地震后18个月救援武警创伤后应激障碍状况评估

目的探讨汶川地震救援后18个月救援武警创伤后应激障碍(PTSD)的发病率、症状严重程度及与人口学、创伤暴露和人格因素的关系,为制订特殊人群PTSD防治策略提供依据。方法随机整群抽取地震救援武警官兵748名,采用一般资料调查表、创伤后应激障碍症状清单—平民版(PCL-C)、艾森克人格问卷简式量表中国版(EPQ-RSC)、特质焦虑量表(TAI)评估PTSD发病率、严重程度及影响因素。结果地震救援后18个月救援武警PTSD阳性检出率1.7%(13/748),7.9%的救援官兵存在创伤重体验症状,3.1%的官兵存在警觉性增高症状,2.1%的官兵存在情感麻木和回避症状。不同暴露程度组间PCL-C总分差异有显著性(P0.01);多元线性回归分析显示,年龄、暴露水平、是否有家人受灾、神经质、特质焦虑进入方程。结论地震救援后18个月武警官兵PTSD发生率较低,但伴有PTSD症状比例仍较高。低年龄、高暴露水平、有家人受灾、神经质、高特质焦虑是创伤后应激障碍严重程度的预测因素。     

地震极重灾区小学教师的创伤后应激障碍调查

目的了解地震极重灾区小学教师1年后的创伤后应激障碍(post-traumatic stress disorder,PTSD)的程度。方法用创伤后应激障碍自评量表(PTSD-SS)和暴露情况调查表对188名青川县小学教师进行测评。结果 71.2%的教师存在PTSD症状,男女教师之间的差异有统计学意义(P0.05);亲友死亡是导致PTSD的重要原因。结论地震极重灾区小学教师,尤其是男性教师,存在严重的慢性PTSD。     

汶川县中学生地震后1年创伤后应激障碍调查

目的了解汶川重灾区地震后1 a青少年创伤后应激障碍(Post-Traumatic Stress Disorder,PTSD)的现患情况,为制定干预措施提供科学依据。方法采用创伤后应激障碍自评量表(PTSD Checklist-Civilian Version,PCL-C),对汶川地震重灾区3所中学初一、初二、高一、高二年级的在校学生进行问卷调查,PTSD的诊断依据DSM-Ⅳ标准。结果地震后1 a重灾区中学生PTSD的筛查阳性率为6.1%,以警觉性过强所致易激惹症状(D组)阳性率最高(75.1%)。初二和高一年级,居住在农村、家庭有财产损失的学生PTSD阳性率及B,C,D 3组症候群阳性率较高;女生和地震中受伤学生B,C,D 3组症候群阳性率较高。结论地震后1 a青少年PTSD阳性筛查率仍较高,继续采取有效干预措施降低重灾区青少年PTSD造成的长期心理危害十分必要。     

地震灾区居民创伤应激障碍调查

目的 了解汶川地震1个月后青川县灾民创伤后应激障碍(PTSD)的发生率及其分布特征,为震后心理危机干预提供依据.方法 按受灾群众居住区域和帐篷编号,随机抽取灾民409人,使用创伤后应激障碍自评量表进行调查.结果 震后1个月灾民PTSD评为阳性的发生率为62.8%;女性、有亲人死伤者、财产损失较大者、41～50岁年龄组的灾民PTSD评分阳性的发生率分别为71.1%,70.4%,66.6%和78.8%,显著高于男性、无亲人死伤者、无财产损失者较大者和其他年龄组(P<0.05).结论 地震后灾民PTSD评分阳性率较高,应针对不同灾民的特点尽早进行有效的心理危机干预.     

高危妊娠产妇产后创伤后应激障碍现状调查及危险因素分析

目的 调查高危妊娠产妇产后创伤后应激障碍(post-traumatic stress disorder, PTSD)发生现状,探究影响产后发生PTSD的危险因素。方法 选取2020年6月至2021年12月期间于同济大学附属第十人民医院待产的高危妊娠女性120例。采用自行设计调查问卷调查研究对象一般资料,根据产后创伤后应激障碍量表(PCL-C)评估PTSD发生情况,分析PTSD发生现状及其可能的危险因素。结果 120例高危妊娠产妇产后PTSD阳性率为11.67%(14/120),主要表现为反复体验症状和警觉性增高症状。PTSD阳性产妇心理弹性量表(CD-RISC)总分及各维度得分低于PTSD阴性,爱丁堡产后抑郁量表(EPDS)得分高于PTSD阴性,差异有统计学意义(P<0.05)。Pearson相关性显示,产妇PCL-C得分与CD-RISC得分呈负相关(r=-0.457,P<0.05),与EPDS得分呈正相关(r=0.538,P<0.05)。Logistic回归分析显示,睡眠质量、分娩方式、精神创伤史、产后抑郁、妊娠期并发症、婴儿健康状况、产妇目前健康状况及心理弹性是高...     

