灾难救助者替代性创伤问卷的编制及初步应用
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摘要
替代性创伤的研究始于上世纪九十年代,广义的替代性创伤可以理解为非直接遭受创伤伤害的人们以任何方式接触到创伤性事件而引起的不适反应。其中,灾难救助者群体的替代性创伤研究倍受国内外学者的关注。鉴于目前国内相关实证性研究较少,且缺乏标准化测量工具,编制适用于我国灾难救助者的替代性创伤问卷,有着重要的理论意义和实践价值。
本研究旨在编制灾难救助者替代性创伤问卷,并初步探讨救助者替代性创伤的基本特征。在开放式访谈和文献综述的基础上,采用问卷调查的方式对哈尔滨、北京、唐山、保定等地211名5.12地震救灾志愿者进行测量。通过项目分析、相关分析、因素分析等方法检验问卷信、效度,并通过方差分析等方法探讨替代性创伤人口学变量上的差异,主要得出以下结论：
灾难救助者替代性创伤由心理和生理两部分组成,心理部分由认知反应、情绪反应、行为反应和生活信念四个因素组成,问卷具有良好的信、效度；灾难救助者替代性创伤在年龄、职业、是否曾接受过专业培训以及工作历时等变量上存在显著性差异,在性别变量上仅行为反应因素存在显著性差异；心理工作者和医护人员中,志愿者与非志愿者替代性创伤无显著性差异,而在学生、媒体工作者及其他职业工作者中,志愿者替代性创伤表现程度较非志愿者严重。
Vicarious traumatization refers to a set of negative responses of individual who are exposed to traumatic events by any ways. Particularly, the trauma helpers were paid close attention by professionals. Due to the lack of relevant empirical research and standardized measurement instruments in China, the purposes of this study were developing vicarious traumatization questionnaire and exploring the different demographic characteristics of vicarious traumatization on trauma helpers as well. Based on interview and pilot study, the research subjects who were 211 trauma helpers to Si Chuan after "5.12 earthquake" were investigated.
The questionnaire included two parts of psychological and physiological, and through item analysis and factor analysis, the psychological part were found of four dimensions: cognitive response, emotional response, behavioral response and life beliefs. The reliability and validity of those five subscales were also established.
By the results of ANOVA, the major results were:there were significant differences of vicarious traumatization of trauma helpers on age, occupation, professional training and lengths of helping hours,as the same as that on behavioral response of gender. In addition, trauma participant helpers tend to suffer from more vicarious traumatization than non-participant helpers among students, media workers and other professional helpers, but it was not found in both mental helpers and healthcare helpers.
本研究旨在编制灾难救助者替代性创伤问卷,并初步探讨救助者替代性创伤的基本特征。在开放式访谈和文献综述的基础上,采用问卷调查的方式对哈尔滨、北京、唐山、保定等地211名5.12地震救灾志愿者进行测量。通过项目分析、相关分析、因素分析等方法检验问卷信、效度,并通过方差分析等方法探讨替代性创伤人口学变量上的差异,主要得出以下结论：
灾难救助者替代性创伤由心理和生理两部分组成,心理部分由认知反应、情绪反应、行为反应和生活信念四个因素组成,问卷具有良好的信、效度；灾难救助者替代性创伤在年龄、职业、是否曾接受过专业培训以及工作历时等变量上存在显著性差异,在性别变量上仅行为反应因素存在显著性差异；心理工作者和医护人员中,志愿者与非志愿者替代性创伤无显著性差异,而在学生、媒体工作者及其他职业工作者中,志愿者替代性创伤表现程度较非志愿者严重。
Vicarious traumatization refers to a set of negative responses of individual who are exposed to traumatic events by any ways. Particularly, the trauma helpers were paid close attention by professionals. Due to the lack of relevant empirical research and standardized measurement instruments in China, the purposes of this study were developing vicarious traumatization questionnaire and exploring the different demographic characteristics of vicarious traumatization on trauma helpers as well. Based on interview and pilot study, the research subjects who were 211 trauma helpers to Si Chuan after "5.12 earthquake" were investigated.
The questionnaire included two parts of psychological and physiological, and through item analysis and factor analysis, the psychological part were found of four dimensions: cognitive response, emotional response, behavioral response and life beliefs. The reliability and validity of those five subscales were also established.
