汶川震后两年异地复学青少年创伤后应激反应及心理状况研究
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摘要
目的:在汶川地震两周年时,调查长春市某中学震区异地复学青少年创伤后应激障碍(PTSD)症状检出率,应对方式特点和心理健康状况,分析并探讨地震和异地复学对震区青少年的心理健康影响及危险因素;为今后心理干预和震后安置提供依据。
方法:采取整群抽样法,抽取在长春市某中学异地复学的190名来自地震极重灾区四川省茂县羌族初中二年级学生作为研究样本,予以问卷调查。共计190名学生接受了调查并填写了问卷,收回有效问卷180份,有效回收率为94.74%。其中男性85人,女性95人。被试年龄13-17岁,平均年龄为15.08±0.967岁。调查问卷包括自编地震基本情况调查表,创伤后应激障碍自评量表,症状自评量表,简易应对方式问卷等。心理测查过程严格质量控制。所有数据录入Excel2000建立数据库并整理编码。采用SPSS14.0统计软件对资料统计学分析。统计方法包括:统计描述,t检验,方差分析,Pearson相关及Spearman相关分析。
结果:1.创伤后应激症状(PTSS)检出率为65.6%,其中轻度PTSS占16.7%;中重度占48.9%。
2. 92.8%的震区异地复学青少年感到有学习压力;女性被试比男性被试体验到更多的分离症状; 167人(94.4%)使用积极应对方式;10人(5.7%)采取消极应对方式。
3.在地震中是否有被困经历、是否有恐怖经历、是否目睹/接触遇难遗体等因素对PTSD-SS总分及三个因子分(重现/回避症状、心理障碍/功能受损、情感麻木/紧张敏感)有显著影响(p<0.001);有被困经历、恐怖经历、目睹/接触过遇难遗体的被试要比没有此类经历的被试在PTSS总分及三个因子上的得分高,且差异显著(p<0.05)。
4.不同年龄、不同性别的被试PTSS总分及因子得分上有差异。13～14岁年龄组比15、16～17岁年龄组在PTSS总分[F(2,177)=4.048, p<0.05]及重现/回避症状[F(2,177)=3.361, p<0.05]、心理障碍/功能受损[F(2,177)=3.420, p<0.05]、情感麻木/紧张敏感[F(2,177)=3.419, p<0.05]等三个因子的得分低,差异显著;女性在PTSS总分及三个因子的得分比男性高,差异显著(p<0.05)。
5.震区异地复学青少年中有61.1%的人存在不同程度心理问题。被试群体在躯体化、强迫、人际敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性等各因子得分均显著高于中国青少年常模水平(p<0.001);有过被困经历、恐怖经历以及目睹/接触过遇难遗体的被试比没有此类经历的被试SCL-90总分及各因子分高,存在统计学差异(p<0.05)。在躯体化、强迫、人际敏感、抑郁、焦虑、恐怖、偏执、精神病性八个因子上女性被试的得分均高于男性;特别是在在强迫、抑郁、恐怖这三个因子上,女性被试得分显著高于男性被试,但在敌对因子上男性得分高于女性,但差异不显著。
6.震区异地复学青少年心理健康状况与PTSD-SS总分和因子分的相关分析:结果显示SCL-90总分以及躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性各因子得分和PTSD-SS总分以及重现/回避症状、心理障碍/功能受损、情感麻木/紧张敏感这三个因子分都呈显著正相关(p<0.05);
7.震区异地复学青少年经历地震后有28.3%的人感到中、重度痛苦,65%的人感到轻度痛苦;地震痛苦程度与PTSD-SS总分及因子分呈显著正相关(p<0.05)。
结论:1.地震极重灾区异地复学青少年在地震两年后存在较高创伤后应激反应和心理健康问题,其中创伤后应激症状检出率为65.6%;有61.1%的青少年存在心理健康问题。异地复学青少年心理健康水平低于中国青少年平均水平。女性比男性更易出现创伤后应激症状和心理问题,女性心理问题主要症状为强迫、抑郁、恐怖;心理问题越重,创伤后应激症状会越明显。
2.在地震中有过被困经历、有恐怖经历、有目睹/接触过遇难者遗体以及地震痛苦程度是创伤后应激症状和心理问题的重要相关因素。
3.震区异地复学青少年心理健康需要特别关注;有必要对这一群体进行有效的心理干预;提供社会和家庭支持。
Purpose:
The aim of the study is to investigate the relevance ratio of PTSD, evaluate the psychologic status and the defense mechanism as well as the coping style in teenagers survived in the earthquake who had returned to school in different places and a psychological service had been provided for them. We analyzed the psychologic influence and risk factor to the adolescents suffered from the demographic factors,, the earthquake exposure levels, coping styles and had been back to school in different places. We hope this study can provide a guidance for the psychological intervention and treatment for future.