地震情景再现对灾区大学生创伤后应激障碍及其共病的影响

目的了解地震情景再现对5.12汶川大地震重灾区大学生的创伤后应激障碍(PTSD)及其共病的影响,为地震灾区大学生PTSD及其共病的治疗提供依据。方法以主题短片"无情的地震"为再现方式,用创伤后应激障碍自评量表(PTSD-SS)、焦虑自评量表(SAS)和抑郁自评量表(SDS)等对四川文理学院地震灾区176名大学生进行短片呈现前后测评。结果前后测发现,除回避症状差异无统计学意义(t=0.94,P>0.05)外,其余各症状差异均有统计学意义(P<0.01或P<0.05);有PTSD、PTSD和焦虑、PTSD和抑郁共病以及3种障碍共病的人数分别增加了5.7%,5.39%,2.86%和0.60%,但差异无统计学意义(P>0.05);后测发现,房屋倒塌和财产损失与PTSD和抑郁症状增强的相关性良好(P<0.01或P<0.05);警觉性提高是焦虑和抑郁症状增强的重要原因。结论地震情景再现时重灾区大学生会出现急性PTSD及其共病症状,或原有症状更突出。     

汶川地震早期救援官兵心理应激特点及相关因素

目的探讨汶川地震早期救援官兵心理应激特点及相关因素,为制定救援官兵心理干预措施提供科学依据。方法采用整群抽样和自编一般情况问卷、创伤后应激反应症状自评量表(PCL-C)、领悟社会支持量表(PSSS)、应对方式问卷(SCSQ)对752名汶川地震早期救援官兵进行测评,结合半结构式访谈,确定急性心理应激障碍(ASD)组和对照组,对相关因素进行spearman分析。结果(1)汶川地震早期救援官兵心理应激障碍发生率为15.0%;(2)救援官兵心理应激反应的主要症状有7个:强烈的心理痛苦烦恼,反复闯入性痛苦性回忆,噩梦,睡眠障碍,创伤事件场景的重现,兴趣下降,烦躁不安和暴怒;(3)在解决问题、求助、主客观社会支持和对社会支持利用度等因子上,ASD组得分显著低于对照组(P0.01),而在幻想、退避、自责、合理化因子上,ASD组的得分显著高于对照组(P0.01);(4)解决问题、求助、社会支持总分和主客观支持分与PCL-C总分和3个因子分(创伤再体验,麻木与回避,警觉性增高)呈负相关,自责、幻想、退避因子与ASD总分和3个因子分呈正相关。结论救援官兵的急性心理应激障碍发生率较高,与应对方式、社会支持相关。     

胚胎停育患者创伤后应激症状及相关因素分析

目的:了解胚胎停育患者的心理损伤情况和创伤后应激障碍(PTSD)症状阳性的相关因素。方法:对2012年10月~2013年10月就诊于宁夏医科大学总医院、银川市妇幼保健院的206对胚胎停育患者及配偶,应用创伤后应激障碍筛查量表平民版(PCL-C)对其反复创伤性体验症状、情感麻木与回避状及警觉性过强所致易激惹症状进行客观测量。结果:206名胚胎停育患者PCL-C量表分值为23.7±2.7分,PTSD筛查症状阳性率为13.6%(28/206)。多因素非条件logistic回归分析结果显示,配偶PTSD症状筛查阳性时,胚胎停育患者PTSD症状阳性率高(OR:2.9,95%CI:1.8~9.7),社会支持中从兄弟姐妹得到支持和照顾时,胚胎停育患者PTSD症状阳性率低(OR:0.5,95%CI:0.3~0.9)。结论:胚胎停育事件可能会引起孕妇产生创伤后应激障碍症状。配偶PTSD症状阳性会增加胚胎停育孕妇PTSD症状阳性率,而社会支持,尤其是从兄弟姐妹得到支持和照顾,有助于缓解胚胎停育孕妇PTSD症状。     

