汶川地震影响区某小学学生心理健康状况调查

国外研究者对儿童和青少年的创伤后应激障碍(PTSD)、抑郁症(DD)等心理障碍的研究显示,儿童应激或创伤后PTSD的发生率为21%～70%[1-2],如1988年美国地震后的发生率为70%[3],1999年台湾地震后的发生率为21.7%[1],2004年12月泰国南部海啸影响地区儿童有PTSD和DD症状的占72%[4].     

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.     

战争引发的精神心理障碍及其治疗进展

正1创伤后应激障碍概念创伤后应激障碍(post traumatic stress disorder,PTSD)是指个体遭受重大的、威胁性的、灾难性的损伤,并致使其职业能力和社会功能受损的、延迟出现和持续存在的精神障碍,最早源自战争中对战斗应激相关精神行为的描述[1]。随着现代高科技战争的巨大破坏力和震慑力增加,以及某些特殊战场环境对军人心理造成巨大压力,容易引发心理与生理应激     

自然灾害后儿童和青少年创伤后应激障碍评估量表的应用

目的旨在总结应用于评估灾后儿童和青少年创伤后应激障碍的诊断和评估量表,分析其实际适用情况,并针对目前量表应用存在的问题提出相应的观点和建议,以期为我国儿童和青少年创伤后应激障碍(posttraumatic stress disorder,PTSD)相关研究提供参考。方法对近10年来国内外的相关文章进行综述。结果阐述了5种PTSD评估量表,包括临床访谈(采用量表的结构化形式)和自评量表两大类,应用量表的文章的创伤领域则包括4种,分别是地震、龙卷风、台风或飓风以及海啸,研究者在各量表的选择缺乏统一标准。结论适合灾后儿童和青少年PTSD的评估量表有待进一步的研究,以防止对此年龄段人群未能作出PTSD的全面诊断或者治疗不足。     

文献快报(9):创伤经历的发生时间预测女童不同类型精神病理障碍

正青春期前后神经发育可塑性增加,这一时期发生的应激或创伤会对心理健康产生长远的影响。美国宾夕法尼亚州立大学Marshall博士利用美国国家共病复测调查——青少年补充样本(National Comorbidity Survey Replication-Adolescent Supplement),探讨创伤经历发生时间(相对于青春期的早晚),对不同类型精神病理障碍的预测效应,包括创伤后应激综合征(posttraumatic stress disorder,PTSD)、抑郁障碍和焦虑障碍。2 899名女性青少年的精神病理症状用WHO复合性国际诊断访谈表     

消防员社会支持与工作倦怠和创伤性应激障碍的关系

摘要:目的　探讨我国消防员社会支持、工作倦怠和创伤后应激障碍（PTSD）三者之间的关系。方法　本研究采用自编的消防员社会支持问卷、创伤后应激障碍测查量表（PCL-C）、事件影响量表（IES-R）以及工作倦怠问卷（CMBI）,以全国1 379名一线消防员为被试进行问卷调查。结果　PTSD与工作倦怠呈显著正相关;社会支持与工作倦怠呈显著负相关;社会支持与PTSD呈显著负相关;当社会支持作为自变量,PTSD可以作为社会支持影响工作倦怠的中介变量,起到部分中介作用,且社会支持中的战友支持和组织支持主要是通过PTSD中的闯入和唤醒维度来影响工作倦怠的。结论　PTSD是社会支持影响工作倦怠的中介变量。研究结果可作为建立消防员社会心理支持系统的参考和借鉴。     

脑卒中后运动功能障碍患者创伤后应激障碍水平及其影响因素的调查研究

目的调查脑卒中后运动功能障碍患者创伤后应激障碍水平及影响因素,为制定针对性心理干预措施提供科学依据。方法采取问卷调查法,选取2018年11月至2019年4月北京市某两所三甲医院脑病科收治的脑卒中后运动功能障碍患者作为研究对象。调查问卷包括创伤后应激障碍自评量表(PTSD-SS)、社会支持评定量表(SSRS)及研究者自行设计的一般情况调查表,对调查结果行统计学分析。结果被调查三甲医院脑卒中后运动功能障碍患者创伤后应激障碍阳性率为19.27%,社会支持度、医疗费用支付方式等因素影响患者创伤后应激障碍水平。结论脑卒中后运动功能障碍患者创伤后应激障碍阳性率较高,应给予充足的社会支持及给予患者心理关注与干预避免PTSD的发生,以促进患者尽早康复。     

三甲医院急诊护士述情障碍、社会阻抑对创伤后应激障碍的影响

目的探讨三甲医院急诊护士述情障碍、社会阻抑对创伤后应激障碍的影响。方法于2017年3—9月选取陕西省6所三甲医院169例急诊护士作为研究对象进行随机抽样。使用创伤后应激障碍量表(平民版)、多伦多述情障碍量表和社会阻抑量表进行调查。结果研究对象述情障碍、社会阻抑和创伤后应激障碍(PTSD)水平得分分别为55.10±8.83,44.21±6.58和35.46±8.63。经多元线性逐步回归分析,述情障碍、主管护师、社会阻抑和急诊科工作年限是研究对象PTSD水平的影响因素,且可解释总变异的53.8%。结论医院管理者应重视急诊护士,尤其是急诊主管护师的心理健康状况,为其营造良好的工作环境和氛围,建立适应科室实际情况的社会阻抑应对策略或制度,以减轻其负性情绪和应激水平。     

