汶川地震安置点灾民急性应激障碍及影响因素分析
摘要
目的评估汶川地震后第2周安置点灾民的急性应激障碍(ASD)及影响因素。方法对江油市太平镇安置点灾民随机抽样后,利用斯坦福急性应激反应量表(SASRQ)、汉密尔顿抑郁量表(HRSD)、应激反应问卷(SRQ)、创伤后应激障碍(PTSD)症状清单平民版(PCL-C)及自编调查问卷进行评估,225名灾民完成调查。结果ASD阳性率为7.18%,有分离症状的38.12%,有创伤再体验症状的54.14%,有回避症状的38.67%,有焦虑或醒觉性增高症状的64.64%。SASRQ总分与PCL-C总分呈正相关(r=0.62,P<0.001)。不同年龄组的SASRQ总分(F=3.15,P=0.01)、分离症状(F=2.71,P=0.02)、焦虑或醒觉性增高(F=3.53,P=0.005)的差异有统计学意义,儿童组的急性应激症状较轻(P<0.05)。女性灾民的SASRQ总分(t=-2.199,P=0.03)、创伤再体验症状(t=-2.59,P=0.01)、回避症状(t=-2.195,P=0.03)、焦虑或醒觉性增高症状(t=-2.12,P=0.035)得分明显高于男性。有亲属遇难组的ASD创伤再体验症状分高于仅经济损失组(t=-2.16,P=0.03)。以ASD总分为因变量的线性回归分析结果显示,自杀观念、烦扰程度、最糟糕天数、文化程度进入回归方程(R=0.81,F=60.33,P<0.001)。结论灾民在地震发生后1周存在明显的急性应激症状,灾后心理干预应尤其关注女性等特殊人群,自杀观念、最糟糕天数以及烦扰程度可作为评估ASD的简易指标。
引文
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[2]温盛霖,王相兰,陶炯,等.四川江油太平镇安置点北川、平武地震灾民一周后心理症状分析[J].中国神经精神疾病杂志,2008,34(9):525-527.
[3]庞天鉴,译.DSM-分类与诊断标准.美国精神科学会,2001,170-172.
[4]Harvey AG,Bryant RA.Two-year prospective evaluation of the re-lationship between acute stress disorder and posttraumatic stress disorder following mild traumatic brain injury[J].Am J Psychia-try,2000,157(4):626-628.
[5]Staab JP,Grieger TA,Fullerton CS,et al.Acute stress disorder,subsequent posttraumatic stress disorder and depression after a se-ries of typhoons[J].Anxiety,1996,2(5):219-225.
[6]唐宏宇,郭延庆,姜荣环,等,译.Oxford Handbook of Psychiatry[M].北京:人民卫生出版社,2006.305-315.
[7]Cohen M.Acute stress disorder in older,middle-aged and younger adults in reaction to the second Lebanon war[J].Int J Geriatr Psy-chiatry,2008,23(1):34-40.
[8]Bryant RA,Harvey AG.Gender differences in the relationship be-tween acute stress disorder and posttraumatic stress disorder follow-ing motor vehicle accidents[J].Aust N Z J Psychiatry,2003,37(2):226-229.
[9]Kuo HW,Wu SJ,Ma TC,et al.Posttraumatic symptoms were worst among quake victims with injuries following the Chi-chi quake in Taiwan[J].J Psychosom Res,2007,62(4):495-500.
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