救援军人创伤后应激障碍阳性检出率及心理社会影响因素研究

目的：调查研究救援军人创伤后应激障碍（ post-traumatic stress disorder ，PTSD）阳性检出率及其心理社会影响因素，探索针对救援部队的PTSD预防措施。方法从汶川地震救援部队整群抽取2600名军人，采用创伤后应激障碍评定量表（ PCL-S）对救援军人的PTSD症状进行评定，采用自制救援军人一般情况问卷、军事群体应激预警检测问卷（ ATQMGS）、状态-特质焦虑清单分析救援军人PTSD的影响因素。结果救援军人中PTSD阳性检出71例，阳性率为2．9％；以人口学资料分组差异检验显示，不同职别、救援持续时间、家庭结构、创伤史、精神问题史和救援中伤病史的救援军人，PTSD症状差异显著；初始暴露强度不同的救援军人，PTSD症状差异不显著；PTSD症状与特质焦虑、士气、自我效能呈显著正相关，与领导支持、控制感、晋升动机、任务认知、单位归属感、岗位价值感呈显著负相关；多元线性回归分析显示，特质焦虑、领导支持、创伤史、控制感、精神问题史、救援中伤病史、救援持续时间、职别是救援军人PTSD症状的主要影响因素。结论与以往研究相比，此次救援军人的PTSD阳性检出率处于更低水平；职别、家庭结构、创伤史、救援持续时间、精神问题史、救援中伤病史以及特质焦虑、士气、自我效能、领导支持、控制感、晋升动机、任务认知、单位归属感、岗位价值感等因素与救援军人PTSD症状均相关；PTSD症状的主要影响因素有：特质焦虑、领导支持、创伤史、控制感、精神问题史、救援中伤病史、职别、救援持续时间。初始暴露强度不是救援军人PTSD发生的决定因素。

Detection rate of post-traumatic stress disorder symptoms among military rescuers in Wenchuan earthquake and its interventional factors

Objective To investigate the positive detectable rate of post-traumatic stress disorder （ PTSD ） and its influencing factors among the military rescuers , and explore preventive measures for rescuers .Method At three points , 2600 soldiers from Wenchuan military rescuers were enrolled , whose PTSD symptoms were evaluated by PCL-S.Self-edited questionnaires on the general state , Alerting Test Questionnaires for Military Group Stress （ ATQMGS ） , and State-Trait Anxiety Inventory（STAI）were used to evaluate the influencing factors of rescuers′PTSD symptoms.Results Seventy-one rescuers were tested positive for PTSD and the positive detectable rate was 2.9%.On the basis of demographic data , the difference test suggested that rescuers different in terms of positions , duration of rescue, family structure, trauma history, mental problem history or trauma history during the rescue were significantly differenct in PTSD symptoms , which were strongly and positively correlated with anxiety , morale, and self-efficacy, but were strongly and negatively correlated with leadership support , control feeling , promotion motivation , cognition of tasks , sense of belonging and work value .Multiple linear regression showed that the influencing factors of PTSD symptoms included the trait of anxiety , leadership support , trauma history, control feeling, mental problem history, trauma history during the rescue, position and duration of rescue. Conclusion The PTSD positive detectable rates among the military rescuers are lower than in the previous research.PTSD symptoms of military rescuers are related to such factors as the position , duration of rescue , family structure , trauma histo ry, mental problem history, trauma history during the rescue, trait of anxiety, morale, self -efficacy, leadership support, control feeling , promotion motivation , cognition of tasks , sense of belonging and work value .The influencing factors of PTSD symptoms are the trait of anxiety , leadership support, trauma history, control feeling, mental problem history, trau-ma history during the rescue , position level and rescue duration .