失独父母创伤后应激障碍症状及相关因素
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摘要
目的:探讨失独父母的创伤后应激障碍(PTSD)症状随失独年限变化的特点及相关因素。方法:以我国五省十市为调查点,选取373位失独父母开展调查,使用创伤后应激障碍筛查量表(PCL-5)、简版流调中心抑郁量表(CES-D-10)对其心理创伤症状进行评估。结果:失独父母PTSD症状筛查阳性率为57. 1%(213/373),症状B、C、D、E的筛查阳性率分别为77. 7%(290/373)、75. 9%(283/373)、71. 0%(265/373)和68. 6%(256/373)。回归分析表明,家庭经济状况能够负向预测PCL-5和症状D得分,即经济状况越好症状得分越低(β=-0. 13～-0. 10,P <0. 05);孩子去世年龄能够负向预测PCL-5、症状B和D得分,即孩子去世时年龄越小创伤症状得分越高(β=-0. 12～-0. 10,P <0. 05);CES-D得分能够正向预测PCL-5及其子症状得分(β=0. 67～0. 78,P <0. 05)。结论:失独父母创伤后应激障碍症状的筛查阳性率较高,其创伤症状受家庭经济情况、孩子去世的年龄和抑郁症状等因素的影响较为明显。
Objective: To investigate the prevalence rates of the symptoms of post-traumatic stress disorder( PTSD) among the parents who lost their single child and related factors. Methods: Totally 373 parents who lost their single child from ten cities of five provinces in China were recruited in this investigation, and the PTSD Checklist for DSM-5( PCL-5) and a short Chinese version of Center for Epidemiological Studies Depression Scale( CES-D-10) were used to evaluate their traumatic symptoms. Results: The rates of PTSD symptom and its four symptom clusters were 57. 1%( 213/373),77. 7%( 290/373),75. 9%( 283/373),71. 0%( 265/373),68. 6%( 256/373) respectively. Family economic situation could negatively predict PCL-5 and symptom D( β =-0. 13--0. 11,P < 0. 05). The age of the child' s death also negatively predicted PCL-5,symptom B and D( β =-0. 12--0. 10,P < 0. 05). PCL-5 and its four symptom clusters were positively predicted by CES-D score( β = 0. 67-0. 78,P < 0. 05). Conclusion: Parents who lost their single child experienced higher traumatic symptoms,and the symptoms were influenced by economic conditions,child' s age at death,and depressive symptom.
Objective: To investigate the prevalence rates of the symptoms of post-traumatic stress disorder( PTSD) among the parents who lost their single child and related factors. Methods: Totally 373 parents who lost their single child from ten cities of five provinces in China were recruited in this investigation, and the PTSD Checklist for DSM-5( PCL-5) and a short Chinese version of Center for Epidemiological Studies Depression Scale( CES-D-10) were used to evaluate their traumatic symptoms. Results: The rates of PTSD symptom and its four symptom clusters were 57. 1%( 213/373),77. 7%( 290/373),75. 9%( 283/373),71. 0%( 265/373),68. 6%( 256/373) respectively. Family economic situation could negatively predict PCL-5 and symptom D( β =-0. 13--0. 11,P < 0. 05). The age of the child' s death also negatively predicted PCL-5,symptom B and D( β =-0. 12--0. 10,P < 0. 05). PCL-5 and its four symptom clusters were positively predicted by CES-D score( β = 0. 67-0. 78,P < 0. 05). Conclusion: Parents who lost their single child experienced higher traumatic symptoms,and the symptoms were influenced by economic conditions,child' s age at death,and depressive symptom.
引文
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[24]Wang L, Zhang Y,Wang W, et al. Symptoms of posttraumatic stress disorder among adult survivors three months after the Sichuan earthquake in China[J]. J Trauma Str,2009,22(5):444-450.
[25]龙小芳.乳腺癌术后化疗患者创伤后应激障碍(PTSD)症状及影响因素研究[D].广州:中山大学,2008.
[26]张静秋,汤永隆,邓丽俐,等. 5爛12四川地震灾民社会支持的调查[J].心理科学进展,2009,17(3):542-546.
[27]Horesh D,Lowe SR,Galea S,et al. An in-depth look into PTSD-depression comorbidity:a longitudinal study of chronically-exposed Detroit residents[J]. J Affect Disord,2017,208:653-661. doi:10. 1016/j. jad. 2016. 08. 053.
[2]王丽萍,张本,姜涛,等.唐山大地震所致慢性创伤后应激障碍临床研究[J].中国心理卫生杂志,2005,19(8):517-520.
