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
|
摘要
目的:探讨汶川地震后1月内脱离/未脱离震区的亲历者创伤后应激障碍(posttraumaticstress disorder,PTSD)筛查阳性的发生及心理健康的影响因素。方法:对什邡地区235人(现场组,称A组)、转入湘雅二医院住院的伤病员44人(伤病员组,称B组)及家属36人(家属组,称C组)采用事件影响量表修订版等进行心理评估。结果:(1)灾后1月内PTSD筛查总阳性率为35.56%,女性明显高于男性(χ2=16.27,P<0.001);A组、B组和C组PTSD筛查阳性率分别为39.15%,31.82%和16.67%,差异有统计学意义(χm2h=5.243,P<0.05);在PTSD筛查阳性者的3组人群中,A组在"麻木/回避"和"过度唤起"症状得分上明显高于B组和C组(均P<0.01)。(2)A组和B组的"焦虑"、"抑郁"和"躯体化"因子得分均明显高于C组(均P<0.05);(3)性别、居住地和是否脱离震区是PTSD症状的影响因素。结论:震后1月内对亲历者的心理影响较大,PTSD症状群、焦虑与抑郁症状是其主要心理问题,尤其是女性群体,应予更多关注。早期脱离震区环境、扩大和强化支持系统是其保护性因素。早期心理干预有助于提高亲历者的心理承受力,有效预防PTSD的发生。
Objective To explore posttraumatic stress disorder(PTSD) positive screening and factors influencing the mental state in victims who were evacuated/were not evacuated from Wenchuan earthquake area within 1 month.Methods The 3 groups included 235 victims who were not evacuated from Shifang territory(the incident scene,Group A),44 victims who were evacuated to Second Xiangya Hospital(the wounded,Group B) and 36 relatives(the relatives,Group C).The mental state of all subjects was evaluated by Impact of Event Scale-Revised(IES-R)and other tools.Results(1) One month after the disaster,and the positive rate of PTSD screening in these survivors was 35.56%,the positive rate in women was significantly higher than that in men(χ2=16.27,P<0.001).The positive rate of PTSD screening in Group A,Group B and Group C was 39.15%,31.82%,and 16.67%,respectively,with significant difference(χ2mh=5.243,P<0.05).Among the three groups which met the diagnosis criterion of PTSD symptoms,the scores for "numbness/avoidance symptom" and "excessive arousing symptom" in Group A were significantly higher than those in Group B and C(P<0.01).(2) The scores for "anxiety" and "depression" and "psychosomatic" symptoms in Group A and Group B were significantly higher than those in Group C(P<0.05).(3) Gender,place of residence and evacuating from the earthquake area or not were factors of PTSD symptoms.Conclusion One month after the earthquake,the victims suffered psychologically.PTSD symptoms,anxiety and depression symptoms were their major mental problems,more attention to especially women victims.The protection factors include dispersing victims to the secure place as soon as possible,expanding and strengthening society support.Early psychological interventions will help victims to raise their psychological endurance and prevent PTSD effectively.
Objective To explore posttraumatic stress disorder(PTSD) positive screening and factors influencing the mental state in victims who were evacuated/were not evacuated from Wenchuan earthquake area within 1 month.Methods The 3 groups included 235 victims who were not evacuated from Shifang territory(the incident scene,Group A),44 victims who were evacuated to Second Xiangya Hospital(the wounded,Group B) and 36 relatives(the relatives,Group C).The mental state of all subjects was evaluated by Impact of Event Scale-Revised(IES-R)and other tools.Results(1) One month after the disaster,and the positive rate of PTSD screening in these survivors was 35.56%,the positive rate in women was significantly higher than that in men(χ2=16.27,P<0.001).The positive rate of PTSD screening in Group A,Group B and Group C was 39.15%,31.82%,and 16.67%,respectively,with significant difference(χ2mh=5.243,P<0.05).Among the three groups which met the diagnosis criterion of PTSD symptoms,the scores for "numbness/avoidance symptom" and "excessive arousing symptom" in Group A were significantly higher than those in Group B and C(P<0.01).(2) The scores for "anxiety" and "depression" and "psychosomatic" symptoms in Group A and Group B were significantly higher than those in Group C(P<0.05).(3) Gender,place of residence and evacuating from the earthquake area or not were factors of PTSD symptoms.Conclusion One month after the earthquake,the victims suffered psychologically.PTSD symptoms,anxiety and depression symptoms were their major mental problems,more attention to especially women victims.The protection factors include dispersing victims to the secure place as soon as possible,expanding and strengthening society support.Early psychological interventions will help victims to raise their psychological endurance and prevent PTSD effectively.
引文
[1]Jordan N N,Hoge C W,Tobler S K,et al.Mental health impact of9/11Pentagon attack:Validation of a rapid as-sessment tool[J].Am J Prev Med,2004,26(4):284-293.
[2]Ehlers A,Clark D M,Hackmann A,et al.A randomized controlled trial of cognitive therapy,a self-help booklet and repeated assessments as early interventions for post-traumatic stress disorder[J].Arch Gen Psychiat,2003,60(10):1024-1032.
