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.

A follow-up study on the post-traumatic stress disorders among middle school students in Wenchuan earthquake region

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.