创伤后应激障碍的心理生物学分析与创伤应对

创伤后应激障碍(PTSD)是少数精神疾病状态之一.人们对心理社会应激源的情绪和神经生物反应存在明显的个体差异.本文着重探讨认知评价和应对方式对神经内分泌应激反应及随后的心理健康结果中潜在的个别差异的影响.从心理生物学角度对创伤和PTSD进行持续性研究将提高人们对心理社会应激源适应的理解,同时有助于人们治疗相关的心理和生理后遗症.     

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。     

Adolescent suicide in New York City: plenty of room for new research

The act of adolescent suicide continues to threaten adolescent populations in New York City (NYC). Consistent positive correlations have been found between a plethora of risk factors present in NYC adolescent populations and suicidal ideations and behaviors. Psychiatric conditions that may contribute to the rate of adolescent suicide in NYC include depression, bipolar disorder, substance abuse and schizophrenia. Unique factors that have been found to contribute to increased rates of completed suicides in NYC include the phenomena of railway suicides and suicide tourism. Homelessness and income inequality in NYC have also been consistently correlated with increased suicidality; with one study finding suicide attempts reported by a significant percentage of new admissions to homeless shelters. Adolescent populations in NYC that have been identified as particularly vulnerable to suicidality include runaway youth, homosexual youth, victimized adolescents and adolescents with a recent history of posttraumatic stress disorder (PTSD). Longitudinal studies in NYC have found that physical and sexual abuse is highly predictive of adolescent suicidality, with variations by ethnic group. Currently, there is a disturbing lack of sufficient research on adolescent suicide in NYC, specifically regarding causal factors, the effects of television on suicide, comorbid suicidality and drug abuse, and cultural factors contributing to suicide. This dearth of literature may be related to the ethical problems inherent in suicide research, self reports and/or post mortem analyses.     

Family context of mental health risk in Tsunami-exposed adolescents: findings from a pilot study in Sri Lanka

Using survey data from 325 Tsunami-exposed adolescents and mothers from two villages in southern Sri Lanka, this pilot study investigated influences of Tsunami exposure and subsequent psychosocial losses on adolescent depressive and post-traumatic stress disorder (PTSD) symptoms. Findings generally support the study hypotheses: disaster exposure (for example experiences of property destruction and deaths of close others) contributes to depressive and PTSD symptoms in adolescents. Findings also show that psychosocial losses associated with Tsunami exposure, such as prolonged displacement, social losses, family losses, and mental health impairment among mothers, contribute to depressive and PTSD symptoms in adolescents. Results suggest that the influence of Tsunami exposure on adolescent mental health operates partially through Tsunami-related psychosocial losses. As expected, positive mother-child relationships provide a compensatory influence on both depressive and PTSD symptoms of adolescents. In addition, high levels of depressive symptoms among mothers increases the detrimental influence of other Tsunami-related psychosocial losses on adolescent mental health. These preliminary findings suggest ways to improve ongoing recovery and reconstruction programs and assist in formulating new programs for families exposed to both the Tsunami and other natural disasters. More importantly, findings from this pilot study emphasize the urgent need for larger systematic studies focusing on mental health following disaster exposure.     

Prevention programs for reducing adolescent problem behaviors: Implications of the co-occurrence of problem behaviors in adolescence

PurposeTo examine the correlations between multiple risk behaviors in adolescent populations to document the extent to which problem behaviors are intercorrelated and to identify factors associated with variations in these correlations.MethodsStudies from 1977 through the end of 1999 that included two or more problem behaviors in adolescents were identified by literature searches using the PsychLit database, Social Sciences Citation Index, manual journal searches and “ancestry” approaches. The behaviors studied were alcohol use, marijuana use, illicit drug use, cigarette smoking, general deviant behavior, and sexual activity. Included studies reported correlation coefficients between variables.ResultsAcross all studies, the mean correlation between any two pairs of problem behaviors was 0.35, with a standard deviation of 0.28. This suggests that, on average, about two-thirds of the variation in problem behavior is the result of unique rather than common causes. The magnitude of the correlations varied as a function of the age of the adolescent, with lower correlations being evident for older adolescents. In addition, the magnitude of the correlation varied as a function of when the study was conducted, with studies of past generations showing stronger connections between risk behaviors than current generations.ConclusionsThe data suggest that there is considerably more unique variation in classic adolescent problem behaviors than common variation.     

Keepin' it R.E.A.L.!: program description and results of baseline assessment.

