中小学生注意偏向和焦虑抑郁情绪与创伤后应激障碍症状的关系

目的 考察新冠肺炎疫情暴发后消极注意偏向与创伤后应激障碍(PTSD)症状在抑郁、焦虑负向情绪作用下的关系,为中小学校开展心理教育提供科学依据。方法 2021年3—4月,采用方便整群方法抽取北京、山西、湖南、山东、河北、湖北省的小学六年级至初三708名学生,采用事件冲击量表(儿童版)、中文版积极/消极注意偏向量表、抑郁-焦虑-压力量表进行问卷调查。结果 中小学生PTSD共检出242名,检出率为34.2%。男生在闯入、高唤醒维度上得分(7.92±5.33,8.60±5.41)低于女生(8.72±4.85,9.50±4.76),差异均有统计学意义(t值分别为-2.04,-2.32,P值均<0.05);不同年级中小学生在消极注意偏向、事件冲动量表总分及闯入、回避、高唤醒维度得分差异均有统计学意义(F值分别为3.57,5.99,4.45,4.60,7.40,P值均<0.05);消极注意偏向、焦虑、抑郁与PTSD症状之间均呈正相关(r=0.27～0.84,P值均<0.05)。Logistic回归分析显示,焦虑(OR=1.13,95%CI=1.06～1.20)和消极注意偏向(OR=...     

汶川地震后儿童青少年创伤后应激障碍和抑郁症状及影响因素

目的 研究汶川地震对儿童青少年心理问题造成影响的相关因素.方法 样本来自成都、都江堰、北川、汶川等地,分别选取受地震影响严重的12所中、小学,采用自编的一般情况调查表、儿童事件影响量表(CRIES-13)、儿童抑郁障碍自评量表(DSRC),调查上述学校儿童青少年在震后3、6、24个月后的心理卫生状况.3、6、24个月调查有效的学生人数分别为:7341名、7387名、7395名.采用多因素logistic回归模型分析创伤后应激障碍(PTSD)和抑郁障碍的危险因素.结果 震后3、6、24个月CRIES-13量表总分分别为(27.51±12.26)、(23.54 4-12.79)、(21.35±12.59)分(F=28.842,P≤0.05);DSRSC量表总分分别为(11.79±5.73)、(10.94±5.50)、(10.75 ±5.27)分(F=17.084,P≤0.05).震后3、6、24个月时与DSRSC得分相关的危险因素是女性(OR值分别为2.14、2.72、2.31,95%CI/值分别为1.01～3.03、1.10～5.01、1.02～4.58),年龄小于12岁(OR值分别为1.97、2.22、1.93,95%CI值分别为1.43～3.17、1.02～3.54、1.32～3.27),家人伤亡(OR值分别为2.19、2.45、2.35,95%CI值分别为1.04～2.89、1.16～2.08、1.02～2.79),绝望感(OR值分别为2.24、2.09、2.16,95%CI值分别为1.00～2.54、1.70～2.58、1.00～4.56);震后3、6、24个月时与CRIES-13得分均相关的危险因素为女性(OR值分别为2.16、2.94、1.96,95%CI值分别为1.36～2.53、1.36～2.53、1.06～3.92),年龄小于12岁(OR值分别为3.51、2.62、1.92,95%CI值分别为1.22～5.40、1.14～4.93、1.08～3.35),同学老师伤亡(OR值分别为2.32、2.48、2.36,95%CI值分别为1.17～2.48、1.30～2.72、1.02～2.85),家人伤亡(OR值分别为2.73、2.21、1.85,95%CI值分别为1.67～3.61、1.04～3.15、1.05～2.38),目睹受伤(OR值分别为2.17、2.36、2.34,95%CI值分别为1.15～3.65、1.17～2.67、1.02～3.67),目睹死亡(OR值分别为1.98、2.39、1.71,95%CI值分别为1.10～2.56、1.14～3.70、1.57～3.88),绝望感(OR值分别为2.02、1.94、2.02,95%CI值分别为1.67～2.35、1.66～2.27、1.82～2.26).结论 汶川地震灾区儿童青少年幸存者PTSD及抑郁症状随时间的推移逐渐减少,年龄小于12岁、女性、家人有伤亡和震时绝望感等是影响灾后儿童青少年心理健康的主要危险因素.

