地震后儿童创伤后应激障碍的症状及其治疗
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摘要
地震灾害作为一种心理应激源与身心健康的关系早已引起了人们的广泛关注。在汶川大地震发生后,本文作者在广东省心理卫生协会心理咨询师专业委员会的组织下,赴四川什邡妇幼保健院进行了为期20d的儿童心理干预,亲身感受到经历地震灾害后的儿童产生了不同程度的创伤心理应激反应。纵观国内外有关儿童创伤后应激障碍的研究,此类儿童若得不到及时诊断与治疗,必然会导致长远的负面影响,有的到成年期甚至终生伴有一系列的心理障碍。因此,对创伤后应激障碍的儿童及时诊断并实施心理咨询和治疗显得尤为重要。本文结合自身赴川进行心理干预的体验对地震后儿童创伤后应激障碍的流行病学、症状表现及其治疗进行概述。
Earthquake as a source of psychological stress, its relationship with physical and mental health attracted wide attention. After Wenchuan earthquake, the authors went to Sichuan Shifang Maternal and Child Health Care Hospital organized by Guangdong Province Mental Health Association of Professional Psychological Consultant Committee, and carried out a 20-day psychological intervention treatment for the children. The authors found that these children had varying degrees of psychological trauma stress. After a panoramic view of children post-traumatic stress disorder research at home and abroad, if these children have no access to diagnosis and treatment might lead to long-term negative effects, and some even grow up to adulthood with a series of life-long mental disorders. As a result, it is especially important for children with post-traumatic stress disorder to diagnose in a timely manner and to give implementation of psychological counseling and treatment. In this paper, the authors conducted their own psychological experience and reviewed the epidemiology, symptoms, and treatment of the children with post-traumatic stress disorder after earthquake.
Earthquake as a source of psychological stress, its relationship with physical and mental health attracted wide attention. After Wenchuan earthquake, the authors went to Sichuan Shifang Maternal and Child Health Care Hospital organized by Guangdong Province Mental Health Association of Professional Psychological Consultant Committee, and carried out a 20-day psychological intervention treatment for the children. The authors found that these children had varying degrees of psychological trauma stress. After a panoramic view of children post-traumatic stress disorder research at home and abroad, if these children have no access to diagnosis and treatment might lead to long-term negative effects, and some even grow up to adulthood with a series of life-long mental disorders. As a result, it is especially important for children with post-traumatic stress disorder to diagnose in a timely manner and to give implementation of psychological counseling and treatment. In this paper, the authors conducted their own psychological experience and reviewed the epidemiology, symptoms, and treatment of the children with post-traumatic stress disorder after earthquake.
引文
[1]张义,党海红.创伤后应激障碍社会心理学危险因素[J].临床心身疾病杂志,2008,14(2):186-192.
[2]李成齐.儿童创伤后应激障碍的症状表现与干预策略[J].中国特殊教育,2006,6:88-91.
[3]贾福军.儿童创伤后应激障碍研究现状[J].中原精神医学学刊,2000,6(2):122-125.
[4]代娟,张定梅,陆家海.地震后预防传染病流行的策略[J].中山大学学报:医学科学版,2008,29(5):506-511.
[5]Goenjian AK,Najarian LM,Pynoos RS,et al.Posttraumatic stress disorder in elderly and younger adults after the1988earthquake in Armenia[J].Am J Psychiatry,1994,151(6):895-901.
[6]赵丞智,李俊福,王明山,等.地震后17个月PTSD及其相关因素[J].中国心理卫生杂志,2001,15(3):145-147.
[7]张本,王学义,孙贺祥,等.唐山大地震所致孤儿心理创伤后应激障碍的调查[J].中华精神科杂志,2000,33(2):111-114.
[8]Lamberg L.Psychiatrists explore legacy of traumatic stress in early life[J].JAMA,2001,286(5):523-526.
[9]关念红,王昆,魏钦令,等.汶川地震异地治疗伤员创伤后应激症状及影响因素分析[J].中山大学学报:医学科学版,2008,29(4):361-366.
[10]王相兰,陶炯,温盛霖,等.汶川地震灾民的心理健康状况及影响因素[J].中山大学学报:医学科学版,2008,29(4):367-371.
[11]Metin B,Cengiz K,Ebru S,et al.Prevalence of posttraumatic stress disorder and comorbid depression in earthquake survivors in Turkey:an epidemiological study[J].J Traumatic Stress,2004,17(2):133-141.
[12]王志阳,汤月芬,施慎逊.创伤后应激障碍国内研究现状[J].上海精神医学,2006,18(6):372-374.
[13]秦虹云,季建林.PTSD及其危机干预[J].中国心理卫生杂志,2003,17(9):614-616.
[14]Khouzam HR,Donnelly NJ.Posttraumatic stress disorder,safe,effective management in the primary care setting[J].Postgrad Med,2001,110(5):60-78.
[15]Celano M,Rothbaum BO.Psychotherapeutic approaches with survivors of childhood trauma[J].Semin Clin Neuropsychiatry,2002,7(2):120-128.
[16]王丽颖,杨蕴萍.创伤后应激障碍的研究进展(二)[J].国外医学精神病学分册,2004,31(2):112-115.
