汶川地震男性救援者创伤后应激障碍危险因素研究
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摘要
目的调查参加汶川地震中男性救援者创伤后应激障碍相关危险因素。方法采用分层随机抽样方法,对1590名男性救援者进行创伤后应激障碍检查问卷(PLC-C)测量,并将其分为PTSD组和非PTSD组,比较两组社会人口学资料、地震暴露初期个体心理特征问卷(SRQ)和灾后个体认知特征调查问卷(PTCI)测量结果,并利用Log istic回归分析筛选PTSD危险因素。结果 PTSD患者与其它男性救援者相比较在SRQ(10.75±3.75/3.29±3.31)和PTC I(104.72±29.13/55.94±20.16)上的得分明显较高(P<0.001),其PTSD症状发生频率明显高于其它男性救援者(P<0.001)。Logistic回归分析筛选出4个预测因素包括运送炸药(OR=2.76)、排除危房(OR=0.47)、PTCI(OR=0.97)和SRQ(OR=0.77)。结论汶川抗震救灾6个月后男性救援者的PTSD患病率与执行任务种类如运送炸药、排除危房以及第1个月地震暴露时的应激反应和对地震的认知评价方式明显相关。
Objective To investigate the current prevalence and risk factors of Post-traumatic Stress Disorder in male-rescuers in the Wenchuan Earthquake.Methods A total of 1590 male-rescuers were assessed with the Self-reporting Questionnaire(SRQ),the Post-traumatic Stress Disorder Checklist-civilian Version(PLC-C) and the Post-traumatic Stress Disorder Cognitions Inventory(PTCI) six mouths after Wenchuan Earthquake.A stepwise Logistic regression model was administrated to identify the risk factors of PTSD.Results Rescuers with PTSD compared to ones with non-PTSD had significantly higher scores of SRQ(10.75±3.75/3.29±3.31),and PTCI(104.72±29.13/55.94±20.16).The symptoms of them occurred frequently than non-PTSD rescuers.In a stepwise Logistic regression model,four risk factors were obviously corrected with the development of PTSD including transport dynamites(OR=2.76),removed unsafe houses(OR=0.47),the scores of PTCI(OR=0.97) and the scores of SRQ(OR=0.77).Conclusion The incidence of PTSD for the male-rescuers six months after Wenchuan Earthquake is obviously correlated with rescuers' executing missions such as transport dynamites and removed unsafe houses,and stressful reaction within one month after the earthquake and cognitive estimate methods for the earthquake.
Objective To investigate the current prevalence and risk factors of Post-traumatic Stress Disorder in male-rescuers in the Wenchuan Earthquake.Methods A total of 1590 male-rescuers were assessed with the Self-reporting Questionnaire(SRQ),the Post-traumatic Stress Disorder Checklist-civilian Version(PLC-C) and the Post-traumatic Stress Disorder Cognitions Inventory(PTCI) six mouths after Wenchuan Earthquake.A stepwise Logistic regression model was administrated to identify the risk factors of PTSD.Results Rescuers with PTSD compared to ones with non-PTSD had significantly higher scores of SRQ(10.75±3.75/3.29±3.31),and PTCI(104.72±29.13/55.94±20.16).The symptoms of them occurred frequently than non-PTSD rescuers.In a stepwise Logistic regression model,four risk factors were obviously corrected with the development of PTSD including transport dynamites(OR=2.76),removed unsafe houses(OR=0.47),the scores of PTCI(OR=0.97) and the scores of SRQ(OR=0.77).Conclusion The incidence of PTSD for the male-rescuers six months after Wenchuan Earthquake is obviously correlated with rescuers' executing missions such as transport dynamites and removed unsafe houses,and stressful reaction within one month after the earthquake and cognitive estimate methods for the earthquake.
引文
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[2]Schnyder U.Post-traumatic stress disorder:diagnostic and thera-peutic principles[J].Schweiz Rundsch Med Prax,2003,92(8):337-343
[3]Costello E J,Erkanli A,Fairbank J A,et al.The prevalence of po-tentially traumatic events in childhood and adolescence[J].J Trauma Stress,2002,15(2):99-112
[4]Bokszczanin A.Parental support,family conflict,and overprotec-tiveness:predicting PTSD symptom levels of adolescents 28 monthsafter a natural disaster[J].Anxiety Stress Coping,2008,21(4):325-335
[5]Dobie D J,Kivlahan D R,Maynard C,et al.Screening for post-traumatic stress disorder in female Veteran's Affairs patients:vali-dation of the PTSD check list[J].J General hospital psychiatry,2002,24(6):367-374
[6]汪向东,赵丞智、新福尚隆,等.地震后创伤性应激障碍的发生率及影响因素[J].中国心理卫生杂志,1999,13(1):28-30
[7]Pynoos R S,Goenjian A,Tashjian M,et al.Post-traumatic stressreaction in children after the 1988 American earthquake in Armenia[J].J Am Psychiatry,1994,151:895-901
[8]Johnsen G E,Asbjornsen AE.Consistent impaired verbal memory inPTSD:a meta-analysis[J].J Affect Disorder,2008,111(1):74-82
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