Abstract：

Objective This study was to analyze the mental health status of the children and adolescents from the areas struck by Wenchuan earthquake and to understand the factors that may have impact on their mental health after exposing to the earthquake.Methods Subjects of this survey were tudents(8-16 years old)from Chendu,Dujiangyan,Beichuan and Wenchuan districts which were the most severely affected areas in the earthquake.We analyzed the subjects'mental health conditions after Wenchuan earthquake by using a general questionnaire that was composed of the Children's Revised Impact of Event Scale(CRIES-13)and Depression Self-rating Scale for Children(DSRSC).Students are investigated 7341 case,7387 case,7395 case after 3,6,24 months.The data were analyzed with logistic regression model.Results The CRIES-13 scores were(27.51±12.26),(23.54±12.79)and(21.35±12.59)(F=28.842,P≤0.05)and the DSRSC scores were(11.79±5.73),(10.94±5.50)and(10.75±5.27)(F=17.084,P≤0.05)3,6 and 24 months after the earthquake,respectively.The risk factors associated with depression 3,6,24 months after the earthquake were gender(female)(OR values were 2.14,2.72,2.31：95％CI values were 1.01-3.03,1.10-5.01,1.02-4.58),age(less than 12 years old)(OR values were 1.97,2.22,1.93;95％CI values were 1.43-3.17,1.02-3.54,1.32-3.27),having family member iniury and death(OR values ware 2.19,2.45,2.35;95％CI valves were 1.04-2.89,1.16-2.08,1.02-2.79),desperation(OR values were 2.24,2.09,2.16;95％CI values were 1.00-2.54,1.70-2.58,1.00-4.56).The risk factors associated with PTSD 3,6.24 months after the earthquake were gender(OR values were 2.16,2.94,1.96;95％CI values were 1.36-2.53,1.36-2.53,1.06-3.92),age(less than 12 years old)(OR values were 3.51,2.62,1.92;95％CI values were 1.22-5.40,1.14-4.93,1.08-3.35),having teachers and schoolmates injury and death(OR values were 2.32,2.48,2.36;95％CI values were 1.17-2.48,1.30-2.72,1.02-2.85),having family member injury and death(OR values were 2.73,2.21,1.85;95％CI valties were 1.67-3.61,1.04-3.15,1.05-2.38),witnessing injury(OR values were 2.17,2.36,2.34;95％CI values were 1.15-3.65,1.17-2.67,1.02-3.67),witnessing death(OR values were 1.98,2.39,1.71;95％CI values were 1.10-2.56,1.14-3.70,1.57-3.88),desperation(OR values were 2.02,1.94,2.02;95％CI values were 1.67-2.35,1.66-2.27,1.82-2.26).Conclusion The symotoms of PTSD and depression of young survivors from the earthquake-struck areas had gradually alleviated 3,6,24 months after the earthquake.Age(less than 12 years old),gender (female),having family member injury and death,witnessing injury and death,and desperation were the main risk factors that affected the children and adolescents mental health.     