Methods:
By using the cluster sampling method, The psychological measurements were made in 190 junior middle school students of Qiang Nationality, who were from disaster area, Mao county, Sichuan, and had returned to school in Changchun. One hundred ninety questionnaires were sent out and there were 180 valid questionnaires, availability is 94.74% , The students screened included 85 boys, 95 , age range, 13–17 years; mean age, 15.08±0.967 years. The measuring scales used were as follows: self-designed basic questionnaire for earthquake traumatic exposure, post-traumatic stress disorder self-rating scale(PTSD-SS), symptom checklist 90(SCL-90), simplified coping style questionnaire, etc. All data were logged in Excel 2000 and a database was established. All analyses were performed using SPSS for Windows, version 14.0. Statistical methods included as follows: statistical description, t test, ANOVA, Pearson correlation and Spearman correlation analysis.
Results:
1. The detection rate of post -traumatic stress symptoms(PTSS)is 65.6%. including 16.7% with mildly abnormal PTSS and 48.9% with moderate to severe.
2. Teenagers felt progressive study pressures; Women who had experience separation symptoms gain more feeling than that of men in this test. 167 people (94.4%) use positive coping styles; 10 people (5.7%) take negative coping styles.
3. Whether trapped experience in the quake, whether have the experience of fear and terror, Whether or not witnessed or contacted corpse have significantly effect(p<0.001)(reappear/avoidance symptoms, psychological barrier/dysfunction score, emotional numbing/nervous sensitive symptoms). One who has the experience of been trapped and fear, witnessed or contacted corpse gets a higher score in total score and three factors of PTSD-SS than who has no these experiences, and have a significantly differences(p<0.05).
4. People of different ages have different scores in PTSS and the three factors. 13 to 14 age group get lower score than 15 and 16 ~ 17 years old age group in PTSS total cent [F(2,177)=4.048, p<0.05]and recreate/withdrawal symptoms[F(2,177)=3.361, p<0.05], psychological obstacles/function is impaired[F(2,177)=3.420, p<0.05], emotional numbing/nervous sensitive[F(2,177)=3.419, p<0.05] and have significant differences; Girls get higher score ,significant differences, than boys in total cent and three factors of PTSS(p<0.05).
5. 61.1% of teens who had returned to school in different places have lots of different psychological problems, including somzatization , force, interpersonal sensitive, depression, anxiety, hostile, terror, paranoid, psychoticism and so on , various factors score significantly higher level of the norm of Chinese teenagers (p < 0.001); Trapped experience, horror and see/contact corpses was trying to get higher score than others who has no experience and exist statistical differences in SCL - 90 (p < 0.05). Except in hostile factor on males gets higher than men; In force, depression, terror that three factors, there was a significant difference between women and men, women were trying to get higher score than men.
6. Teenagers who had returned to school in different places, their mental health and PTSS total score and factors of correlation analysis: result points total score of SCL - 90, and somzatization, sensitive interpersonal relation, depression, anxiety, hostile, terror, paranoid, psychoticism factor score respectively with total score of PTSD - SS/ar symptoms, and reproduce psychological barrier/function damaged and emotional numbing/nervous sensitive these three factors points are positively correlated (p<0.05).
