团体干预对地震灾区初中生创伤后应激和抑郁症状的作用
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摘要
目的:探索团体干预是否有助于缓解地震灾区初中生的创伤后应激症状和抑郁症状。方法:在汶川地震发生后6个月,以方便取样的原则选取四川彭州地区某学校初二的2个班级,1个班为对照组(n=38),另1个班为干预组(n=47),对干预组实施以提高社会支持为目标的班级团体干预方案(共2周,每周2次)。用儿童事件影响量表(Children's Revised Impact of Event Scale,CRIES)和儿童抑郁量表(Children's Depression Inventory,CDI)进行测量,比较两组在干预前(前测)、干预2周后(后测)及干预结束4个月后(追踪)CRIES和CDI得分的变化。结果:在CRIES得分上,组别和测量时间交互作用显著,前测时两组得分差异无统计学意义(P>0.05),干预2周后,两组的CRIES得分均降低,但干预结束4个月后,干预组得分持续降低,而对照组升高;在CDI得分上,组别和测量时间交互作用不显著。在3个时间点上,干预组得分始终低于对照组,并且两组CDI得分均持续降低,干预组下降程度要高于对照组(P<0.01)。结论:团体干预能够在短期内降低初中生的创伤后应激症状和抑郁水平。在干预结束后较长时间内,干预的作用持续存在。
Object:To test the effects of social support enhancement group on depression and post-traumatic stress symptoms in junior middle school students.Methods:A social support and self-esteem enhancement group was conducted for Junior 2 students in Pengzhou City,Sichuan Province.Both the intervention group and the control group completed the Children's Revised Impact of Event Scale(CRIES) and Children's Depression Inventory(CDI) before and after the intervention.The effect of intervention was evaluated by the comparison of the two group's scores in both scales.Result:There was interaction effect between group and time on the score of CRIES.No significant difference was found in the pre-intervention test between the two groups[(19.4±12.0)vs.(22.4±10.8),P>0.05].After 2-week intervention,both the two groups decreased in the score of CRIES.However,the intervention group continued to decrease after 4 months while the control group had an increase.No significant interaction effect was found between group and time on the scores of CDI.The control group had higher scores than the intervention group in the three tests.Both of the two groups decreased in CDI scores,but the intervention group decreased more(P<0.01).Conclusion:This study shows that the short-term group intervention can effectively alleviate depression and post-trauma stress symptoms in junior middle school students in long term.The intervention can prevent the relapse of the post-traumatic stress symptoms.
Object:To test the effects of social support enhancement group on depression and post-traumatic stress symptoms in junior middle school students.Methods:A social support and self-esteem enhancement group was conducted for Junior 2 students in Pengzhou City,Sichuan Province.Both the intervention group and the control group completed the Children's Revised Impact of Event Scale(CRIES) and Children's Depression Inventory(CDI) before and after the intervention.The effect of intervention was evaluated by the comparison of the two group's scores in both scales.Result:There was interaction effect between group and time on the score of CRIES.No significant difference was found in the pre-intervention test between the two groups[(19.4±12.0)vs.(22.4±10.8),P>0.05].After 2-week intervention,both the two groups decreased in the score of CRIES.However,the intervention group continued to decrease after 4 months while the control group had an increase.No significant interaction effect was found between group and time on the scores of CDI.The control group had higher scores than the intervention group in the three tests.Both of the two groups decreased in CDI scores,but the intervention group decreased more(P<0.01).Conclusion:This study shows that the short-term group intervention can effectively alleviate depression and post-trauma stress symptoms in junior middle school students in long term.The intervention can prevent the relapse of the post-traumatic stress symptoms.
引文
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[12]汪智艳,高隽,邓晶,等.修订版儿童事件影响量表在地震灾区初中学生中的信效度[J].中国心理卫生杂志2010,24(6):463-466.
[13]俞大维,李旭.儿童抑郁量表(CDI)在中国儿童中的初步运用[J].中国心理卫生杂志,2000,14(4):225-227.
[14]Ken Lee.心理康复技术工作坊[R].北京,2009.
[15]Reich W,Shayka JJ.The Diagnostic Interview for Children andAdolescents-Revised.St.Louis,MO[R].Washington:De-partment of Psychiatry,Washington University,1991.