地震后灾区中学生创伤后应激障碍变化趋势及相关因素分析

目的探讨"5.12"汶川地震后灾区中学生创伤后应激障碍(PTSD)阳性率的变化趋势及其影响因素,为灾区青少年心理干预策略和措施提供科学依据。方法采用方便抽样方法,选取"5.12"汶川地震灾区3所中学1 966名中学生,使用创伤后应激障碍症状清单平民版(PCL-C)和领悟社会支持量表(PSSS)进行3次自填式问卷随访调查。结果中学生PTSD筛查阳性率和严重程度变化(2χ=65.440,48.368,P值均<0.01)均呈下降趋势。多元Logistic回归分析显示,女性(OR=1.46)、居住地为农村(OR=1.28)、本人受伤(OR=2.46)、房屋财产损失(OR=1.67)是PTSD发生的危险因素;汉族(OR=0.66)、灾后时间越久(OR=0.73)、领悟社会支持越高(OR=0.97)是PTSD的保护因素。结论随着时间推移,灾区中学生的PTSD阳性率逐渐降低。应加强灾区学生尤其是PTSD高危人群和阳性人群的关注,增加其各方面社会支持。     

创伤后应激障碍的临床特征分析

[目的]观察分析创伤后应激障碍的临床特征。[方法]选择76例创伤后应激障碍患者,对其进行社会支持评定量表评定和创伤后应激障碍自评量表评定。调查和观察过程均在知情同意下进行。[结果]治疗前后患者SSRS评定客观支持分比较差异无统计学意义(P﹥0.05),主观支持分比较差异有统计学意义(P﹤0.05),回避症状和警觉性增高症状比较差异有统计学意义(P﹤0.01)。治疗前后患者PTSD-SS评定结果经统计学比较差异有统计学意义(P﹤0.05)。[结论]创伤后应激障碍患者在遭受创伤后延迟出现精神障碍,具有接触创伤性事件、重现创伤体验、回避和警觉性增高4个特点,主观支持不足和对支持利用度差,需及时给予心理干预和适当抗抑郁药物治疗。     

Long-Term Effects of Conflict-Related Sexual Violence Compared with Non-Sexual War Trauma in Female World War II Survivors: A Matched Pairs Study

The aim of the study was to compare the long-term effects of conflict-related sexual violence experienced at the end of World War II (WWII) with non-sexual WWII trauma (e.g., being exposed to shell shock or physical violence). A total of 27 elderly wartime rape survivors were compared to age- and gender-matched control subjects who were drawn from a larger sample of subjects over 70 years of age who had experienced WWII-related trauma. A modified version of the Posttraumatic Diagnostic Scale was used to assess trauma characteristics and posttraumatic stress disorder (PTSD) symptoms and the Brief Symptom Inventory-18 was used to assess current psychopathology. Additionally, measures of posttraumatic growth (Posttraumatic Growth Inventory) and social acknowledgement as a trauma survivor (Social Acknowledgement Questionnaire) were used to assess two mediating variables in post-trauma conditions of rape victims. Women exposed to conflict-related sexual violence reported greater severity of PTSD-related avoidance and hyperarousal symptoms, as well as anxiety, compared with female long-term survivors of non-sexual WWII trauma. The vast majority (80.9 %) of these women also reported severe sexual problems during their lifetimes relative to 19.0 % of women who experienced non-sexual war trauma. Women exposed to conflict-related sexual violence also reported greater posttraumatic growth, but less social acknowledgement as trauma survivors, compared to survivors of non-sexual war trauma. The results were consistent with emerging neurobiological research, which suggests that different traumas may be differentially associated with long-term posttraumatic sequelae in sexual assault survivors than in other survivor groups and highlights the need to treat (or better prevent) deleterious effects of conflict-related sexual violence in current worldwide crisis zones.     

Examining Changes in Sexual Functioning after Cognitive Processing Therapy in a Sample of Women Trauma Survivors

Background

Posttraumatic stress disorder (PTSD) and sexual dysfunction commonly co-occur. Although sexual dysfunction is more prevalent among women and the negative impact of sexual dysfunction on quality of life is stronger in women compared with men, few studies examine the impact of evidence-based PTSD treatments on sexual functioning outcomes in women with PTSD. The current study examined the relationship between PTSD and sexual functioning among women trauma survivors to examine if sexual functioning improves after cognitive processing therapy (CPT).