7. 28.3% of teenagers who had returned to school in different places felt medium or heavy pain after the earthquake, 65 percent of people felt mild pain; Pain degree of degree and total cent of PTSD - SS and factor points is a significant positive correlation.
Conclusion:
1. Teenagers who had returned to school in different places to study from the heavy earthquake area after two years ago, still existing the higher post-traumatic stress and psychological problems . The detection rate of post -traumatic stress symptoms(PTSS)is 65.6%; 61.1% of them have lots of different psychological problems. Back to school mental health of young people in different places lower than the average level of the China Youth. Women are more vulnerable than men to post-traumatic stress symptoms and psychological problems, The main symptoms of psychological problems of women is compulsion, depression, terror. The heavier psychological problem , the more obvious PTSS will be.
2.Trapped in the earthquake, had experience with the horrors, witnessed/contact bodies and the degree of seismic suffering post-traumatic stress symptoms and psychological problems are important factors.
3. All of these teenagers’mental health must pay attention; It is necessary to effectively this group psychological intervention; Provide social and family support to help them to alleviate post-traumatic stress symptoms and solve the psychological problems.
方法:采取整群抽样法,抽取在长春市某中学异地复学的190名来自地震极重灾区四川省茂县羌族初中二年级学生作为研究样本,予以问卷调查。共计190名学生接受了调查并填写了问卷,收回有效问卷180份,有效回收率为94.74%。其中男性85人,女性95人。被试年龄13-17岁,平均年龄为15.08±0.967岁。调查问卷包括自编地震基本情况调查表,创伤后应激障碍自评量表,症状自评量表,简易应对方式问卷等。心理测查过程严格质量控制。所有数据录入Excel2000建立数据库并整理编码。采用SPSS14.0统计软件对资料统计学分析。统计方法包括:统计描述,t检验,方差分析,Pearson相关及Spearman相关分析。
结果:1.创伤后应激症状(PTSS)检出率为65.6%,其中轻度PTSS占16.7%;中重度占48.9%。
2. 92.8%的震区异地复学青少年感到有学习压力;女性被试比男性被试体验到更多的分离症状; 167人(94.4%)使用积极应对方式;10人(5.7%)采取消极应对方式。
3.在地震中是否有被困经历、是否有恐怖经历、是否目睹/接触遇难遗体等因素对PTSD-SS总分及三个因子分(重现/回避症状、心理障碍/功能受损、情感麻木/紧张敏感)有显著影响(p<0.001);有被困经历、恐怖经历、目睹/接触过遇难遗体的被试要比没有此类经历的被试在PTSS总分及三个因子上的得分高,且差异显著(p<0.05)。
4.不同年龄、不同性别的被试PTSS总分及因子得分上有差异。13～14岁年龄组比15、16～17岁年龄组在PTSS总分[F(2,177)=4.048, p<0.05]及重现/回避症状[F(2,177)=3.361, p<0.05]、心理障碍/功能受损[F(2,177)=3.420, p<0.05]、情感麻木/紧张敏感[F(2,177)=3.419, p<0.05]等三个因子的得分低,差异显著;女性在PTSS总分及三个因子的得分比男性高,差异显著(p<0.05)。
5.震区异地复学青少年中有61.1%的人存在不同程度心理问题。被试群体在躯体化、强迫、人际敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性等各因子得分均显著高于中国青少年常模水平(p<0.001);有过被困经历、恐怖经历以及目睹/接触过遇难遗体的被试比没有此类经历的被试SCL-90总分及各因子分高,存在统计学差异(p<0.05)。在躯体化、强迫、人际敏感、抑郁、焦虑、恐怖、偏执、精神病性八个因子上女性被试的得分均高于男性;特别是在在强迫、抑郁、恐怖这三个因子上,女性被试得分显著高于男性被试,但在敌对因子上男性得分高于女性,但差异不显著。
6.震区异地复学青少年心理健康状况与PTSD-SS总分和因子分的相关分析:结果显示SCL-90总分以及躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性各因子得分和PTSD-SS总分以及重现/回避症状、心理障碍/功能受损、情感麻木/紧张敏感这三个因子分都呈显著正相关(p<0.05);
7.震区异地复学青少年经历地震后有28.3%的人感到中、重度痛苦,65%的人感到轻度痛苦;地震痛苦程度与PTSD-SS总分及因子分呈显著正相关(p<0.05)。
结论:1.地震极重灾区异地复学青少年在地震两年后存在较高创伤后应激反应和心理健康问题,其中创伤后应激症状检出率为65.6%;有61.1%的青少年存在心理健康问题。异地复学青少年心理健康水平低于中国青少年平均水平。女性比男性更易出现创伤后应激症状和心理问题,女性心理问题主要症状为强迫、抑郁、恐怖;心理问题越重,创伤后应激症状会越明显。
2.在地震中有过被困经历、有恐怖经历、有目睹/接触过遇难者遗体以及地震痛苦程度是创伤后应激症状和心理问题的重要相关因素。