汶川地震后儿童青少年创伤后应激障碍和抑郁症状及影响因素

Objective This study was to analyze the mental health status of the children and adolescents from the areas struck by Wenchuan earthquake and to understand the factors that may have impact on their mental health after exposing to the earthquake.Methods Subjects of this survey were tudents(8-16 years old)from Chendu,Dujiangyan,Beichuan and Wenchuan districts which were the most severely affected areas in the earthquake.We analyzed the subjects'mental health conditions after Wenchuan earthquake by using a general questionnaire that was composed of the Children's Revised Impact of Event Scale(CRIES-13)and Depression Self-rating Scale for Children(DSRSC).Students are investigated 7341 case,7387 case,7395 case after 3,6,24 months.The data were analyzed with logistic regression model.Results The CRIES-13 scores were(27.51±12.26),(23.54±12.79)and(21.35±12.59)(F=28.842,P≤0.05)and the DSRSC scores were(11.79±5.73),(10.94±5.50)and(10.75±5.27)(F=17.084,P≤0.05)3,6 and 24 months after the earthquake,respectively.The risk factors associated with depression 3,6,24 months after the earthquake were gender(female)(OR values were 2.14,2.72,2.31：95％CI values were 1.01-3.03,1.10-5.01,1.02-4.58),age(less than 12 years old)(OR values were 1.97,2.22,1.93;95％CI values were 1.43-3.17,1.02-3.54,1.32-3.27),having family member iniury and death(OR values ware 2.19,2.45,2.35;95％CI valves were 1.04-2.89,1.16-2.08,1.02-2.79),desperation(OR values were 2.24,2.09,2.16;95％CI values were 1.00-2.54,1.70-2.58,1.00-4.56).The risk factors associated with PTSD 3,6.24 months after the earthquake were gender(OR values were 2.16,2.94,1.96;95％CI values were 1.36-2.53,1.36-2.53,1.06-3.92),age(less than 12 years old)(OR values were 3.51,2.62,1.92;95％CI values were 1.22-5.40,1.14-4.93,1.08-3.35),having teachers and schoolmates injury and death(OR values were 2.32,2.48,2.36;95％CI values were 1.17-2.48,1.30-2.72,1.02-2.85),having family member injury and death(OR values were 2.73,2.21,1.85;95％CI valties were 1.67-3.61,1.04-3.15,1.05-2.38),witnessing injury(OR values were 2.17,2.36,2.34;95％CI values were 1.15-3.65,1.17-2.67,1.02-3.67),witnessing death(OR values were 1.98,2.39,1.71;95％CI values were 1.10-2.56,1.14-3.70,1.57-3.88),desperation(OR values were 2.02,1.94,2.02;95％CI values were 1.67-2.35,1.66-2.27,1.82-2.26).Conclusion The symotoms of PTSD and depression of young survivors from the earthquake-struck areas had gradually alleviated 3,6,24 months after the earthquake.Age(less than 12 years old),gender (female),having family member injury and death,witnessing injury and death,and desperation were the main risk factors that affected the children and adolescents mental health.     

汶川地震后儿童青少年创伤后应激障碍和抑郁症状及影响因素

Objective This study was to analyze the mental health status of the children and adolescents from the areas struck by Wenchuan earthquake and to understand the factors that may have impact on their mental health after exposing to the earthquake.Methods Subjects of this survey were tudents(8-16 years old)from Chendu,Dujiangyan,Beichuan and Wenchuan districts which were the most severely affected areas in the earthquake.We analyzed the subjects'mental health conditions after Wenchuan earthquake by using a general questionnaire that was composed of the Children's Revised Impact of Event Scale(CRIES-13)and Depression Self-rating Scale for Children(DSRSC).Students are investigated 7341 case,7387 case,7395 case after 3,6,24 months.The data were analyzed with logistic regression model.Results The CRIES-13 scores were(27.51±12.26),(23.54±12.79)and(21.35±12.59)(F=28.842,P≤0.05)and the DSRSC scores were(11.79±5.73),(10.94±5.50)and(10.75±5.27)(F=17.084,P≤0.05)3,6 and 24 months after the earthquake,respectively.The risk factors associated with depression 3,6,24 months after the earthquake were gender(female)(OR values were 2.14,2.72,2.31：95％CI values were 1.01-3.03,1.10-5.01,1.02-4.58),age(less than 12 years old)(OR values were 1.97,2.22,1.93;95％CI values were 1.43-3.17,1.02-3.54,1.32-3.27),having family member iniury and death(OR values ware 2.19,2.45,2.35;95％CI valves were 1.04-2.89,1.16-2.08,1.02-2.79),desperation(OR values were 2.24,2.09,2.16;95％CI values were 1.00-2.54,1.70-2.58,1.00-4.56).The risk factors associated with PTSD 3,6.24 months after the earthquake were gender(OR values were 2.16,2.94,1.96;95％CI values were 1.36-2.53,1.36-2.53,1.06-3.92),age(less than 12 years old)(OR values were 3.51,2.62,1.92;95％CI values were 1.22-5.40,1.14-4.93,1.08-3.35),having teachers and schoolmates injury and death(OR values were 2.32,2.48,2.36;95％CI values were 1.17-2.48,1.30-2.72,1.02-2.85),having family member injury and death(OR values were 2.73,2.21,1.85;95％CI valties were 1.67-3.61,1.04-3.15,1.05-2.38),witnessing injury(OR values were 2.17,2.36,2.34;95％CI values were 1.15-3.65,1.17-2.67,1.02-3.67),witnessing death(OR values were 1.98,2.39,1.71;95％CI values were 1.10-2.56,1.14-3.70,1.57-3.88),desperation(OR values were 2.02,1.94,2.02;95％CI values were 1.67-2.35,1.66-2.27,1.82-2.26).Conclusion The symotoms of PTSD and depression of young survivors from the earthquake-struck areas had gradually alleviated 3,6,24 months after the earthquake.Age(less than 12 years old),gender (female),having family member injury and death,witnessing injury and death,and desperation were the main risk factors that affected the children and adolescents mental health.     