In this article, the authors present the results of the analysis of the baseline data from Keepin' it R.E.A.L.!, an HIV prevention project developed for mothers and their adolescents. Six hundred twelve mostly male (60.6%) and African American (98.2%) adolescents completed baseline assessments. Eleven percent of the adolescent participants reported initiating sexual intercourse. Adolescent participants expressing higher levels of self-efficacy to resist peer pressure, more favorable outcome expectancies, less communication about sex with their mothers, higher levels of self-concept related to their behavior, lower levels of self-concept related to popularity, and less stress reported fewer types of intimate sexual behaviors. Adolescent participants who reported higher self-efficacy to resist peer pressure to have sex and lower levels of stress were less likely to have initiated sexual intercourse. Selected characteristics of mothers did not contribute to understanding factors associated with intimate sexual behaviors or initiation of sexual intercourse among adolescent participants.     

Adolescent sexuality at the dawn of the 21st century

Human sexuality can be defined as including the physical characteristics of and capacities for specific sex behaviors, together with psychosocial values, norms, attitudes, and learning processes that influence these behaviors. It also includes a sense of gender identity and related concepts, behaviors, and attitudes about the self and others as women or men in the context of one's society. At the dawn of the new century, adolescent sexuality remains a topic of concern to adults throughout the world. This concern is not unique to this new age. In each era of recorded history, adults have been concerned about adolescent sexual behavior, particularly sexual intercourse and its consequences. Things have not changed all that much in the realm of adolescent sexual behavior. What has changed is our ability to prevent the serious consequences of this behavior and, hopefully, to help adolescents avoid behaviors that put them at risk for the negative consequences of expressing their burgeoning sexuality. This article reviews the major influences on adolescents developing' sexuality, the data on adolescent sexual activity, some tips on caring for adolescents comprehensively, and ends with some predictions of how this issue will be addressed in the new century.     

Weight-control behaviors among adults and adolescents: associations with dietary intake

BACKGROUND: This study aimed to assess the prevalence of weight-control behaviors and their associations with overall dietary intake among adults and adolescents. METHODS: Participants included 3,832 adults and 459 adolescents from four regions of the United States. Cross-sectional data were collected on energy and nutrient intake, weight-control behaviors, body mass index (BMI), and sociodemographics. RESULTS: Current weight-control behaviors were reported by 52.7% of the study population (adult women, 56.7%; adult men, 50.3%; adolescent girls, 44.0%; adolescent boys, 36.8%). Weight-control behaviors were consistently and positively associated with socioeconomic status among adults, but not among adolescents. Among "dieters," unhealthy practices were reported by 22.7% of adult women, 21.3% of adult men, 30.4% of adolescent girls, and 18.5% of adolescent boys. Adults trying to control their weight reported healthier nutrient intakes than those not trying to control their weight, in particular when moderate weight-control methods were employed. Among adolescents, there were fewer differences across dieting status and these were not suggestive of healthier intakes among dieters than nondieters. CONCLUSIONS: Weight-control behaviors are reported by a large percentage of the population. Weight-control behaviors tend to be healthier among adults than among adolescents, in terms of the types of behaviors used and their impact on nutrient intakes. Obesity prevention interventions should emphasize the importance of using healthy weight-control practices.     

Health counseling in adolescent preventive visits: effectiveness, current practices, and quality measurement

Most morbidity and mortality among adolescents results from their participation in health-compromising behaviors. Recent guidelines for clinical adolescent preventive services recommend that primary care clinicians routinely screen for and counsel adolescents about these behaviors, identify and address related social, psychological, and biologic factors. Office-based counseling can influence adult health behaviors, but little is known about the effectiveness of office-based counseling for adolescents. In this review we: (a) evaluate available information about the effectiveness of office-based health counseling to improve outcomes; (b) report what is known about the health counseling adolescents receive from primary care clinicians; and (c) critically review different approaches that have been, or might be, used to measure the content and quality of health counseling provided during adolescent medical visits. With the emphasis on accountability in the current health care environment, evidence supporting the effectiveness of counseling is needed to justify investment in this aspect of clinical adolescent preventive services. Challenges to studying the effectiveness of health counseling include the lack of well-defined theory-based models for adolescent office-based counseling, the complexity of measuring counseling quality, and the many factors that influence adolescent outcomes. Reliable and valid measures of counseling quality are needed both to study and to ensure the quality of counseling received by adolescents. No single measure can be expected to fully capture counseling quality, although patient self-report deserves further development.     

Sensation seeking and adolescent drug use: the mediating role of association with deviant peers and pro-drug discussions

In this study, I examined direct and indirect influences of sensation seeking, a personality trait, on adolescent drug use. I hypothesized that some or even most of the contribution of sensation seeking to drug use by adolescents is mediated through association with deviant peers and communication with peers that is favorable toward drug use. I examined the role of additional risk or protective factors in facilitating or impeding association with deviant peers, pro-drug communication, and marijuana use as well. The results of analyzing nationally representative cross-sectional data from the evaluation of the National Youth Anti-Drug Media Campaign support the study's hypotheses and suggest that different factors may protect high sensation-seeking adolescents from using drugs or engaging in activities (e.g., association with deviant peers) that may increase their risk for drug use. I discuss the theoretical, methodological, and practical implications of these findings to the design of health communication interventions.