3.震区异地复学青少年心理健康需要特别关注;有必要对这一群体进行有效的心理干预;提供社会和家庭支持。
Purpose:
The aim of the study is to investigate the relevance ratio of PTSD, evaluate the psychologic status and the defense mechanism as well as the coping style in teenagers survived in the earthquake who had returned to school in different places and a psychological service had been provided for them. We analyzed the psychologic influence and risk factor to the adolescents suffered from the demographic factors,, the earthquake exposure levels, coping styles and had been back to school in different places. We hope this study can provide a guidance for the psychological intervention and treatment for future.
Methods:
By using the cluster sampling method, The psychological measurements were made in 190 junior middle school students of Qiang Nationality, who were from disaster area, Mao county, Sichuan, and had returned to school in Changchun. One hundred ninety questionnaires were sent out and there were 180 valid questionnaires, availability is 94.74% , The students screened included 85 boys, 95 , age range, 13–17 years; mean age, 15.08±0.967 years. The measuring scales used were as follows: self-designed basic questionnaire for earthquake traumatic exposure, post-traumatic stress disorder self-rating scale(PTSD-SS), symptom checklist 90(SCL-90), simplified coping style questionnaire, etc. All data were logged in Excel 2000 and a database was established. All analyses were performed using SPSS for Windows, version 14.0. Statistical methods included as follows: statistical description, t test, ANOVA, Pearson correlation and Spearman correlation analysis.
Results:
1. The detection rate of post -traumatic stress symptoms(PTSS)is 65.6%. including 16.7% with mildly abnormal PTSS and 48.9% with moderate to severe.
2. Teenagers felt progressive study pressures; Women who had experience separation symptoms gain more feeling than that of men in this test. 167 people (94.4%) use positive coping styles; 10 people (5.7%) take negative coping styles.
3. Whether trapped experience in the quake, whether have the experience of fear and terror, Whether or not witnessed or contacted corpse have significantly effect(p<0.001)(reappear/avoidance symptoms, psychological barrier/dysfunction score, emotional numbing/nervous sensitive symptoms). One who has the experience of been trapped and fear, witnessed or contacted corpse gets a higher score in total score and three factors of PTSD-SS than who has no these experiences, and have a significantly differences(p<0.05).
4. People of different ages have different scores in PTSS and the three factors. 13 to 14 age group get lower score than 15 and 16 ~ 17 years old age group in PTSS total cent [F(2,177)=4.048, p<0.05]and recreate/withdrawal symptoms[F(2,177)=3.361, p<0.05], psychological obstacles/function is impaired[F(2,177)=3.420, p<0.05], emotional numbing/nervous sensitive[F(2,177)=3.419, p<0.05] and have significant differences; Girls get higher score ,significant differences, than boys in total cent and three factors of PTSS(p<0.05).
