地震后半年未愈伤员创伤后应激障碍调查
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摘要
目的:探讨汶川地震灾后半年,震伤未愈伤者创伤后应激障碍(PTSD)的发生率和相关因素。方法:选取成都市某医院地震伤员康复中心未愈伤者58例,采用自制一般情况问卷、心理健康自评问卷、分离性体验量表、PTSD自评量表和特质应对方式问卷进行测评。结果:未愈伤者在地震灾后半年患PTSD者占41.4%;男性伤者中残疾率28.6%和PTSD发生率28.6%明显低于女性伤者的46.7%和53.3%(P<0.05)。创伤后应激水平与积极应对方式呈正相关(r=0.483,P<0.01);和消极应对方式呈负相关(r=-0.449,P<0.01)。伤者中分离水平极低,遗忘和创伤后应激水平呈正相关(r=0.541,P<0.01);残疾、低社会支持和创伤后应激水平显著相关(r=0.642,P<0.05)。结论:地震灾后半年,震伤未愈伤者PTSD患病率较高,残疾、社会支持差、遗忘水平高、消极的应对方式是震伤未愈者发生PTSD的主要相关因素,应给予充分的药物及心理治疗。
Objective:To study the incidence rate and relevant factors of post-traumatic stress disorder(PTSD)that occurs in the wounded,who still stay in hospital half a year after the Wenchuan earthquake.Method:Select 58 uncured wounded of a rehabilitation centre for earthquake injured in Chengdu,and assess them with self reporting questionnaire,dissociative experience scale,post-taumatic stress disorder self-rating scale and coping styles questionnaire.Results:41.4% of those wounded of earthquake who still stay in hospital had PTSD.The rate of disability and PTSD in male(28.57% and 28.6%)were significantly lower than female(46.7% and 53.3%,P<0.05).The level of post-traumatic stress was positively correlated with positive coping styles(r=0.483,P<0.01),and was negatively correlated with negative coping styles(r=-0.449,P<0.01).The level of dissociative was very low,amnesia was positively correlated with that of post-traumatic stress(r=0541,P<0.01).Disability and the low grades of social support were significantly correlated with the lever of post-traumatic stress(r=0.642,P<0.05).Conclusion:Wounded who still stay in hospital half a year after the earthquake had high rate of suffering from PTSD.Disability,low grades of social support,high level of amnesia and negative coping styles were the main factors of PTSD,which should be give enough drug treatment and psychotherapy.
Objective:To study the incidence rate and relevant factors of post-traumatic stress disorder(PTSD)that occurs in the wounded,who still stay in hospital half a year after the Wenchuan earthquake.Method:Select 58 uncured wounded of a rehabilitation centre for earthquake injured in Chengdu,and assess them with self reporting questionnaire,dissociative experience scale,post-taumatic stress disorder self-rating scale and coping styles questionnaire.Results:41.4% of those wounded of earthquake who still stay in hospital had PTSD.The rate of disability and PTSD in male(28.57% and 28.6%)were significantly lower than female(46.7% and 53.3%,P<0.05).The level of post-traumatic stress was positively correlated with positive coping styles(r=0.483,P<0.01),and was negatively correlated with negative coping styles(r=-0.449,P<0.01).The level of dissociative was very low,amnesia was positively correlated with that of post-traumatic stress(r=0541,P<0.01).Disability and the low grades of social support were significantly correlated with the lever of post-traumatic stress(r=0.642,P<0.05).Conclusion:Wounded who still stay in hospital half a year after the earthquake had high rate of suffering from PTSD.Disability,low grades of social support,high level of amnesia and negative coping styles were the main factors of PTSD,which should be give enough drug treatment and psychotherapy.
引文
[1]胡建波,黄满丽,黄文武,等.心理健康自评问卷在汶川地震受灾人群中应用的信效度分析[J].中华预防医学杂志,2008,11:810-813.
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[3]刘贤臣,马登岱,刘连启,等.心理创伤后应激障碍自评量表的编制和信度效度研究[J].中国行为医学科学,1998,2:93-96.
[4]姜乾金,黄丽,卢杭生,等.心理应激-应对的分类与心身健康[J].中国心理卫生杂志,1993,7:145-147.
[5]张义,党海红.创伤后应激障碍社会心理学危险因素[J].临床心身疾病杂志,2008,14:186-192.
[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,1999,13:28-30.
[7]李洁,郭建雄,徐文军,等.四川汶川地震伤员的心理卫生状况调查[J].中国神经精神疾病杂志,2008,34:523-524.
[8]Candel I,Merckelbach H.Dissociation as a predictor of post-trau-matic stress disorder:a critical review[J].Compr Psychiatry,2004,45:44-50.
[9]Morgan CA,Hazlett G,Wang S,et al.Symptoms of dissociation in humans experiencing acute,uncontrollable stress:a prospective in-vestigation[J].AMJ Psychiatry,2001,158:1239-1247.
[10]马萍,潘集阳.PTSD的预测因素[J].中山大学学报,2008,29:378-382.
[11]Feeny NC,Zoellner LA,Fitzgibbons LA,et al.Exploring the roles of emotional numbing,depression,and dissociation in PTSD[J].J Traumatic stress,2000,13:489-498.
[2]方莉,刘协和.分离体验量表Ⅱ的信度与效度检测[J].中国临床康复,2006,42:1-4.
[3]刘贤臣,马登岱,刘连启,等.心理创伤后应激障碍自评量表的编制和信度效度研究[J].中国行为医学科学,1998,2:93-96.
[4]姜乾金,黄丽,卢杭生,等.心理应激-应对的分类与心身健康[J].中国心理卫生杂志,1993,7:145-147.
[5]张义,党海红.创伤后应激障碍社会心理学危险因素[J].临床心身疾病杂志,2008,14:186-192.
[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,1999,13:28-30.
[7]李洁,郭建雄,徐文军,等.四川汶川地震伤员的心理卫生状况调查[J].中国神经精神疾病杂志,2008,34:523-524.
[8]Candel I,Merckelbach H.Dissociation as a predictor of post-trau-matic stress disorder:a critical review[J].Compr Psychiatry,2004,45:44-50.
[9]Morgan CA,Hazlett G,Wang S,et al.Symptoms of dissociation in humans experiencing acute,uncontrollable stress:a prospective in-vestigation[J].AMJ Psychiatry,2001,158:1239-1247.
[10]马萍,潘集阳.PTSD的预测因素[J].中山大学学报,2008,29:378-382.
[11]Feeny NC,Zoellner LA,Fitzgibbons LA,et al.Exploring the roles of emotional numbing,depression,and dissociation in PTSD[J].J Traumatic stress,2000,13:489-498.
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