汶川大地震后女性内分泌紊乱与创伤后应激障碍的相关性调查

目的探讨汶川大地震后女性内分泌紊乱与创伤后应激障碍(PTSD)的相关性,为其临床防治提供有效措施。方法采用横断面调查和队列随访研究方案,收集1 000例汶川大地震后妇女为研究对象,根据是否发生内分泌紊乱分为两组:内分泌失调组477例和内分泌正常组523例。分别采用自制调查量表、PTSD症状清单平民版调查其一般情况和PTSD患病情况,并抽取所有研究对象的外周静脉血,采用ELISA实验测定雌激素与孕激素水平,分析PTSD症状评分与血清激素水平的相关性。结果调查对象中发生内分泌失调477例,占47.7%,内分泌失调组年龄偏大,地震时在建筑物内、房屋倒塌、受伤、掩埋、家庭成员伤亡的发生率偏高,地震后获得居所所需时间更长,食物短缺和药物短缺的比例更高,组间差异均有统计学意义(均P0.05)。内分泌失调组PTSD发生率和症状评分高于内分泌正常组,血清雌二醇(E_2)、孕激素(P)和卵泡刺激素(FSH)水平低于内分泌正常组,组间差异均有统计学意义(均P0.05);经相关性分析,PTSD症状评分与血清E_2、P和FSH水平呈直线负相关关系(P0.05)。结论汶川大地震后女性内分泌紊乱可能是PTSD的信号,应引起重视,做好临床防治工作。     

唐山大地震所致心理创伤后应激障碍患者神经内分泌的研究

目的：研究唐山大地震所致慢性创伤后应激障碍患基础血清皮质醇浓度和地塞米松抑制试验。方法：唐山大地震所致创伤后应激障碍35例（研究组）和33例正常人（对照组）接受了基础血清皮质醇的水平的测定和地塞米松抑制试验。结果：两组基础血清皮质醇水平比较无显性差异，两组各自男女之间基础血清皮质醇水平分别比较亦无显性差异。两组服用相同剂量的地塞米松后，研究组基础血清皮质醇水平显低于对照组和对地塞米松的抑制作用显高于对照组。两组男女之间的基础血清皮质醇水平、服用地塞米松后血清皮质醇水平和对地塞米松的抑制率比较无显性差异。结论：唐山大地震所致慢性PTSD患对糖皮质激素的敏感性增高而导致PHA轴负反馈抑制增强，男女之间无差异。     

汶川大地震中、小学生创伤后应激障碍影响因素的多水平模型分析

[目的]客观分析汶川大地震后中、小学生的创伤后应激障碍(Post-traumatic Stress Disorder,PTSD)的影响因素,为地震后心理干预工作提供信息和依据。[方法]运用多水平模型对极重灾区45个中小学校的4282名中小学生的创伤后应激障碍的影响因素进行分析,采用SAS9.2统计软件的PROC MIXED过程分析实现。[结果]创伤后应激障碍筛查量表得分确实在学校水平存在聚集性;汶川大地震中、小学生PTSD的影响因素有:性别、年龄、是否有亲人朋友遇难、是否看到遗体和残肢、是否受伤、震前震后一起生活的人是否一样,前4个因素对PTSD症状得分的影响在学校水平上有差异。[结论]具有层次结构的心理研究资料运用多水平模型进行分析能得到更多的信息;不应忽视学校环境对灾区中小学生心理状况的影响。     