By the results of ANOVA, the major results were:there were significant differences of vicarious traumatization of trauma helpers on age, occupation, professional training and lengths of helping hours,as the same as that on behavioral response of gender. In addition, trauma participant helpers tend to suffer from more vicarious traumatization than non-participant helpers among students, media workers and other professional helpers, but it was not found in both mental helpers and healthcare helpers.
引文
[1]Marne Ludick, ed. Vicarious Trau-matisation:Secondary Traumatic Stress Levels in Claims Workers in the Short-Term Insurance Industry in South Africa, Problems and Perspectives in Management.2007,5(3):99-110P
[2]Mitchell K. Byrne, ed. Predicting vicarious traumatization in those indirectly exposed to bushfires. Stress and Health,2006, 22:167,171,173-177P
[3]McCann L.&Pearlman, L. A. Vicarious traumatization:a framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress,1990,3:131-149P
[4]Haley, A. S. When the patient reports atrocities. Archives of General Psychiatry,1974,31:191-196P
[5]Baranowsky, A. B., ed. PTSD transmission:a review of secondary traumatization in Holocaust survivor families. Canadian Psychology,1998,39:247-256P
[6]Anton Hafkenscheid. Event countertransference and vicarious traumatization:Theoretically valid and clinically useful concepts? European Journal of Psychotherapy, Counselling and Health,2005;7 (3):159-168P
[7]Katie B & Amanda C. K. Vicarious traumatization and secondary traumatic stress:A research synthesis. Counselling Psychology Quarterly,2006,19(2):181-188P
[8]钟思嘉.专业助人者的替代性创伤与因应策略.921震后心理复建学术研讨会.台湾,1999
[9]Doukessa Lerias&Mitchell K. Byrne. Vicarious traumatizatio-n:symptoms and predictors. Stress and Health,2003,19:129-138P
[10]杨霞等译.异常心理学.北京：中国轻工业出版社,2006,7：164-167页
[11]Jane Dunkiey. Vicarious traumatisation:current status and future directions. British Journal of Guidance & Counselling, 2006,34(1):107-116P
[12]Figley, C. R. Compassion fatigue as secondary traumatic stress disorder:an overview. In C. R. Figley, Compassion fatigue: coping with secondary traumatic stress disorder in those who treat the traumatized. New York:Brunner Maze,1995:1-20P
[13]Gamble,S.J. Self-care for bereavement counselors. In:WEBB, N, Helping Bereaved Children:a Handbook for Practitioners. NewYork: Guilford Press,2002:346-362P
[14]Blair, D. T.& Ramones, V. A. Understanding VT. Journal of Psychosoc-ial Nursing and Mental Health Services,1996,34:24-30P
[15]Figley, C. R. Compassion fatigue:towards a new understanding of the costs of caring. In B. H. Stamm, Secondary traumatic stress:self care issues for clinicians, researchers, and educators Lutherville, MD:Sidran Press,1995:3-27P
[16]Sexton, L. Vicarious traumatisation of counsellors and effects on their workplaces. British Journal of Guidelines & Counselling, 1999,27:393-403P
[17]Pearlman, L. A,&Saakvitne, K.W. Trauma and the therapist: countertransference and vicarious traumatization in psychotherapy with incest survivors. London:W. W. Norton,1995
[18]马建青主编.震后心理援助指南.杭州：浙江大学社,2008,10：212-244页
[19]Alexander, D. A.&Atcheson, S. F. Psychiatric aspects of trauma care: survey of nurses and doctors. Psychiatric Bulletin,1998,22:132P
[20]Rachel Sabin-Farrell. Vicarious traumatization:implications for the mental health of health workers? Clinical Psychology Review,2003,23:449-450P
[21]McCann, ed. Vicarious traumatization:the emotional costs of working with survivors. Treating Abuse Today,1993,3:28 31P
|22] lliffe, G.,& Steed, L. G. Exploring the counselor's experience of working with perpetrators and survivors of domestic violence. Journal of Interpersonal Violence,2000,15:393-412P
[23]Hunter, M. Vicarious traumatization in counsell-ors working in the New South Wales Sexual Assault Service:an exploratory study. Work and Stress,1997,11:319-328P
[24]Schauben, L. j.& Frazier, P. A. Vicarious trauma:the effects on female counselors of working with sexual violence victims. Psychology of Women Quarterly,1995,19:49-64P
