汶川地震救援人员创伤后应激反应特征的初步研究
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摘要
目的:探讨5.12汶川地震军队救援人员创伤后应激损伤状况。方法:采用创伤后压力诊断量表、焦虑自评量表、抑郁自评量表和匹兹堡睡眠质量问卷,在地震爆发后65天左右,对107名执行运输遗体任务的官兵进行了测量。结果:PTSD症状轻度的占84%,中重度的占15%。其中症状在1个月内消失的占63%。从症状的分布来看,闯入性回忆占36.4%,回避29.9%,过度警觉29.9%,焦躁不安或易怒37.4%,入睡困难、睡眠易醒或早醒43.9%,难以集中注意力45.8%,对重要的活动兴趣下降32.7%。救援人员抑郁症状得分低于全国常模水平;焦虑自评量表得分与全国常模差异不显著。睡眠质量差的占72%,以入睡时间长和日间功能降低为主。结论:担任遗体运输的救援官兵在救援早期普遍存在创伤后应激反症状,症状程度较轻,多数在1个月内消失,焦虑和抑郁症状水平的总体状况也比较低,但普遍存在睡眠质量差的问题,并且直接影响到日间功能。
Objective: Investigating of PTSD symptoms among rescue soldiers in may 12 Wenchuan earthquake.Methods: 107 soldiers as drivers in charge of carrying out victims' corpses were investigated after 65 days of the earthquake.Subjects fulfilled four questionnaires,which are PTSD Scale,PSIQ,SDS,and SAS.Results: Subjects with minor PTSD symptoms were 84%,with middle and severe symptoms were 15%,and 63% were recovered within one month.The symptoms distributed as 36.4% of intrusive thoughts,29.9% of avoidance,29.9% of hypervigilance,37.4% of emotional numbing,43.9% of insomnia,45.8% of memory/concentration difficulty,32.7% of loss of interest,72% of poor sleep quality,and subjects have higher depression scores compared with norms.Conclusion: Soldiers in charge of carrying out corpses appeared minor degree of PTSD during early time of rescue,and most of them would recover within one month.Subjects exhibited lower anxiety and depression,but significant disorder of sleep.
Objective: Investigating of PTSD symptoms among rescue soldiers in may 12 Wenchuan earthquake.Methods: 107 soldiers as drivers in charge of carrying out victims' corpses were investigated after 65 days of the earthquake.Subjects fulfilled four questionnaires,which are PTSD Scale,PSIQ,SDS,and SAS.Results: Subjects with minor PTSD symptoms were 84%,with middle and severe symptoms were 15%,and 63% were recovered within one month.The symptoms distributed as 36.4% of intrusive thoughts,29.9% of avoidance,29.9% of hypervigilance,37.4% of emotional numbing,43.9% of insomnia,45.8% of memory/concentration difficulty,32.7% of loss of interest,72% of poor sleep quality,and subjects have higher depression scores compared with norms.Conclusion: Soldiers in charge of carrying out corpses appeared minor degree of PTSD during early time of rescue,and most of them would recover within one month.Subjects exhibited lower anxiety and depression,but significant disorder of sleep.
引文
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[13]Felice E,Saliba J,Grech V,et a1.Prevalence rates and psychosocialcharacteristics associated with depression in pregnancy and postpartu-m in Maltese women[J].J Afect Disord,2004,82(2):297-301
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[15]甘景梨,杨代德,高存友,等.心理干预对新兵心理健康状况和适应能力影响的研究[J].中国行为医学科学,2003,12(1):76 Gan Jing-li,Yang Dai-de,Gao Cun-you,et a1.A study on psycholog-ical intervention to improve the psychological status and the adaptab-ility of the recruit[J].Chinese Journal of Behavioral Medical Science,2003,12(1):76(In Chinese)
[16]Bisson J,Andrew M.Psychological treatment of post-traumatic stress disorder(PTSD)[J].Cochrane Database Syst Rev,2007,18(3):CD0033-88Review
[17]Lagarde D.Pharmacological approach to desychronization of the sle-ep-wakefulness cycle in the military and sport environment[J].Ann Pharm Fr,2007,65(4):258-64Review
[18]赵静波,解亚宁,任忠文,等.高原军人的睡眠质量及其影响因素的研究[J].中国神经精神疾病杂志,2006,32(2):154-156 Zhao Jing-bo,Xie Ya-ning,Ren Zhong-wen,et a1.A study on sleep quality and its influencing factors of Soldiers at high altitude[J].Chi-nese Journal of Nervous and Mental Diseases,2006,32(2):154-156(In Chinese)
[19]崔红,胡军生.军人睡眠自适应量表的编制[J].中国临床心理学杂志,2011,19(1):31-34 Cui Hong,Hu Jun-sheng.Development and validation of the soldier sleep self-adaptation scale[J].Chinese Journal of Clinical Psychology,2011,19(1):31-34(In Chinese)
[20]Chang CM,Lee LC,Connor KM,et a1.Posttraumatic distress and c-oping strategies among rescue workers after an earthquake[J].J Nerv Ment Dis,2003,191(6):391-398
