"4·28"胶济铁路交通事故伤员心理危机的干预

目的 分析淄博铁路交通事故伤员心理行为反应特点以寻找救治交通事故后患者的心理的有效方法.方法 采用心理危机结构式访谈问卷,对2008年4月28日发生的山东淄博胶济铁路重大交通事故中的226伤员进行心理状态评估,并对22名ASD患者进行眼动脱敏再加工(eyemovement desensitization and reprocessing,EMDR)治疗,比较EMDR治疗前后的心理行为反应的差异.结果 有22名达到ASD(急性应激障碍)诊断标准,本次铁路交通事故中ASD的发生率为9.73%,伤员中主要以闯入、警觉性增高表现为主,并伴随着其他的负性情绪体验.女性组ASD的发生率(14.85%)高于男性组(5.60%),P<0.05.女性组心理行为反应结果明显重于男性组(P<0.05).EMDR能够显著改善ASD患者的闯入、警觉性增高症状(P<0.01),但愤怒情绪没有显著改善((P=0.227)).结论 铁路交通事故后,女性比男性更容易发生ASD.EMDR可有效地解决ASD患者除愤怒以外的心理危机.

Psychological intervention in the casualties of 4·28 train crash on the Jiao-Ji railway line

Objective To investigate the psychological characteristics in the casualties of 4·28 train crash on the Jiao-Ji railway track and to find a effective way to relieve the psychological crisis induced by traffic accident.Method A total of 226 casualties were assessed in respect of psychological crisis with interview questionfrom DSM-IV were treated with EMDR.The therapeutic effects of eye movement desensitization and reprocessing (EMDR) on ASD were assessed.Results The incidence of ASD was 9.73% (22 casualties).The major psychological consequences in casualties were intrusive symptoms,symptoms of hyperaroasal,and negative emotional symptoms.Significant differences on gender had been found in incidence rate of ASD female 14.85% and male 5.60%,P<0.05.The women manifested more severe psychological consequences than men in this wain crash accident.Significant treatment effect was found in EMDR on ASD.EMDR can significantly improve the intrusive symptoms and symptoms of hyperaronsal (P<0.05),but can not significantly improve negative emotional symptoms (P>0.05).Conclusions The women showed more severe psychological consequences than men after train crash accident.EMDR was effective treatment on ASD but negative emotional symptoms.