[25]Tedeschi & Calhoun. Posttraumatic growth:conceptual foundations and empirical evidence. Psychological Inquiry,2004,15:1-18P
[26]Kiesler, D. J. Therapist countertransference:In search of common themes and empirical referents. Journal of Clinical Psychology, 2001,57:1053-1063P
[27]Safran, J. D., ed. The resolution of ruptures in the therapeutic alliance. Journal of Consulting and Clinical Psychology,1996, 64:447-458P
[28]Gabbard, G.O. A contemporary psychoanalytic model of countertra ns ference. Journal of Clinical Psychology,2001,57:983-991P
[29]Norcross, J. C. Introduction:in search of the meaning and utility of countertransference. Journal of Clinical Psychology,2001,57: 981 982P
[30]Catherall, D. R. Gression and projective identification in the treatment of victims. Psychotherapy,1991,28:145-149P
[31]Neumann, D. A.,&Gamble, S. J. Issues in the professional development of psychotherapists:countertransference and VT in the new trauma therapist. Psychotherapy,1995,32:341-347P
[32]罗杰斯著.个我形成论.北京,中国人民大学出版社.2004：25-28页
[33]Reynolds, W. Scott, B. Empathy:'a crucial component of the helping relationship. Journal of Psychiatric and Mental Health Nursing, 1999,6:363-370P
[34]Ehlers, A.,& Clark, D. A cognitive model of post traumatic stress disorder. Behaviour Research and Therapy,2000,38:319-345P
[35]Pearlman, ed. Vicarious Traumatization:An Empirical Study of the Effects of Trauma Work on Trauma Therapists. Professional Psychology:Research and Practice.1995,26(6):558-565P
[36]Sundin, E.,&Horowitz, M. Impact of Events Scale:Psychometric properties. British Journal of Psychiatry,2002,180:205-209P
[37]Shelah A. Adams & Shelley A. Riggs. An Exploratory Study of Vicarious Trauma Among Therapist. Trainees. Training and Education in Professional Psychology.2008,2(1):26-34aviour Research and Therapy,2000,38:319-345P
[38]Briere, J. Trauma symptom inventory: Professional manual. Odessa, FL:Psychological Assessment Resources, Inc,1995
[39]Johnsen,B., ed. Posttraumatic stress symptoms in non-exposed, victims and spontaneous rescuers after an avalanche. Journal of TraumaticStress.1997,10:133-140P
[40]Weiss, D., ed. Predicting symptomatic distress in emergency services personnel. Journal of Consulting and Clinical Psychology:1995,63:361-368P
[41]Brewin, C., ed. Metaanalysis of risk factors for posttraumatic stress disorder in trauma exposed adults. Jour-nal of Consulting and Clinical Psychology.2000,68:748-766P
[42]Edward B. Blanchard. Studies of the vicarious traumatization of college students by the September 11th attacks:effects of proximity, exposure and connectedness. Behaviour Research and Therapy.2004,42:191-205P
[43]Gidron.Y. ed. Bus commuters' coping, strategies and anxiety from terrorism:an example of the Israeli experience. Journal of Traumatic Stress.1999,12:185-192P
[44]金瑜.心理测量.上海：华东师范大学出版社,2001：209-226页
[45]吴明降.SPSS统计应用实务.北京：科学出版社,2000：138页
[46]侯杰泰,温忠麟.结构方程模型及其应用.北京：北京教育科学出社,2004
[47]Rachel Sabin-Farrell. Vicarious traumatization:implications for the mental health of health workers? Clinical Psychology Review,2003,23:469-480P
[48]Edward B. Blanchard. Studies of the vicarious traumatization of college students by the September 11th attacks:effects of proximity, exposure and connectedness.Behaviour Research and Therapy.2004,42:2005P
[49]Mitchell ed. Predicting vicarious traumatization in those indirectly exposed to bushfires. Stress and Health,2006,22:170P
[50]De Jong, ed. A comprehensive model of stress:the role of experien-ced stress and neuroticism in explaining the stress-distress relationship. Psychotherapy ad Psychosomatic,1999,68:290-300P
[51]Ensel,W.ed.The stress process,and physical distress:the role of di stal stressors.Journal of Aging and Health,1998,12:139-168P
[52]Adams,K.B.,ed.The traumatic stress institute belief scale as a measure of vicarious trauma in a national sample of clinical socjal workers.Families in Socjety,2001,82:363-371P
[53]Beaton, R., ed.Coping responses and posttraumatic stress symptomatology in urban fire service persnnel. Journal of Traumatie Stress, 1999,12:293-307P