Differences in the association of spirituality,forgiveness, PTSD and stress among social workers and social work students treating trauma survivors

ABSTRACT

Providing professional assistance to trauma victims may cause significant emotional distress to those who provide the assistance. Dealing with such stress requires attention to significant personal resources. This study examined the relationship between tendency to forgive and spirituality with PTSD symptoms and stress among social workers and social work students (N = 157) who are at the front line dealing with trauma survivors. The study results demonstrated that social work students had higher levels of stress while no significant differences were found regarding spiritually, PTSD, and forgiveness. Examining the subscales revealed that social work students had higher negative PTSD alteration symptoms than trained social workers while trained social workers had higher levels of forgiveness to self. Additionally, structural equation models showed that among social workers, forgiveness to self and spirituality were associated simultaneously with lower PTSD symptoms and stress. However, among social work students, the tendency to forgive the self was associated with lower PTSD symptoms only. The findings illuminate spirituality and forgiveness as key factors that can help cope with the emotional toll of those who assist trauma survivors, while focusing on differences for trained professionals and training professionals. Theoretical and clinical implications are discussed.     

生活事件对震后中学生心理应激状况的影响

目的探讨生活事件对震后中学生心理应激反应状况的影响,为开展震后中学生心理健康教育工作提供参考。方法采用青少年生活事件量表(ASLEC)和创伤后应激障碍自评量表(PTSD)对震区413名中学生进行问卷调查。结果中学生PTSD症状有显著的性别差异,女生高于男生;生活事件与PTSD症状反应总分有显著相关;生活事件对PTSD总分及各维度的影响显著,解释了PTSD总分变异的16%,再体验变异的12%,逃避及麻木变异的11%,过度警觉变异的14%。结论生活事件会影响震后中学生心理应激状况的反应。     

汶川地震后儿童和青少年生命质量随访研究

目的 探讨汶川地震后儿童和青少年生命质量变化趋势和影响因素.方法 采用随机抽样和系统抽样相结合的方法,利用地震创伤经历问卷（EEQ）、儿童创伤后应激障碍反应指数量表（CPTSD-RI）、儿童抑郁指数量表（CDI）以及儿童生命质量量表（PedsQL）进行调查,采用描述性统计分析、x2检验和多元线性回归进行统计分析.结果 596名调查对象中,其生命质量总分随时间显著下降2.0（82.2∶80.2,P=0.01）.创伤后应激障碍（PTSD）和抑郁是影响灾区儿童和青少年生命质量的最重要因素,PTSD或抑郁每变化1分都会引起生命质量0.3～0.5的反向变动.结论 遭遇严重受伤、丧失亲人的儿童和青少年生命质量持续低迷,但没有特定创伤经历的个体生命质量也随时间显著下降,灾后心理危机干预的对象不应只包括直接卷入灾难的儿童和青少年,还应涵盖间接暴露的个体.     

Relationship between sense of coherence and post-traumatic stress disorder symptoms among firefighters

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), published by the American Psychiatric Association, the post-traumatic stress disorder (PTSD) is diagnosed when a person: (a) is exposed to a traumatic event that is well outside the range of usual human experience accompanied by intense fear or horror; (b) reexperiences the event in his/her thoughts, dreams and daily life; (c) avoids the stimuli associated with the trauma and numbs his/her emotions; (d) demonstrates symptoms of increased arousal; and (e) manifests these disturbances for a longer period than one month. Since the 1980s, it has been pointed out that PTSD may occur not only among survivors of severe traumatic events but also among those who have rescued the victims of those events. Members of fire brigades constitute a large occupational group exposed to traumatic experiences. The aim of our study was to find an answer to the question of what are the relationships between the level of PTSD symptoms and the sense of coherence (and its three dimensions). In all, 464 firemen were interviewed. PTSD-Interview developed by Watson et al. was used to assess the level of PTSD symptoms and the presence]absence of PTSD. The higher level of PTSD symptoms was associated with the lower level of the sense of coherence. A small group (3.9%) of subjects who experienced traumatic events met DSM-IV diagnostic criteria for PTSD. The sense of coherence of these people was significantly lower than that of others.     

Posttraumatic stress disorder and extent of trauma exposure as correlates of medical problems and perceived health among women with childhood abuse.

This study examined the relative contributions of Posttraumatic Stress Disorder (PTSD) symptoms and the extent of trauma exposure as factors contributing to the current health status of childhood abuse survivors. Sixty-seven women with a history of familial childhood abuse (sexual and/or physical) and twenty-nine women with no abuse history were assessed on two distinct aspects of health status: reported number of medical problems and perceptions of overall health. Women with abuse were found to have a greater number of medical problems and poorer perceived physical well-being than the no abuse comparison group. Regression analyses of the women with abuse histories revealed that trauma exposure was a stronger predictor than PTSD symptoms of medical problems. PTSD symptoms, however, were better predictors of the experience of physical well-being than trauma exposure. These results suggest that the nature of a traumatic exposure, especially when there is repeated, cumulative trauma may be more significant to medical problems than the psychological symptoms of PTSD. Perceived health, however, appears to be predominantly influenced by psychological factors, suggesting the importance of these variables in the quality of life of multiply traumatized women.     