[2]Sakir O,Aytekin S.Frequency of PTSD in a group of search and rescu-e workers two months after 2003 Bingol(Turkey)earthquake[J].J Ne-rvous and Mental Disease,2004,192:573-575
[3]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):372-374Wang Zhi-yang,Tang Yue-fen,Shi Shen-xun.Current study of the PT-SD symptom within China[J].Shanghai Archives of Psychiatry,2006,18(6):372-374(In Chinese)
[4]甘景梨,胡兴焕,李晓琼,等.军人创伤后应激障碍与适应障碍患者的P300研究[J].实用医学杂志,2004,21(10):914-918Gan Jing-li,Hu Xing-huan,Li Xiao-qiong,et a1.The changes of event-related potentials P300 in patients with post-traumatic stress disorderand adjustment disorder[J].Prac J tried&Pharm,2004,21(10):914-918(In Chinese)
[5]Foa.E.B.,Riggs,D.S.,Dancu,C.V.,and Rothbaum,B.O.(1993).Reliability and validity of a brief instrument for assessing post-trauma-tic stress disorder[J].Journal of Traumatic Stress,6:459-473
[6]汪向东,王希林,马弘.心理卫生评定量表手册[J].中国心理卫生杂志社,1999增刊Wang Xiang-dong,Wang Xi-lin,Ma Hong.Rating scales for mentalhealth[J].Chinese Mental Health Journal,1999 a supplementary issue(In Chinese)
[7]崔红,牛晟,顾克胜,等.重大灾难救援人员心理应激状况的质性研究[J].中华保健医学杂志,2011,13(1):25-27Cui Hong,Niu Sheng,Gu Ke-sheng,et a1.Qualitative research on PT-SD symptoms among succors in major disasters[J].Journal of HealthCare And Medicine in Chinese PLA,2011,13(1):25-27(In Chinese)
[8]Sutker PB,UddoM,Brailey K.War-zone trauma and stress-related sy-mptoms in Operation Desert Shield Storm(ODS)returnees[J].Soc Issu-es,1993,49:33-49
[9]Ross MC,Wonder J.An exploration of the characteristics of post-trau-matic stress disorder in reserve forces deployed during Desert Storm[J].Arch Psychiatry Nurs,1993,7:265-269
[10]Perconte ST,Dietrick AL,Wilson AT.Psychological and war stresssymptoms among the deployed and non-deployed reservists followingthe Persian Gulf War[J].Mil Med,1993,158:516-521
[11]焦清艳,孔伶俐.社会支持对躯体形式障碍患者疗效的影响[J].精神医学杂志,2008,21(4):293-294Jiao Qing-yan,Kong Ling-li.Social support's curative effect on patie-nts with somatoform disorders[J].Journal of Psychiatry,2008,21(4):293-294(In Chinese)
[12]Jackson Y,Warren Js.Appraisal,social support,and life events:pred-icting outcome behavior in school-age children[J].Child Dev,2000,71(5):1441-1457
[13]Felice E,Saliba J,Grech V,et a1.Prevalence rates and psychosocialcharacteristics associated with depression in pregnancy and postpartu-m in Maltese women[J].J Afect Disord,2004,82(2):297-301
[14]黄文锋,徐富明.大学生学习适应性与一般自我效能感、社会支持的关系[J].中国临床心理学杂志,2004,12(4):369-370Huang Wen-feng,Xu Fu-ming.Relationship of College Students'Lea-rning Adaptability with General Self-efficacy and Social Support[J].Chinese Journal of Clinical Psychology,2004,12(4):369-370(In Chin-ese)
[15]甘景梨,杨代德,高存友,等.心理干预对新兵心理健康状况和适应能力影响的研究[J].中国行为医学科学,2003,12(1):76 Gan Jing-li,Yang Dai-de,Gao Cun-you,et a1.A study on psycholog-ical intervention to improve the psychological status and the adaptab-ility of the recruit[J].Chinese Journal of Behavioral Medical Science,2003,12(1):76(In Chinese)
[16]Bisson J,Andrew M.Psychological treatment of post-traumatic stress disorder(PTSD)[J].Cochrane Database Syst Rev,2007,18(3):CD0033-88Review
[17]Lagarde D.Pharmacological approach to desychronization of the sle-ep-wakefulness cycle in the military and sport environment[J].Ann Pharm Fr,2007,65(4):258-64Review
[18]赵静波,解亚宁,任忠文,等.高原军人的睡眠质量及其影响因素的研究[J].中国神经精神疾病杂志,2006,32(2):154-156 Zhao Jing-bo,Xie Ya-ning,Ren Zhong-wen,et a1.A study on sleep quality and its influencing factors of Soldiers at high altitude[J].Chi-nese Journal of Nervous and Mental Diseases,2006,32(2):154-156(In Chinese)
[19]崔红,胡军生.军人睡眠自适应量表的编制[J].中国临床心理学杂志,2011,19(1):31-34 Cui Hong,Hu Jun-sheng.Development and validation of the soldier sleep self-adaptation scale[J].Chinese Journal of Clinical Psychology,2011,19(1):31-34(In Chinese)
[20]Chang CM,Lee LC,Connor KM,et a1.Posttraumatic distress and c-oping strategies among rescue workers after an earthquake[J].J Nerv Ment Dis,2003,191(6):391-398
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