[16]Pynoos RS,Fredrick C,Nader K,et al.Life threat and postt-raumatic stress in school-aged children[J].Arch Genl Psychia-try,1987,44(12):1057-1063.
[17]Wolfe VV,Gentile C,Michienzi T,et al.The Children's Im-pact of Traumatic Events Scale:a measure of post-sexual-abusePTSD symptoms[J].Behav Assess,1991,13(4):359-383.
[18]程族桁,王奕冉.团体心理辅导对大学新生抑郁焦虑症状的治疗效果研究[J].中国健康心理学杂志,2008,16(8):843-844.
[19]裴利华.人际关系团体咨询对大学生抑郁症状的干预探讨[J].中国健康心理学杂志,2006,14(4):371-373.
[20]向群英.贫困大学生抑郁心理的干预研究-团体心理辅导与自我教育[J].西南交通大学学报(社会科学版),2008,9(1):27-32.
[2]王相兰,陶炯,温盛霖,等.汶川地震灾民的心理健康状况及影响因素[J].中山大学学报(医学科学版),2008,9(4):367-371.
[3]张毅,司徒明镜,方慧,等.汶川大地震灾区儿童青少年的地震经历与抑郁情绪[J].华西医学,2009,24(1):21-24.
[4]张本,王学义,孙贺祥,等.唐山大地震所致孤儿心理创伤后应激障碍的调查[J].中华精神科杂志,1999,33(2):11l-114.
[5]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.
[6]阳德华.大学生抑郁、焦虑的影响因素调查[J].中国心理卫生杂志,2004,18(5):253-254.
[7]Bisson JI,Brayne M,Ochberg FM,et al.Early psychosocialintervention following traumatic events[J].Am J Psychiatry,2007,164(7):1016-1019.
[8]赵景欣,刘霞,申继亮.留守青少年的社会支持网络与其抑郁、孤独之间的关系-基于变量中心和个体中心的视角[J].心理发展与教育,2008,24(1):36-42.
[9]Kaniasty KZ.Social support as a mediator of stress following nat-ural disaster:A test of a social support deterioration model usingmeasures of kin support,nonkin support,and social embedded-ness[R].Dessertation:University of Louisvill,1991.
[10]Sattler DN,de Alvarado AM,de Castro NB,et al.El Salvadorearthquakes:Relationships among acute stress disorder symp-toms,depression,traumatic event exposure,and resource loss[J].J Traumat Stress,2006,19(6):879.
[11]Udwin O,Boyle S,Yule W,et al.Risk factors for long-termpsychological effects of a disaster experienced in adolescence:Predictors of post traumatic stress disorder[J].J Child PsycholPsychiatry Allied Discipl,2000,41(8):969.
[12]汪智艳,高隽,邓晶,等.修订版儿童事件影响量表在地震灾区初中学生中的信效度[J].中国心理卫生杂志2010,24(6):463-466.
[13]俞大维,李旭.儿童抑郁量表(CDI)在中国儿童中的初步运用[J].中国心理卫生杂志,2000,14(4):225-227.
[14]Ken Lee.心理康复技术工作坊[R].北京,2009.
[15]Reich W,Shayka JJ.The Diagnostic Interview for Children andAdolescents-Revised.St.Louis,MO[R].Washington:De-partment of Psychiatry,Washington University,1991.
[16]Pynoos RS,Fredrick C,Nader K,et al.Life threat and postt-raumatic stress in school-aged children[J].Arch Genl Psychia-try,1987,44(12):1057-1063.
[17]Wolfe VV,Gentile C,Michienzi T,et al.The Children's Im-pact of Traumatic Events Scale:a measure of post-sexual-abusePTSD symptoms[J].Behav Assess,1991,13(4):359-383.
[18]程族桁,王奕冉.团体心理辅导对大学新生抑郁焦虑症状的治疗效果研究[J].中国健康心理学杂志,2008,16(8):843-844.
[19]裴利华.人际关系团体咨询对大学生抑郁症状的干预探讨[J].中国健康心理学杂志,2006,14(4):371-373.
[20]向群英.贫困大学生抑郁心理的干预研究-团体心理辅导与自我教育[J].西南交通大学学报(社会科学版),2008,9(1):27-32.
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