[54]Marmar,C.,ed.Characteristics of emer- gency services personnel related to peritraumatic dissociation during critical incident exposure. American.Journal of Psychiatry.1996,153:94一102P
[55]Mitchell ed. Predicting Vicarious traumatization in those indirectly exposed to bushfires.Stress and Health,2006,22:177P
[2]Mitchell K. Byrne, ed. Predicting vicarious traumatization in those indirectly exposed to bushfires. Stress and Health,2006, 22:167,171,173-177P
[3]McCann L.&Pearlman, L. A. Vicarious traumatization:a framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress,1990,3:131-149P
[4]Haley, A. S. When the patient reports atrocities. Archives of General Psychiatry,1974,31:191-196P
[5]Baranowsky, A. B., ed. PTSD transmission:a review of secondary traumatization in Holocaust survivor families. Canadian Psychology,1998,39:247-256P
[6]Anton Hafkenscheid. Event countertransference and vicarious traumatization:Theoretically valid and clinically useful concepts? European Journal of Psychotherapy, Counselling and Health,2005;7 (3):159-168P
[7]Katie B & Amanda C. K. Vicarious traumatization and secondary traumatic stress:A research synthesis. Counselling Psychology Quarterly,2006,19(2):181-188P
[8]钟思嘉.专业助人者的替代性创伤与因应策略.921震后心理复建学术研讨会.台湾,1999
[9]Doukessa Lerias&Mitchell K. Byrne. Vicarious traumatizatio-n:symptoms and predictors. Stress and Health,2003,19:129-138P
[10]杨霞等译.异常心理学.北京：中国轻工业出版社,2006,7：164-167页
[11]Jane Dunkiey. Vicarious traumatisation:current status and future directions. British Journal of Guidance & Counselling, 2006,34(1):107-116P
[12]Figley, C. R. Compassion fatigue as secondary traumatic stress disorder:an overview. In C. R. Figley, Compassion fatigue: coping with secondary traumatic stress disorder in those who treat the traumatized. New York:Brunner Maze,1995:1-20P
[13]Gamble,S.J. Self-care for bereavement counselors. In:WEBB, N, Helping Bereaved Children:a Handbook for Practitioners. NewYork: Guilford Press,2002:346-362P
[14]Blair, D. T.& Ramones, V. A. Understanding VT. Journal of Psychosoc-ial Nursing and Mental Health Services,1996,34:24-30P
[15]Figley, C. R. Compassion fatigue:towards a new understanding of the costs of caring. In B. H. Stamm, Secondary traumatic stress:self care issues for clinicians, researchers, and educators Lutherville, MD:Sidran Press,1995:3-27P
[16]Sexton, L. Vicarious traumatisation of counsellors and effects on their workplaces. British Journal of Guidelines & Counselling, 1999,27:393-403P
[17]Pearlman, L. A,&Saakvitne, K.W. Trauma and the therapist: countertransference and vicarious traumatization in psychotherapy with incest survivors. London:W. W. Norton,1995
[18]马建青主编.震后心理援助指南.杭州：浙江大学社,2008,10：212-244页
[19]Alexander, D. A.&Atcheson, S. F. Psychiatric aspects of trauma care: survey of nurses and doctors. Psychiatric Bulletin,1998,22:132P
[20]Rachel Sabin-Farrell. Vicarious traumatization:implications for the mental health of health workers? Clinical Psychology Review,2003,23:449-450P
[21]McCann, ed. Vicarious traumatization:the emotional costs of working with survivors. Treating Abuse Today,1993,3:28 31P
|22] lliffe, G.,& Steed, L. G. Exploring the counselor's experience of working with perpetrators and survivors of domestic violence. Journal of Interpersonal Violence,2000,15:393-412P
[23]Hunter, M. Vicarious traumatization in counsell-ors working in the New South Wales Sexual Assault Service:an exploratory study. Work and Stress,1997,11:319-328P
[24]Schauben, L. j.& Frazier, P. A. Vicarious trauma:the effects on female counselors of working with sexual violence victims. Psychology of Women Quarterly,1995,19:49-64P
[25]Tedeschi & Calhoun. Posttraumatic growth:conceptual foundations and empirical evidence. Psychological Inquiry,2004,15:1-18P
[26]Kiesler, D. J. Therapist countertransference:In search of common themes and empirical referents. Journal of Clinical Psychology, 2001,57:1053-1063P
[27]Safran, J. D., ed. The resolution of ruptures in the therapeutic alliance. Journal of Consulting and Clinical Psychology,1996, 64:447-458P