What are the determinants of post-traumatic stress disorder: age,gender, ethnicity or other? Evidence from 2008 Wenchuan earthquake

Objective

To estimate the prevalence of post-traumatic stress disorder (PTSD) and assess determinants related to PTSD symptoms among adult earthquake survivors after the 2008 Wenchuan earthquake in China.

Study design

Cross-sectional multicluster sample surveys with data collected from four counties.

Methods

Surveys were conducted separately in four counties in Sichuan Province, with a total of 2004 respondents. Beichuan County and Dujiangyan City were damaged more severely than Yaan County and Langzhong County during the earthquake. In total, 1890 households were represented, with a mean of 2.2 respondents per household. Data were collected using structured interviews, and the Harvard Trauma Questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria were used to diagnose PTSD.

Results

The prevalence rates of suspected PTSD were 47.3% (n = 436) in heavily damaged areas and 10.4% (n = 93) in moderately damaged areas. The prevalence rates of PTSD symptoms among elderly, middle aged and young adults were 55.8%, 50.2% and 28.6% (P = 0.001), respectively, in heavily damaged areas. Older age, female gender, unmarried/divorced/widowed, ethnic minority, death of family member, no household income and damaged household were independent risk factors for PTSD symptoms in heavily damaged areas.

Conclusion

Interventions designed to reduce PTSD among populations affected by the 2008 earthquake should focus on people without household incomes, those with damaged households and those who experienced the death of a family member. Effective, sustainable and culturally sensitive psychosocial interventions and mental health services are required, and attention should be directed to survivors who experienced the death of a family member, women and older adults following the devastating natural disaster. Governments should support income-generating activities and improve living conditions. Trained field personnel can assist with PTSD assessments and referrals, and existing rural healthcare services can be used to provide treatment for common psychiatric disorders.     

Posttraumatic stress and lifestyles are associated with natural killer cell activity in victims of the Hanshin-Awaji earthquake in Japan

BACKGROUND: The relationships among mental health status, lifestyle, and natural killer (NK) cell activity, which plays important roles in the immune surveillance of tumors and viral infections, were investigated in victims of the Hanshin-Awaji Earthquake. METHODS: About 1 and 1/3 years after the earthquake, 155 male workers who experienced the event were administered questionnaires concerning their unhealthy mental status, such as symptoms of posttraumatic stress disorder (PTSD), lifestyles, and demographic variables. Peripheral blood was taken from all of them to measure NK cell activity. RESULTS: Subjects who had PTSD symptoms showed lower NK cell activity than those without symptoms. Subjects with positive lifestyles showed higher NK cell activity than those with poor or moderate lifestyles. When subjects were divided into four groups by lifestyle and PTSD symptoms, subjects with positive lifestyles and few or no PTSD symptoms showed the highest NK cell activity among the four groups. The other three groups were subjects with positive lifestyles but many PTSD symptoms; subjects with poor or moderate lifestyles and many PTSD symptoms; and subjects with poor or moderate lifestyles and few or no PTSD symptoms. CONCLUSION: PTSD symptoms and lifestyles were associated with NK cell activity in the earthquake victims.     

“5.12”特大地震两年后板房灾民生活质量评估

目的评价汶川地震两年后板房灾民的生活质量,了解其影响因素。方法采用SF-36生活质量问卷、创伤后应激障碍筛查量表平民版(PCL-C)、匹兹堡睡眠质量指数量表(PSQI)以及自制的相关社会人口学问卷进行入户调查。结果①单因素分析显示,地震两年后板房灾民的生活质量除精神健康维度外其余各维度得分均低于常模(P<0.05),不同地区、性别、年龄、文化程度、职业、婚姻状况等因素对生活质量的某些维度或加权总分有影响。②多重线性回归分析显示,影响板房灾民生活质量的主要因素有PSQI总分、PCL-C总分、职业。结论地震两年后板房灾民的身心健康仍不容乐观,尤其应重点关注极重灾区灾民、女性、睡眠障碍者、创伤后应激障碍患者以及低收入者,以改善板房灾民的生活质量。