[17]何跃,张洪涛.创伤后应激障碍的心理学效应和心理康复[J].中国临床康复,2003,7(16):2346-2347.
[18]刘庆海,王贵山.创伤后应激障碍的治疗进展[J].国外医学精神病学分册,2003,30(3):191-192.
[19]Michael SS,Alison S,Ruth AA,et al.Feasibility and effectiveness of cognitive-behavioral therapy for posttraumatic stress disorder in preschool children:two case reports[J].J Traumatic Stress,2007,20(4):631-636.
[20]Perrin S,Smith P,Yule W.Practitioner review:the assessment and treatment of post-traumatic stress disorder in children and adolescents[J].J Child Psychol Psychiat,2000,41(3):277-289.
[21]Metin B,Ebru S,Maria L,et al.Single-session behavioral treatment of earthquake-related post-traumatic stress disorder:a randomized waiting list controlled trial[J].J Traumatic Stress,2005,18(1):1-11.
[22]Konuk E,Knipe J,Eke I,et al.The effects of eye movement desensitization and reprocessing(EMDR)therapy on posttraumatic stress disorder in survivors of the1999Marmara,Turkey,earthquake[J].Int J Stress Manag,2006,13(3):291-308.
[23]Zohar J,Juven-Wetzler A,Myers V,et al.Post-traumatic stress disorder:facts and fiction[J].Curr Opin Psychiatry,2008,21(1):74-77.
[2]李成齐.儿童创伤后应激障碍的症状表现与干预策略[J].中国特殊教育,2006,6:88-91.
[3]贾福军.儿童创伤后应激障碍研究现状[J].中原精神医学学刊,2000,6(2):122-125.
[4]代娟,张定梅,陆家海.地震后预防传染病流行的策略[J].中山大学学报:医学科学版,2008,29(5):506-511.
[5]Goenjian AK,Najarian LM,Pynoos RS,et al.Posttraumatic stress disorder in elderly and younger adults after the1988earthquake in Armenia[J].Am J Psychiatry,1994,151(6):895-901.
[6]赵丞智,李俊福,王明山,等.地震后17个月PTSD及其相关因素[J].中国心理卫生杂志,2001,15(3):145-147.
[7]张本,王学义,孙贺祥,等.唐山大地震所致孤儿心理创伤后应激障碍的调查[J].中华精神科杂志,2000,33(2):111-114.
[8]Lamberg L.Psychiatrists explore legacy of traumatic stress in early life[J].JAMA,2001,286(5):523-526.
[9]关念红,王昆,魏钦令,等.汶川地震异地治疗伤员创伤后应激症状及影响因素分析[J].中山大学学报:医学科学版,2008,29(4):361-366.
[10]王相兰,陶炯,温盛霖,等.汶川地震灾民的心理健康状况及影响因素[J].中山大学学报:医学科学版,2008,29(4):367-371.
[11]Metin B,Cengiz K,Ebru S,et al.Prevalence of posttraumatic stress disorder and comorbid depression in earthquake survivors in Turkey:an epidemiological study[J].J Traumatic Stress,2004,17(2):133-141.
[12]王志阳,汤月芬,施慎逊.创伤后应激障碍国内研究现状[J].上海精神医学,2006,18(6):372-374.
[13]秦虹云,季建林.PTSD及其危机干预[J].中国心理卫生杂志,2003,17(9):614-616.
[14]Khouzam HR,Donnelly NJ.Posttraumatic stress disorder,safe,effective management in the primary care setting[J].Postgrad Med,2001,110(5):60-78.
[15]Celano M,Rothbaum BO.Psychotherapeutic approaches with survivors of childhood trauma[J].Semin Clin Neuropsychiatry,2002,7(2):120-128.
[16]王丽颖,杨蕴萍.创伤后应激障碍的研究进展(二)[J].国外医学精神病学分册,2004,31(2):112-115.
[17]何跃,张洪涛.创伤后应激障碍的心理学效应和心理康复[J].中国临床康复,2003,7(16):2346-2347.
[18]刘庆海,王贵山.创伤后应激障碍的治疗进展[J].国外医学精神病学分册,2003,30(3):191-192.
[19]Michael SS,Alison S,Ruth AA,et al.Feasibility and effectiveness of cognitive-behavioral therapy for posttraumatic stress disorder in preschool children:two case reports[J].J Traumatic Stress,2007,20(4):631-636.
[20]Perrin S,Smith P,Yule W.Practitioner review:the assessment and treatment of post-traumatic stress disorder in children and adolescents[J].J Child Psychol Psychiat,2000,41(3):277-289.
[21]Metin B,Ebru S,Maria L,et al.Single-session behavioral treatment of earthquake-related post-traumatic stress disorder:a randomized waiting list controlled trial[J].J Traumatic Stress,2005,18(1):1-11.
[22]Konuk E,Knipe J,Eke I,et al.The effects of eye movement desensitization and reprocessing(EMDR)therapy on posttraumatic stress disorder in survivors of the1999Marmara,Turkey,earthquake[J].Int J Stress Manag,2006,13(3):291-308.
[23]Zohar J,Juven-Wetzler A,Myers V,et al.Post-traumatic stress disorder:facts and fiction[J].Curr Opin Psychiatry,2008,21(1):74-77.
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