创伤后应激障碍及其躯体症状

2001年9月11日对美国世界贸易中心和五角大楼的恐怖袭击已成为人与人之间暴力、损失和灾难的代表性事件,当时被掩埋致死和失踪者达数千人,数万人在恐惧中逃生,或置身于死亡现场,或失去最爱的亲人;据估计有10万多人直接目击了这一事件,并且在世界各地有许多人通过媒体也目睹了这一恐怖场景.根据此前1995年美国俄克拉何马城爆炸案发生后获得的资料,人们可以预期在直接暴露于9月11日恐怖袭击的人群中,约有35%将出现一种严重的心理障碍,称为创伤后应激障碍(Post Traumatic Stress Disorder,PTSD)[1].     

焦虑、抑郁对创伤性骨折患者急性应激障碍的影响

摘要:目的　了解创伤性骨折患者急性应激障碍情况及其抑郁、焦虑与其的相关性,为采取应对措施提供依据。方法　对2014年5-10月唐山市骨科医院住院的创伤性骨折患者496例,采用一般资料、斯坦福急性应激反应问卷和医院焦虑抑郁量表进行调查。结果　496例患者SASRQ分均值为（32.09±25.01）分,133名患者存在急性应激障碍,占26.8%,性别、年龄、婚姻状况以及焦虑和抑郁进入回归方程,焦虑、抑郁在SASRQ总分及各个维度评分均大于非焦虑、抑郁者（焦虑、抑郁者SASRQ总分t分别为2.678,2.778,各维度t＝16.152～25.791）,差异有统计学意义（P＜0.05）。结论　焦虑和抑郁是创伤性骨折患者发生急性应激障碍的影响因素,应引起重视。     

车祸所致创伤后应激障碍的临床研究

目的 研究车祸所致创伤后应激障碍的发生情况及特点。方法 应用中国精神疾病分类方案与诊断标准第二版修订本中的急性应激障碍（ASR）和创伤后应激障碍（PTSD）诊断标准，对曾因车祸住我院治疗81例患进行诊断，按有无PTSD分为PTSD组和非PTSD组，采用症状自评量表（SCL－90），艾森克个性问卷（EPQ）及症状记录表等进行测评和比较。结果 车祸后3个月，81例中有33例（40．7％）符合ASR诊断标准，31例（38．3％）符合PSD诊断标准。与非PTSD组比较，PTSD组SCL－90总分、阳性项目数、阴性项目数及躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、其它因子分均高（P＜0．05－0．01）。PTSD组情绪稳定性倾向不稳定型（38．71％）的比率显高于对照组（P＜0．01），而中间型的(35．48％）显低于非PTSD组（P＜0．01）。对PTSD发病因素进行Logistic回归分析，进入回归方程的自变量为N、L及性别。结论 车祸所致PTSD并非罕见的精神障碍，且女性、情绪倾向不稳定、掩饰性高的个体车祸后患PTSD的危险性高。应主动提供心理干预。     

绍兴初中生学校生活满意度与抑郁焦虑症状关系

目的 了解初中生学校生活满意度与抑郁、焦虑症状的关系和相互作用,为实施心理健康教育提供依据。方法 采用青少年学校生活满意度问卷、儿童抑郁症状障碍自评量表、儿童焦虑性情绪障碍筛查表对浙江省绍兴市2所初中的3 197名学生进问卷调查。结果 绍兴市初中生学校生活不满意、抑郁症状、焦虑症状检出率分别为24.55%、38.04%、19.74%,学校生活满意度与抑郁、焦虑症状呈负相关关系（r=-0.378、-0.182,均P<0.001）;抑郁、焦虑症状评分随着学校生活满意度评分的升高而逐渐降低（均P<0.001）;多因素logistic回归分析结果显示,抑郁、焦虑症状是学校生活不满意的危险因素,其OR值（95%CI）分别为2.830（2.353～3.404）、1.396（1.130～1.725）。结论 绍兴市初中生抑郁、焦虑症状流行情况不容乐观,学校生活满意度与抑郁、焦虑症状的发生密切相关。     

