汶川大地震后重灾区青少年创伤后应激反应和抑郁情绪的研究

目的 评估"5.12"汶川大地震1个月后重灾区青少年的创伤后应激反应和抑郁障碍的严重性,并对其暴露因素进行相关分析,为早期心理干预提供依据.方法 采用自编地震暴露问卷、创伤后压力反应症状量表(UCLA PTSD Index for DSM-IV)、儿童抑郁自评量表(DSRSC),对278名汶川地震重灾区青少年进行调查.结果 青少年抑郁障碍检出率28.8%(80/278).创伤后应激反应检出率23.0%(64/278),创伤后应激反应指数和抑郁自评量表总数呈显著正相关( r =0.707,P <0.01).青少年抑郁障碍的影响因素为:性别( r =0.227,P <0.01)、以前对地震知识知道情况( r =-0.142,P <0.05)、受伤/死亡的老师/同学与自己的关系( r =0.133,P <0.05).引起青少年创伤后应激反应的影响因素为:性别( r =0.207,P <0.01)、受伤/死亡的老师/同学与自己的关系( r =0.159,P <0.01)、地震时是否在楼内( r =-0.137,P <0.05)、以前对地震知识知道情况( r =-0.122,P <0.05).结论 发现重灾区青少年的心理健康状况受到一定影响,其影响程度与灾难暴露程度等因素显著相关;需要进一步进行相关的随访研究,从而最大限度地减少地震灾难对青少年带来的不利影响.

A study of the post-traumatic stress and depressive reactions of adolescents in the severe disaster areas after the Wenchuan earthquake

Objective To evaluate the severity of the adolescents's post-traumatic stress and depressive reactions of adolescents in the severe disaster areas 1 months after the 5.12 earthquake, and to find it's exposure factors.Methods Based on the classes,using the earthquake exposure questionnaire that made by ourselves,UCLA PTSD Index for DSM-IV,Depression Self-rating Scale for Children(DSRSC);278 adolescents were investigated adopting stratified random cluster sampling method.Results The incidence of adolescents on depressive disorder was 28.8%(80/278) and the incidence on post-traumatic stress reaction was 23.0% (64/278). There were positively corrections between the reaction index of post-traumatic stress disorder and the scores of DSRSC( r =0.707,P <0.001).Depression in adolescents influencing factors were sex( r =0.227,P <0.001), his/her former knowledge of earthquake( r =-0.142,P <0.05),the relation between the student and the hurt/dead teacher/classes( r =0.133,P <0.05).Arising from post-traumatic stress disorder of adolescents influencing factors were sex( r =0.207,P <0.001),the relation between the student and the hurt/dead teacher/classes( r =0.159,P <0.05),where he/she was when the earthquake happened( r =-0.137,P <0.05),his/her former knowledge of earthquake( r =-0.122,P <0.05).Conclusion The mental health of adolescents in the severe disaster areas are seriously impacted. There are significent corrections between the impact degree and the extent of disaster exposure.For further follow-up study will be explored in order to minimize the earthquake disaster on the negative impact of young people.