[3]何丽,王建平,尉玮,等. 301名丧亲者哀伤反应及其影响因素[J].中国临床心理学杂志,2013,21(6):932-936
[4]吴恺君,张雨青,青于兰,等.中国自然灾害幸存者创伤后成长的质性研究——舟曲泥石流后对幸存者的访谈分析[J].中国临床心理学杂志,2013,21(3):474-478.
[5]张宁,张雨青,吴坎坎,等.汶川地震幸存者的创伤后应激障碍及其影响因素[J].中国临床心理学杂志,2010,18(1):69-72.
[6]沈庆群.失独群体心理状况调查与抚慰[J].牡丹江医学院学报,2014,35(6):127-129.
[7]李天蓉.四川攀枝花市仁和区失独及独生子女伤残家庭现状调查分析[J].中国计划生育和妇产科,2015,7(10):70-73.
[8] Liu P,Wang L,Cao C,et al. The underlying dimensions of DSM-5posttraumatic stress disorder symptoms in an epidemiological sample of Chinese earthquake survivors[J]. J Anxiety Disord,2014,28(4):345-351.
[9]黄庆波,王晓华,陈功. 10项流调中心抑郁自评量表在中国中老人群中的信效度[J].中国健康心理学杂志,2015,23(7):1036-1041.
[10]Neria Y,Nandi A,Galea S. Post-traumatic stress disorder following disasters:a systematic review[J]. Psychol Med,2008,38(4):467-480.
[11]吴垠,陈雪军,郑希付.汶川地震极重灾区妇女创伤后应激症状、心理健康及其影响因素[J].中国临床心理学杂志,2011,19(1):92-95.
[12]He L,Tang S,Yu W,et al. The prevalence,comorbidity and risks of prolonged grief disorder among bereaved Chinese adults[J].Psychiatry Res,2014,219(2):347-352.
[13]尚志蕾.重大急性应激(失独)导致的PTSD及其影响因素研究[D].上海:第二军医大学,2016.
[14]Chan CL W,Wang CW,Ho AHY,et al. Symptoms of posttraumatic stress disorder and depression among bereaved and non-bereaved survivors following the 2008 Sichuan earthquake[J]. J Anxiety Disord,2012,26(6):673-679.
[15]徐晓军,刘炳琴.失独人群的创伤后应激障碍及其心理援助[J].武汉大学学报(人文科学版),2017,70(2):122-128.
[16]潘金洪.失独哀伤过程的复杂性及其特征的多样性分析[J].人口与社会,2017,33(1):3-11.
[17]Xu J,Wang Z,Sun Y. Indelible grief:prevalence and risk factors for posttraumatic stress disorder in Shidu parents 6 years after the Wenchuan Earthquake[J]. Curr Psychol,2016,36(3):1-8.
[18]Schwarzer R,Cone J E,Li J,et al. A PTSD symptoms trajectory mediates between exposure levels and emotional support in police responders to 9/11:a growth curve analysis[J]. BMC Psychiatry,2016,16(1):1-7.
[29]Bonanno GA,Mancini AD. Beyond resilience and PTSD:mapping the heterogeneity of responses to potential trauma[J]. Psychol Trauma,2012,4(1):74-83.
[20]张雯,王安妮,姚抒予,等.失独者抑郁症状的分布特征及与心理弹性的关系[J].中国心理卫生杂志,2016,30(8):612-617.
[21]Rogers CH,Floyd FJ,Seltzer MM,et al. Long-term effects of the death of a child on parents'adjustment in midlife[J]. J Fam Psychol,2008,22(2):203-311.
[22] Tolin DF, Foa EB. Sex differences in trauma and posttraumatic stress disorder:a quantitative review of 25 years of research[J].Psychol Bull,2006,132(6):959-992.
[23]高雪屏,罗兴伟.汶川地震后1月内脱离/未脱离震区的亲历者PTSD筛查阳性的发生及心理影响因素[J].中南大学学报(医学版),2009,34(6):504-509.
[24]Wang L, Zhang Y,Wang W, et al. Symptoms of posttraumatic stress disorder among adult survivors three months after the Sichuan earthquake in China[J]. J Trauma Str,2009,22(5):444-450.
[25]龙小芳.乳腺癌术后化疗患者创伤后应激障碍(PTSD)症状及影响因素研究[D].广州:中山大学,2008.
[26]张静秋,汤永隆,邓丽俐,等. 5爛12四川地震灾民社会支持的调查[J].心理科学进展,2009,17(3):542-546.
[27]Horesh D,Lowe SR,Galea S,et al. An in-depth look into PTSD-depression comorbidity:a longitudinal study of chronically-exposed Detroit residents[J]. J Affect Disord,2017,208:653-661. doi:10. 1016/j. jad. 2016. 08. 053.