“5·12”特大地震灾民居住板房两年心理应激状况调查
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摘要
目的了解"5.12"地震两年后江油、北川板房灾民的心理健康状况,为震后心理危机干预提供科学依据。方法采用随机抽样的方法从北川和江油两地区抽取560人为研究对象,采用创伤后应激障碍筛查量表平民版(posttraumatic stress disorder checklist-civilian version,PCL-C)、匹茨堡睡眠质量指数量表(Pittsburgh sleep quali-ty index,PSQI)、健康调查量表(the MOS item short from health survey,SF-36)以及自制社会人口学问卷进行入户调查。结果单因素分析结果显示:地震两年后板房灾民的创伤后应激障碍(posttraumatic stress disorder,PTSD)检出率为7.5%;北川灾民PTSD的检出率(12.4%)高于江油地区(4.7%),差异有统计学意义(P=0.001);女性高于男性,差异有统计学意义(P=0.020);丧偶组PCL-C均分相对较高,与未婚、在婚、离婚组间的差异无统计学意义。Logistic回归分析显示,地区、PSQI总分是PTSD发生的危险因素。结论地震两年后板房灾民的心理健康状况不容乐观,尤以受灾程度重、睡眠紊乱、女性、中老年灾民为主,加强社会、心理支持非常必要。
Objective To investigate the mental health status of survivors living in the temporary settlements two years after "5·12" earthquake and explore related factors,so as to provide scientific basis for intervention.Methods A random sample of 560 subjects who came from Beichuan and Jiangyou areas were investigated by adopting subscale of posttraumatic stress disorder checklist-civilian version(PCL-C),the Pittsburgh sleep quality index(PSQI),the short-form health survey questionnaire(SF-36) and social demographic questionnaire.Results One way variance analysis results showed that the prevalence of PTSD in this sample was 7.5 %,the rate of PTSD was 12.4 %in Beichuan area,which was significantly higher than Jiangyou area(4.7%)(P=0.001).The score of PCL-C in women were significantly higher than men(P=0.020).The score of PCL-C in the people who suffered from losing wife / husband was higher than others,but the differences were not significant.The Logistic regression showed that the worse area in earthquake and sleeping disorder were the risk factors of PTSD.Conclusions Two years after "5·12" earthquake,the mental health status was not optimistic,especially the worse area in the earthquake.So it is very necessary to enhance social and psychological support for them.Female,population with sleeping disorder and middle-aged people should be viewed as the priority of attention.
Objective To investigate the mental health status of survivors living in the temporary settlements two years after "5·12" earthquake and explore related factors,so as to provide scientific basis for intervention.Methods A random sample of 560 subjects who came from Beichuan and Jiangyou areas were investigated by adopting subscale of posttraumatic stress disorder checklist-civilian version(PCL-C),the Pittsburgh sleep quality index(PSQI),the short-form health survey questionnaire(SF-36) and social demographic questionnaire.Results One way variance analysis results showed that the prevalence of PTSD in this sample was 7.5 %,the rate of PTSD was 12.4 %in Beichuan area,which was significantly higher than Jiangyou area(4.7%)(P=0.001).The score of PCL-C in women were significantly higher than men(P=0.020).The score of PCL-C in the people who suffered from losing wife / husband was higher than others,but the differences were not significant.The Logistic regression showed that the worse area in earthquake and sleeping disorder were the risk factors of PTSD.Conclusions Two years after "5·12" earthquake,the mental health status was not optimistic,especially the worse area in the earthquake.So it is very necessary to enhance social and psychological support for them.Female,population with sleeping disorder and middle-aged people should be viewed as the priority of attention.
引文
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[2]张本,张凤阁,王丽萍,等.30年后唐山地震所致孤儿创伤后应激障碍现患率调查[J].中国心理卫生杂志,2008,22(6):469-473.
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[10]Forbes D,Creamer M,Biddle D.The validity of the PTSDchecklist as a measure of symptomatic change in combat-relatedPTSD[J].Behavi Res Ther,2001,39(8):977-986.
[11]Walker EA,Newman E,Dobie DJ,et al.Validation of thePTSD checklist in an HMO sample of women[J].Gen HospPsychiatry,2002,24(6):375-380.
[12]Dobie DJ,Kivlahan DR,Maynard C,et al.Posttraumatic stressdisorder in female veterans:association with self-reported healthproblems and functional impairment[J].Arch Intern Med,2004,164(4):394-400.
[13]Dobie DJ,Kivlahan DR,Maynard C,et al.Screening for post-traumatic stress disorder in female Veteran’s Affairs patients:validation of the PTSD checklist[J].Gen Hosp Psychiatry,2002,24(6):367-374.
[14]Tural U,Coskun B,Onder E,et al.Psychological consequencesof the 1999 earthquake in Turkey[J].J Trauma Stress,2004,17(6):451-459.
[15]Goenjian A.A mental health relief programme in Armenia afterthe 1988 earthquake.implementation and clinicalobservations[J].Br J Psychiatry,1993,163:230-239.
[16]张世英.四川南坝镇灾民身体与心理症状分析[J].中华疾病控制杂志,2009,13(5):561-563.
[17]侯彩兰,李凌江,张燕,等.矿难后2个月和10个月创伤后应激障碍的发生率及相关因素[J].中南大学学报(医学版),2008,33(4):279-283.