汶川地震后重灾区中学生创伤后应激障碍的随访研究

目的 了解汶川地震后1年内重灾区中学生创伤后应激障碍(PTSD)随时间变化趋势以及相关影响因素.方法 采用一般情况问卷和标准心理量表(PTSD自评量表、领悟社会支持量表),分别于震后3、6、9和12个月对汶川县3所中学1966名中学生进行自填式问卷随访调查,通过建立多水平随机系数模型,分析研究对象PTSD随时间的变化趋势及相关危险因素.结果 全程参与灾后PTSD随访研究并获得有效问卷者共1677名.震后3、6、9和12个月,研究对象PTSD总分分别为(35.14±11.08)、(32.90±11.03)、(30.67±11.28)和(29.75±11.22)分,筛查阳性率分别为36.6%(613/1677)、30.7%(515/1677)、24.8%(416/1677)和22.2%(373/1677).领悟社会支持系统得分中位数为60.00分,存在问题者筛查阳性率为17.20%(289/1677).震后1年内,随着时间的推移,研究对象的PTSD得分总体呈下降趋势(β时间=-1.879,x2=47.03,P＜0.05).男生4次随访平均分分别为33.71、31.61、29.66、28.83分,女生分别为36.33、33.98、31.51、30.52分,初中生分别为35.46、33.28、30.18、29.22分,高中生分别为34.89、32.62、31.04、30.15分.性别和年级因素对个体PTSD总分下降趋势有影响,其中,女生快于男生、高中学生快于初中学生(β性别-时间=-0.354,x2=4.83,P＜0.05;β年级-时间=0.622,x2=11.30,P＜0.05).结论灾后1年内调查对象PTSD患病率较高,PTSD存在随时间自行恢复的趋势,但男生和初中学生恢复速度更慢.

Abstract：

Objective This study was to identify the post-traumatic stress disorder(PTSD)changes and the relative risk factors within one year after Wenchuan earthquake among middle school students in the disaster area.Methods A total of 1966 students from 3 schools in Wenchuan earthquake region were selected as the target population.For each student,personal basic information and standard psychological scale(PCL-C,PSSS)were investigated by a self-administrated questionnaire in the 3rd,the 6th,the 9th and the 12th month after the earthquake,respectively.PTSD trends over the time and the associated risk factors were analyzed through the establishment of multi-level random coefficient model.Results There were 1677middle school students fully participated in the PTSD follow-up study by turning in the valid questionnaires.The averaged scores of PTSD at the time of the 3rd,the 6th,the 9th and the 12th month after the earthquake were 35.14 ± 11.08,32.90 ± 11.03,30.67 ± 11.28 and 29.75 ± 11.22,respectively.Meanwhile,the general incidences of PTSD were 36.6%(613/1677),30.7%(515/1677),24.8%(416/1677)and 22.2%(373/1677),respectively.The median score of perceived social support system was 60.00 and the general incidences of PSS was 17.20%(289/1677).The PTSD scores for the students had a decreasing trend during the period of our observation(βtime =-1.879,x2 = 47.03,P ＜0.05).The averaged scores for boys for the 4 follow-up studies were 33.71,31.61,29.66,28.83 ;for girls were 36.33,33.98,31.51,30.52; for junior school students were 35.46,33.28,30.18,29.22; for senior school students were 34.89,32.62,31.04,30.15.Moreover,two factors,gender and grade,were related with the decreasing trend(the trend for girls and senior school students was sharper than that for boys and junior school students)(βgender-time =-0.354,x2 = 4.83,P ＜0.05; βgrade-time = 0.622,x2 = 11.30,P ＜0.05).Conclusions The prevalence of PTSD was high.Meanwhile,there was a trend of self-recovery for adolescent's PTSD during the first year of post-earthquake,but boys and junior school students recovered more slowly.     

创伤后应激障碍与急性应激障碍对比研究

通过对创伤后应激障碍(post-traumatic stress disorder,PTSD)与急性应激障碍(acute stress disorder,ASD)进行比较,研究发现,两者在心理社会因素以及治疗预防等方面十分相似:个体的精神和人格方面影响着ASD与PTSD的发生和发展,对其影响较大的社会因素主要有文化、家庭以及社会支持等;对两者的干预皆为心理治疗和药物治疗相结合,同时要重视社会支持和预防。在发病时间以及病程上两者存在较大差异:ASD发病快、病程短,而PTSD发病慢、病程长。     