[28]Gabbard, G.O. A contemporary psychoanalytic model of countertra ns ference. Journal of Clinical Psychology,2001,57:983-991P
[29]Norcross, J. C. Introduction:in search of the meaning and utility of countertransference. Journal of Clinical Psychology,2001,57: 981 982P
[30]Catherall, D. R. Gression and projective identification in the treatment of victims. Psychotherapy,1991,28:145-149P
[31]Neumann, D. A.,&Gamble, S. J. Issues in the professional development of psychotherapists:countertransference and VT in the new trauma therapist. Psychotherapy,1995,32:341-347P
[32]罗杰斯著.个我形成论.北京,中国人民大学出版社.2004：25-28页
[33]Reynolds, W. Scott, B. Empathy:'a crucial component of the helping relationship. Journal of Psychiatric and Mental Health Nursing, 1999,6:363-370P
[34]Ehlers, A.,& Clark, D. A cognitive model of post traumatic stress disorder. Behaviour Research and Therapy,2000,38:319-345P
[35]Pearlman, ed. Vicarious Traumatization:An Empirical Study of the Effects of Trauma Work on Trauma Therapists. Professional Psychology:Research and Practice.1995,26(6):558-565P
[36]Sundin, E.,&Horowitz, M. Impact of Events Scale:Psychometric properties. British Journal of Psychiatry,2002,180:205-209P
[37]Shelah A. Adams & Shelley A. Riggs. An Exploratory Study of Vicarious Trauma Among Therapist. Trainees. Training and Education in Professional Psychology.2008,2(1):26-34aviour Research and Therapy,2000,38:319-345P
[38]Briere, J. Trauma symptom inventory: Professional manual. Odessa, FL:Psychological Assessment Resources, Inc,1995
[39]Johnsen,B., ed. Posttraumatic stress symptoms in non-exposed, victims and spontaneous rescuers after an avalanche. Journal of TraumaticStress.1997,10:133-140P
[40]Weiss, D., ed. Predicting symptomatic distress in emergency services personnel. Journal of Consulting and Clinical Psychology:1995,63:361-368P
[41]Brewin, C., ed. Metaanalysis of risk factors for posttraumatic stress disorder in trauma exposed adults. Jour-nal of Consulting and Clinical Psychology.2000,68:748-766P
[42]Edward B. Blanchard. Studies of the vicarious traumatization of college students by the September 11th attacks:effects of proximity, exposure and connectedness. Behaviour Research and Therapy.2004,42:191-205P
[43]Gidron.Y. ed. Bus commuters' coping, strategies and anxiety from terrorism:an example of the Israeli experience. Journal of Traumatic Stress.1999,12:185-192P
[44]金瑜.心理测量.上海：华东师范大学出版社,2001：209-226页
[45]吴明降.SPSS统计应用实务.北京：科学出版社,2000：138页
[46]侯杰泰,温忠麟.结构方程模型及其应用.北京：北京教育科学出社,2004
[47]Rachel Sabin-Farrell. Vicarious traumatization:implications for the mental health of health workers? Clinical Psychology Review,2003,23:469-480P
[48]Edward B. Blanchard. Studies of the vicarious traumatization of college students by the September 11th attacks:effects of proximity, exposure and connectedness.Behaviour Research and Therapy.2004,42:2005P
[49]Mitchell ed. Predicting vicarious traumatization in those indirectly exposed to bushfires. Stress and Health,2006,22:170P
[50]De Jong, ed. A comprehensive model of stress:the role of experien-ced stress and neuroticism in explaining the stress-distress relationship. Psychotherapy ad Psychosomatic,1999,68:290-300P
[51]Ensel,W.ed.The stress process,and physical distress:the role of di stal stressors.Journal of Aging and Health,1998,12:139-168P
[52]Adams,K.B.,ed.The traumatic stress institute belief scale as a measure of vicarious trauma in a national sample of clinical socjal workers.Families in Socjety,2001,82:363-371P
[53]Beaton, R., ed.Coping responses and posttraumatic stress symptomatology in urban fire service persnnel. Journal of Traumatie Stress, 1999,12:293-307P
[54]Marmar,C.,ed.Characteristics of emer- gency services personnel related to peritraumatic dissociation during critical incident exposure. American.Journal of Psychiatry.1996,153:94一102P
[55]Mitchell ed. Predicting Vicarious traumatization in those indirectly exposed to bushfires.Stress and Health,2006,22:177P