[18]赵高锋,杨彦春,张强,等.汶川地震极重灾区社区居民创伤后应激障碍发生率及影响因素[J].中国心理卫生杂志,2009,23(7):478-483.
[19]刘婉婷,况利,陈建梅,等.地震伤员PTSD及其影响因素的研究[J].重庆医科大学学报,2009,34(12),1719-1722.
[20]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.
[21]Beszczyńska B.Molecular basis of stress-evoked psychiatric dis-turbances[J].Postepy Hig Med Dosw,2007,61:690-701.
[22]Boehnlein JK,Kinzie JD.Pharmacologic reduction of CNS nora-drenergic activity in PTSD:the case for clonidine and prazosin[J].J Psychiatry Pract,2007,13(2):72-78.
[23]Benight CC,Bandura A.Social cognitive theory of posttraumaticrecovery:the role of perceived self-efficacy[J].Behav Res T-her,2004,42(10):1129-1148.
[24]尚蕾,王择青.创伤后的应激障碍及其预测因素[J].中国临床康复,2005,9(16):127-129.
[2]张本,张凤阁,王丽萍,等.30年后唐山地震所致孤儿创伤后应激障碍现患率调查[J].中国心理卫生杂志,2008,22(6):469-473.
[3]Kessler RC,Sonnega A,Bromet E,et al.Posttraumatics tressdisorder in the National Comorbidity Survey[J].Arch Gen Psy-chiatry,1995,52(12):1048-1060.
[4]Jordan NN,Hoge CW,Tobler SK,et al.Mental health impact of9/11 Pentagon attack:validation of a rapid assessment tool[J].Am J Prev Med,2004,26(4):284-293.
[5]Raphael B,Lundin T,Weisaeth L.A research method for thestudy of psychological and psychiatric aspects of disaster[J].Ac-ta Psychiatrica Scand Suppl,1989,353:1-75.
[6]Weathers FW,Litz BT,Herman DS,et al.The PTSD checklist:Reliability,validityand diagnostic utility.Paper Presented at theAnnual Meeting of the International Society for Traumatic StressStudies[J].San Antonio,TX,1993,168(353):26-33.
[7]汪向东,王希林,马弘.心理卫生评定量表手册[M].增订版.北京:中国心理卫生杂志社,1999.
[8]李宁秀,刘朝杰,李俊,等.四川省城乡居民SF-36评价参考价值[J].华西医科大学学报,2001,32(1):43-47.
[9]王红妹,李鲁,沈毅.中文版SF-36量表用于杭州市区居民生命质量研究[J].中华预防医学杂志,2001,35(6):428-430.
[10]Forbes D,Creamer M,Biddle D.The validity of the PTSDchecklist as a measure of symptomatic change in combat-relatedPTSD[J].Behavi Res Ther,2001,39(8):977-986.
[11]Walker EA,Newman E,Dobie DJ,et al.Validation of thePTSD checklist in an HMO sample of women[J].Gen HospPsychiatry,2002,24(6):375-380.
[12]Dobie DJ,Kivlahan DR,Maynard C,et al.Posttraumatic stressdisorder in female veterans:association with self-reported healthproblems and functional impairment[J].Arch Intern Med,2004,164(4):394-400.
[13]Dobie DJ,Kivlahan DR,Maynard C,et al.Screening for post-traumatic stress disorder in female Veteran’s Affairs patients:validation of the PTSD checklist[J].Gen Hosp Psychiatry,2002,24(6):367-374.
[14]Tural U,Coskun B,Onder E,et al.Psychological consequencesof the 1999 earthquake in Turkey[J].J Trauma Stress,2004,17(6):451-459.
[15]Goenjian A.A mental health relief programme in Armenia afterthe 1988 earthquake.implementation and clinicalobservations[J].Br J Psychiatry,1993,163:230-239.
[16]张世英.四川南坝镇灾民身体与心理症状分析[J].中华疾病控制杂志,2009,13(5):561-563.
[17]侯彩兰,李凌江,张燕,等.矿难后2个月和10个月创伤后应激障碍的发生率及相关因素[J].中南大学学报(医学版),2008,33(4):279-283.
[18]赵高锋,杨彦春,张强,等.汶川地震极重灾区社区居民创伤后应激障碍发生率及影响因素[J].中国心理卫生杂志,2009,23(7):478-483.
[19]刘婉婷,况利,陈建梅,等.地震伤员PTSD及其影响因素的研究[J].重庆医科大学学报,2009,34(12),1719-1722.
[20]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.
[21]Beszczyńska B.Molecular basis of stress-evoked psychiatric dis-turbances[J].Postepy Hig Med Dosw,2007,61:690-701.
[22]Boehnlein JK,Kinzie JD.Pharmacologic reduction of CNS nora-drenergic activity in PTSD:the case for clonidine and prazosin[J].J Psychiatry Pract,2007,13(2):72-78.
[23]Benight CC,Bandura A.Social cognitive theory of posttraumaticrecovery:the role of perceived self-efficacy[J].Behav Res T-her,2004,42(10):1129-1148.
[24]尚蕾,王择青.创伤后的应激障碍及其预测因素[J].中国临床康复,2005,9(16):127-129.
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