾官兵PTSD发生率提供措施。方法应用军事应激障碍核查表(PCL-M)、抑郁自评量表(SDS)、状态焦虑量表(SAI)、简易应对方式问卷(SCSQ)、领悟社会支持量表(PSSS)及一般情况调查表于地震后2年对某营144名首批到达映秀镇救灾的官兵(救灾组)及该营未参加地震救灾的95名官兵(对照组)进行整群抽样调查。结果 (1)救灾组官兵PTSD发生率为16.7%,明显高于对照组(1.0%)(P<0.01)。(2)在PCL-M表中,救灾组官兵3类症状总分、PCL-M表17个条目得分及总分均明显高于对照组(P<0.01)。(3)多元回归分析结果提示,救灾组官兵PTSD的易感因素主要有:应用消极应对方式多、对自己健康担心多、感觉救灾后烦恼多、自觉朋友和其他支持少、自觉平时情绪不稳定、感觉自己救灾成绩未得到承认。结论救灾组官兵PTSD的发生率显著高于对照组,个人应对方式、朋友和社会支持、个人情绪特征、救灾后生活境遇是PTSD的影响因素。
Objective To examine the incidence and related factors of posttraumatic stress disorder(PTSD) in rescue officers/soldiers 2 years after earthquake,thus to provide a theoretical basis for prevention and reduction of PTSD incidence among rescuers after earthquake.Methods PTSD Checklist Military Version(PCL-M),Self-Rating Depression Scale(SDS),State Anxiety Inventory(SAI) test,Simplified Coping Style Questionnaire(SCSQ),and General Questionnaire,as well as cluster sampling were adopted to investigate 144 rescue officers/soldiers after Wenchuan earthquake (the rescue group) and another 95 officers/soldiers who did not attend the rescue mission(the control group) but from the same troop.Results (1)The incidence of PTSD in rescue group(16.7%) was significantly higher than in control group(1.0%),(P<0.01).(2)The factor scores and total score of 17 items in PLC-M,and total score of three symptoms in military rescuers were significantly higher than in the control(P<0.01).(3)Multiple regression analysis showed that the main risk factors of PTSD were too much negative coping style,excessive worry about health,having more trouble after rescue mission,feeling of less friends and other support,feeling of emotional instability ordinarily,and feeling of effort-reward imbalance after rescue mission.Conclusion After 2 years of earthquake,the incidence of PTSD in rescue group was higher than in control group.And personal coping style,support from friends and society,personal emotion,and the living circumstance happened after rescue are the related factors.
Objective To examine the incidence and related factors of posttraumatic stress disorder(PTSD) in rescue officers/soldiers 2 years after earthquake,thus to provide a theoretical basis for prevention and reduction of PTSD incidence among rescuers after earthquake.Methods PTSD Checklist Military Version(PCL-M),Self-Rating Depression Scale(SDS),State Anxiety Inventory(SAI) test,Simplified Coping Style Questionnaire(SCSQ),and General Questionnaire,as well as cluster sampling were adopted to investigate 144 rescue officers/soldiers after Wenchuan earthquake (the rescue group) and another 95 officers/soldiers who did not attend the rescue mission(the control group) but from the same troop.Results (1)The incidence of PTSD in rescue group(16.7%) was significantly higher than in control group(1.0%),(P<0.01).(2)The factor scores and total score of 17 items in PLC-M,and total score of three symptoms in military rescuers were significantly higher than in the control(P<0.01).(3)Multiple regression analysis showed that the main risk factors of PTSD were too much negative coping style,excessive worry about health,having more trouble after rescue mission,feeling of less friends and other support,feeling of emotional instability ordinarily,and feeling of effort-reward imbalance after rescue mission.Conclusion After 2 years of earthquake,the incidence of PTSD in rescue group was higher than in control group.And personal coping style,support from friends and society,personal emotion,and the living circumstance happened after rescue are the related factors.
引文
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[2]胡光涛,李敏,贺英,等.救援官兵地震1周年后创伤后应激障碍发生率及相关因素〔J〕.中华行为医学与脑科学杂志,2010,19(1):50.
[3]安飞,王家同.汶川地震救援军人创伤后应激障碍发生与人格特征的相关研究〔J〕.第四军医大学学报,2009,30(24):3169.
[4]WEATHERS F W,LITZ B T,HERMAN D S,et al.ThePTSD checklist(PCL):reliability,validity,and diagnostic U-tility〔C〕.San Antonio,Texas:9th Annual convention of theInternational Society for Traumatic Stress Studies,1993,Oc-tober 24.
[5]伊丽,武国城,万憬,等.救灾官兵心理健康状况及相关因素分析〔J〕.心理科学进展,2009,17(3):567.
[6]吴文源.抑郁自评量表〔J〕.中国行为医学科学,2001,10(特刊):131.
[7]汪向东,王希林,马弘,等.心理卫生评定量表手册(增订版)〔M〕.北京:中国心理卫生杂志社,1999:205-209.
[8]解亚宁.简易应对方式问卷〔J〕.中国心理卫生杂志,1999,13(增刊):122.
[9]姜乾金.领悟社会支持量表〔J〕.中国行为医学科学,2001,10(10):41.
[10]沈兴华,黄俊龙,刘伟志,等.茂县城区百姓与救灾部队震后7-9周创伤后应激障碍症状比较〔J〕.中国健康心理学杂志,2009,17(9):1136.
[11]高存友,甘景梨,赵兰民,等.抗震救灾官兵心理应激反应及其影响因素〔J〕.中国行为医学与脑科学杂志,2009,18(11):1022.
[12]代静,田梅,曾居里.抗震救灾官兵心理健康状况的跟踪研究〔J〕.科学与财富,2010,(3):141.
[13]BERNINGER A,WEBBER M P,COHEN H W,et al.Trends of elevated PTSD risk in firefighters exposed to theWorld Trade Center disaster:2001-2005〔J〕.PublicHealth Rep,2010,125(4):556.
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