大学生应激与创伤后应激障碍

大学生群体是一个生活事件多发的群体,面临着各种应激事件的冲击,容易罹患各种精神疾病,其中患病率很高的精神疾病一创伤后应激障碍却容易被忽视,以致错过干预的最佳时机,影响大学生的心理健康和顺利发展,因此时其进行早期识别和早期治疗非常重要。     

儿童创伤后应激障碍与自我意识、社会支持的关系研究

目的 通过对儿童创伤后应激障碍与自我意识、社会支持的关系研究,为开展灾区儿童PTSD患者干预或治疗提供依据和支持.方法 用创伤后应激障碍17项筛查问卷（PCL-C）、儿童自我意识量表、社会支持评定量表在舟曲泥石流16个月后,对547名儿童的创伤后应激障碍情况进行了调查分析,并对其与儿童自我意识、社会支持的情况进行了相关研究.结果 儿童PTSD总分在性别和年级上存在显著差异（p＜0.05）,经过多重比较发现高年级症状总分都显著高于低年级儿童;儿童自我意识与PTSD为显著的负相关（r=-0.333,p＜0.05）;社会支持与PTSD之间有显著的负相关（r=-0.099,p＜0.05）.结论 舟曲儿童创伤后应激障碍总体情况较严重;儿童自我意识可以直接预测PTSD的发生,社会支持可通过自我意识间接预测PTSD.     

汶川地震灾区中学生地震创伤后应激障碍与领悟社会支持的关系

Objective To explore the relationship between post-traumatic stress disorder (PTSD) and perceived social support (PSS)ability among middle school students in earthquake-stricken areas after the Wenchuan earthquake accident. Methods A total of 1966 students from three secondary schools of Wenchuan earthquake-stricken areas were evaluated by PTSD Checklist-Civilian Version (PCL-C) and Perceived Social Support Scale (PSSS). Results The overall incidence rate of PTSD was 78.3%, with severe PTSD as 24.38%. Significant differences on the incidence rates of PTSD were found among the students who were in different PSS levels (P<0.05) and significant negative correlation existed between the levels of severity on PTSD and PSS (γ=-0.226, P<0.05). Significant differences on PTSD incidence rates were found among those students who were from different families or out-family PSS levels (P=0.009, P<0.05). Significant negative correlation existed between the severity of PTSD and family or out-family PSS level (γ=-0.176, P<0.05, γ=-0.214, P<0.05). Conclusion Relationships between the incidence rate, severity of PTSD and PSS levels existed among the middle school students in Wenchuan earthquake-stricken areas, with higher PSS, lower incidence rate and lighter severity of PTSD. Psychological intervention for earthquake-stricken students should be carried out.     

汶川地震灾区中学生地震创伤后应激障碍与领悟社会支持的关系

目的 探讨汶川大地震灾区中学生地震创伤后应激障碍(PTSD)与领悟社会支持能力之间的关系.方法 使用创伤后应激障碍自评量表(PCL-C)和领悟社会支持量表(PSSS),对汶川地震灾区3所中学1966名中学生进行自填式问卷调查.结果 1966名中学生的PTSD筛查总阳性率为78.3%,重度PTSD占24.38%.不同领悟社会支持程度的学生PTSD阳性率差异有统计学意义(P<0.05),且PTSD严重程度与领悟社会支持高低程度呈负性相关(γ=-0.226,P<0.05);不同家庭内、外领悟社会支持程度的学生PTSD阳性率差异有统计学意义(P=0.009,P<0.05)且PTSD严重程度与家庭内、外领悟社会支持高低程度呈负性相关(γ=-0.176,P<0.05,γ=-0.214,P<0.05).结论 地震灾区中学生PTSD的发生率及严重程度与其领悟社会支持的高低程度存在一定关系,领悟社会支持越高者,PTSD发生率越低,程度越轻.对灾区中学生的心理干预应有针对性.     

