地震灾区青少年创伤后应激障碍相关因素分析
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摘要
目的了解社会支持和应付方式与四川省汶川地震灾区青少年创伤后应激障碍(PTSD)症状发生的关系,为采取干预措施提供参考依据。方法在四川省汶川地震5个月后采用整群抽样方法对四川省都江堰市都江堰中学抽取的472名高中生进行问卷调查。结果地震灾区高中生PTSD检出率为46.61%,其中男生和女生检出率分别为43.93%和48.84%,差异无统计学意义(P>0.05);PTSD阳性与阴性症状学生比较,客观支持、主观支持、支持利用度和社会支持总分差异均无统计学意义(P>0.05),自责、求助、幻想、退避和合理化因子分差异均有统计学意义(P<0.05),解决问题因子分差异无统计学意义(P>0.05);相关分析结果表明,客观支持与闯入、高警觉因子和事件影响量表(IES)总分均呈负相关(P<0.05);解决问题与高警觉因子呈负相关(P<0.05);求助与闯入因子和IES总分均呈负相关(P<0.05),自责、幻想、退避和合理化与回避、闯入、高警觉因子和IES总分均呈正相关(P<0.01)。结论应用成熟的应付方式和良好的社会支持可提高地震灾区青少年的心理健康水平,减少PTSD的发生。
Objective To understand the relationship between social support and coping style and the prevalence of post-traumatic stress disorder(PTSD) among adolescents in disaster area after Wenchuan earthquake.Methods Totally 472 middle school students in Dujiangyan city of Sichuan province were investigated five months after Wenchuan earthquake with general questionnaire,social support rating scale,coping style questionnaire,and the Chinese version of the Impact of Event Scale(IES)-Revised.Results After the earthquake,220(46.61%) adolescents showed symptoms of PTSD,including 94 male(19.92%) and 126 female(26.69%).There was no significant difference in positive rate of PTSD symptoms between the male and the female(P>0.05).There was no significant difference in objective support,subjective support,utilization of social support,and the total score of social support between the students with and without PTSD symptoms(P>0.05 for all).But there were significant diffeneces in self-blame,resort,illusion,retreat,and rationalization between the adolscents with and without PTSD symptoms(P<0.05).Correlation analyses indicated that objective support was negatively correlated with intrusion,high alert and total score IES(P<0.05);rationalization was negatively correlated with high alert(P<0.05);resort was negatively correlated with intrusion factor and total score of IES;self-blame,illusion,retreat,and rationalization were positively correlated with avoidance,intrusion,high alert,and total score of IES(P<0.01 for all).Conclusion Application of mature coping style and good social support can improve the mental health and reduce prevalence of PTSD among adolescents.
Objective To understand the relationship between social support and coping style and the prevalence of post-traumatic stress disorder(PTSD) among adolescents in disaster area after Wenchuan earthquake.Methods Totally 472 middle school students in Dujiangyan city of Sichuan province were investigated five months after Wenchuan earthquake with general questionnaire,social support rating scale,coping style questionnaire,and the Chinese version of the Impact of Event Scale(IES)-Revised.Results After the earthquake,220(46.61%) adolescents showed symptoms of PTSD,including 94 male(19.92%) and 126 female(26.69%).There was no significant difference in positive rate of PTSD symptoms between the male and the female(P>0.05).There was no significant difference in objective support,subjective support,utilization of social support,and the total score of social support between the students with and without PTSD symptoms(P>0.05 for all).But there were significant diffeneces in self-blame,resort,illusion,retreat,and rationalization between the adolscents with and without PTSD symptoms(P<0.05).Correlation analyses indicated that objective support was negatively correlated with intrusion,high alert and total score IES(P<0.05);rationalization was negatively correlated with high alert(P<0.05);resort was negatively correlated with intrusion factor and total score of IES;self-blame,illusion,retreat,and rationalization were positively correlated with avoidance,intrusion,high alert,and total score of IES(P<0.01 for all).Conclusion Application of mature coping style and good social support can improve the mental health and reduce prevalence of PTSD among adolescents.
引文
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[2]Matthieu M,lvanoff A.Using stress,appraisal,and coping theories inclinical practice:assessments of coping strategies after disasters[J].Brief Treatment and Crisis Intervention,2006,6:337-348.
[3]汪向东,王希林,马弘,等.心理卫生评定量表手册[M].北京,中国心理卫生出版社,1999:127-131.
[4]汪向东,王希林,马弘,等.心理卫生评定量表手册[M].北京,中国心理卫生出版社,1999:109-115.
[5]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.
[6]Sondergaard HP,Ekblad S,Theorell T.Screening for post-traumaticstress disorder among refugees in Stockholm[J].Nord J Psychiatry,2003,57(3):185-189.
[7]何树德.地震灾区大学生创伤后应激障碍及其共病[J].中国公共卫生,2010,26(6):719-720.
[8]王波,王安辉,承海,等.地震灾区居民创伤应激障碍调查[J].中国公共卫生,2009,25(9):1067-1068.
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