[3]郭素然,辛自强,耿柳娜.事件影响量表修订版的信度和效度分析[J].中国临床心理学杂志,2007,15(1):15-17.GUO Suran,XIN Ziqiang,GENG Liuna.Reliability and va-lidity of Chinese version of the impact of event scale-revised[J].Chinese Journal of Clinical Psychology,2007,15(1):15-17.
[4]吴文源.症状自评量表[M]//中国行为医学科学编辑委员会.行为医学量表手册.北京:中华医学电子音像出版社,2005:64-67.WU Wenyuan.Symptom checklist90(SCL-90)[M]//Institute of Chinese Journal of Behavior Medical Science.Handbook of Behavioral Medical Scales.Peking:Chinese Medical Multimedia Press,2005:64-67.
[5]陈树林,李凌江,卢原,等.火灾灾民创伤后应激障碍的发生及其影响因素[J].中国神经精神疾病杂志,2005,31(3):198-201.CHEN Shulin,LI Lingjiang,LU Yuan,et al.The preva-lence and influencing factors of PTSD in victims of the fire[J].Chinese Journal of Nervous and Mental Diseases,2005,31(3):198-201.
[6]Kuo H W,Wu S J,Ma T C,et al.Posttraumatic symp-toms were worst among quake victims with injuries following the Chi-chi quake in Taiwan[J].J Psychosom Res,2007,62(4):495-500.
[7]赵丞智,汪向东,高岚,等.张北尚义地震后创伤后应激障碍随访研究[J].中国心理卫生杂志,2000,14(6):361-363.ZHAO Chengzhi,WANG Xiangdong,GAO Lan,et al.Lon-gitudinal study of earthquake-related PTSD in Zhangbei coun-try[J].Chinese Mental Health Journal,2000,14(6):361-363.
[8]Rhoads J,Mitchell F A,Rick S.Posttraumatic stress disor-der after hurricane Katrina[J].J Nurse Pract,2006,2(1):18-26.
[9]Nemeroff C B,Bremner J D,Foa E B,et al.Posttraumatic stress disorder:a state-of science review[J].J Psychiatr Res,2006,40(1):1-21.
[10]Yilmaz V,Cangur S,Clik H E.Sex difference and earth-quake experience effects on earthquake victims[J].Pers In-divid Dif,2005,39(2):341-348.
[2]Ehlers A,Clark D M,Hackmann A,et al.A randomized controlled trial of cognitive therapy,a self-help booklet and repeated assessments as early interventions for post-traumatic stress disorder[J].Arch Gen Psychiat,2003,60(10):1024-1032.
[3]郭素然,辛自强,耿柳娜.事件影响量表修订版的信度和效度分析[J].中国临床心理学杂志,2007,15(1):15-17.GUO Suran,XIN Ziqiang,GENG Liuna.Reliability and va-lidity of Chinese version of the impact of event scale-revised[J].Chinese Journal of Clinical Psychology,2007,15(1):15-17.
[4]吴文源.症状自评量表[M]//中国行为医学科学编辑委员会.行为医学量表手册.北京:中华医学电子音像出版社,2005:64-67.WU Wenyuan.Symptom checklist90(SCL-90)[M]//Institute of Chinese Journal of Behavior Medical Science.Handbook of Behavioral Medical Scales.Peking:Chinese Medical Multimedia Press,2005:64-67.
[5]陈树林,李凌江,卢原,等.火灾灾民创伤后应激障碍的发生及其影响因素[J].中国神经精神疾病杂志,2005,31(3):198-201.CHEN Shulin,LI Lingjiang,LU Yuan,et al.The preva-lence and influencing factors of PTSD in victims of the fire[J].Chinese Journal of Nervous and Mental Diseases,2005,31(3):198-201.
[6]Kuo H W,Wu S J,Ma T C,et al.Posttraumatic symp-toms were worst among quake victims with injuries following the Chi-chi quake in Taiwan[J].J Psychosom Res,2007,62(4):495-500.
[7]赵丞智,汪向东,高岚,等.张北尚义地震后创伤后应激障碍随访研究[J].中国心理卫生杂志,2000,14(6):361-363.ZHAO Chengzhi,WANG Xiangdong,GAO Lan,et al.Lon-gitudinal study of earthquake-related PTSD in Zhangbei coun-try[J].Chinese Mental Health Journal,2000,14(6):361-363.
[8]Rhoads J,Mitchell F A,Rick S.Posttraumatic stress disor-der after hurricane Katrina[J].J Nurse Pract,2006,2(1):18-26.
[9]Nemeroff C B,Bremner J D,Foa E B,et al.Posttraumatic stress disorder:a state-of science review[J].J Psychiatr Res,2006,40(1):1-21.
[10]Yilmaz V,Cangur S,Clik H E.Sex difference and earth-quake experience effects on earthquake victims[J].Pers In-divid Dif,2005,39(2):341-348.
版权所有：© 2023 中国地质图书馆 中国地质调查局地学文献中心