大学生虐待经历与创伤后应激障碍关系

目的 了解虐待经历与大学生创伤后应激障碍的关系。方法 随机整群抽样广州某大学大一和大二的学生800名,用创伤后应激障碍自评量表(PTSD-SS)进行调查。结果 回收有效问卷757份,有效率为97.2%。有虐待经历大学生占被调查大学生的30.9%;男生及有生理缺陷的大学生更易受到虐待(P<0.05),虐待经历与年龄、是否独生子女、户籍所在地、父母亲文化程度、家庭经济收入及是否单亲家庭无明显关联;遭受虐待的大学生PTSD总分及5个因子分均高于未遭受虐待者(P<0.01),其中,>90%受虐者认为创伤事件对精神有不同程度的打击,近80%的大学生表现出学习或工作受到影响、注意力不集中、看到或听到与事件有关的事情担心事件再度发生。结论 有虐待经历的大学生创伤后应激障碍的症状更明显。     

舟曲泥石流5年后居民创伤后应激障碍和焦虑及抑郁现况调查

目的了解舟曲泥石流5年后居民创伤后应激障碍(PTSD)、焦虑和抑郁现状及其影响因素,为远期心理干预提供科学依据。方法于2015年8月采用整群抽样方法在舟曲县5个卫生服务社区居民中随机抽取300名居民进行问卷调查,共收到有效问卷291份,有效率为97%。采用创伤后应激障碍量表平民版(PCL-C)、焦虑自评量表(SAS)、抑郁自评量表(SDS)对舟曲具5个社区的291名受灾居民进行问卷调查。使用SPSS 17.0软件包对数据进行χ~2检验,影响因素分析应用logistic回归分析。结果舟曲受灾居民PTSD检出率为32.30%,有焦虑症状检出率为25.77%,有抑郁症状检出率为26.80%,焦虑与抑郁共患检出率为22.34%,PTSD伴发焦虑检出率为21.31%,伴发抑郁检出率为21.65%,同时伴发焦虑、抑郁检出率为19.24%。logistic回归分析结果显示,性别(OR=2.057,95%CI:1.140~3.713)、婚姻状况(OR=0.304,95%CI:0.148~0.624)、受教育程度(OR=0.145,95%CI:0.040~0.517)和直系亲人死亡(OR=0.393,95%CI:0.218~0.710)是PTSD的影响因素,性别(OR=1.922,95%CI:1.036~3.567)、受教育程度(OR=0.118,95%CI:0.034~0.403)和被困经历(OR=0.496,95%CI:0.268~0.919)是焦虑的影响因素,性别(OR=2.234,95%CI:1.204~4.147)、受教育程度(OR=0.190,95%CI:0.055~0.655)和被困经历(OR=0.526,95%CI:0.285~0.970)是抑郁的影响因素,受教育程度(OR=0.088,95%CI:0.025~0.308)、直系亲人死亡(OR=0.249,95%CI:0.095~0.651)是三者共患病的影响因素。结论舟曲泥石流5年后受灾居民PTSD与抑郁、焦虑共病症状较为严重,应采取有针对性的远期的心理干预措施。     

童年期虐待与初中生抑郁症状关系

目的探讨童年期虐待经历与初中生抑郁症状的关系。方法整群抽取安徽省霍邱县3所乡镇普通初级中学的1 417名初中生,采用抑郁自评量表(SDS)、自编童年期虐待经历问卷和自编一般情况调查表进行问卷调查。结果1 417名初中生中抑郁症状的检出率为61.3%,女生(66.7%)高于男生(56.6%),初二年级(64.4%)高于初一(62.4%)和初三年级(56.7%),非独生子女(63.5%)高于独生子女(54.9%),差异均有统计学意义(P<0.05或P<0.001);与父母的关系从差、一般到亲密,学习成绩从差、中等到好,初中生抑郁症状的检出率均逐渐下降,差异均有统计学意义(均P<0.001);童年期遭受各种类型反复虐待的初中生抑郁症状的检出率均高于未遭受反复虐待者,差异均有统计学意义(P<0.05或 P<0.001);多因素非条件logistic 回归分析结果显示,童年期遭受反复重度躯体虐待、反复中度躯体虐待、反复情感虐待、反复接触性性虐待和反复非接触性性虐待的初中生抑郁症状发生的危险性分别是未遭受上述虐待的1.989(OR=1.989)、1.436(OR=1.436)、1.698(OR=1.698)、2.834(OR=2.834)和2.235倍(OR=2.235)。结论童年期遭受反复虐待是青少年抑郁症状的危险因素。