5. 61.1% of teens who had returned to school in different places have lots of different psychological problems, including somzatization , force, interpersonal sensitive, depression, anxiety, hostile, terror, paranoid, psychoticism and so on , various factors score significantly higher level of the norm of Chinese teenagers (p < 0.001); Trapped experience, horror and see/contact corpses was trying to get higher score than others who has no experience and exist statistical differences in SCL - 90 (p < 0.05). Except in hostile factor on males gets higher than men; In force, depression, terror that three factors, there was a significant difference between women and men, women were trying to get higher score than men.
6. Teenagers who had returned to school in different places, their mental health and PTSS total score and factors of correlation analysis: result points total score of SCL - 90, and somzatization, sensitive interpersonal relation, depression, anxiety, hostile, terror, paranoid, psychoticism factor score respectively with total score of PTSD - SS/ar symptoms, and reproduce psychological barrier/function damaged and emotional numbing/nervous sensitive these three factors points are positively correlated (p<0.05).
7. 28.3% of teenagers who had returned to school in different places felt medium or heavy pain after the earthquake, 65 percent of people felt mild pain; Pain degree of degree and total cent of PTSD - SS and factor points is a significant positive correlation.
Conclusion:
1. Teenagers who had returned to school in different places to study from the heavy earthquake area after two years ago, still existing the higher post-traumatic stress and psychological problems . The detection rate of post -traumatic stress symptoms(PTSS)is 65.6%; 61.1% of them have lots of different psychological problems. Back to school mental health of young people in different places lower than the average level of the China Youth. Women are more vulnerable than men to post-traumatic stress symptoms and psychological problems, The main symptoms of psychological problems of women is compulsion, depression, terror. The heavier psychological problem , the more obvious PTSS will be.
2.Trapped in the earthquake, had experience with the horrors, witnessed/contact bodies and the degree of seismic suffering post-traumatic stress symptoms and psychological problems are important factors.
3. All of these teenagers’mental health must pay attention; It is necessary to effectively this group psychological intervention; Provide social and family support to help them to alleviate post-traumatic stress symptoms and solve the psychological problems.
引文
[1]徐凯文等译.心理创伤的治疗指南[M].中国轻工业出版社,2009.
[2]宁维卫等.震后心理教育的理论与实践[M].四川出版集团四川人民出版社,2009.
[3]张本,王学义,孙贺祥,等.唐山大地震所致孤儿心理创伤后应激障碍的调查[J].中华精神科杂志,2000,33(2):111-114
[4]赵丞智,汪向东,高岚,等.张北尚义地震后创伤后应激障碍随访研究[J].中国心理卫生杂志.2000,14(6):361-36
[5]侯彩兰,李凌江,张燕,等.矿难后2个月和10个月创伤后应激障碍的发生率及相关因素[J].中南大学学报(医学版),2008,33(4):280-283
[6]惠武利,施旺红,徐德忠,等.烟台海难援救军人创伤后应激障碍发生者SCL-90分析[J].第四军医大学学报,2001,22(19):1818-1820
[7]徐勇,张克让,薛云珍,等. SARS的一线医务人员创伤后应激反应研究[J].护理研究:下半月,2004,18(1):179-181
[8]沈兴华,叶小飞,彭云丽,等.地震震区茂县儿童、中学生震后急性应激心理反应及干预研究.中国健康心理学杂志,2009,17(4):481-483
[9]陶靖,赖念华,樊富珉,等.重新异地安置对地震后青少年的影响:灾后青少年的现状和对相关志愿活动的反思[C].北京市社会心理学会2009年学术年会-5.12汉川大地震纪念专题,2009
[10] GoenjinanAK,Molina L ,Steinberg AM,et al. Posttraumatic stress and depressive reactions among Nicaraguan adolescents after Hurricane Mitch . American Journal of Psychiatry,2001,158(5):788-794.
[11]何鸣,杨德森.翻车事故幸存者中精神创伤后应激障碍[J].中国心理卫生杂志,1993,7(4):148-151.
[12] Hsu C.Chong M,Yang P.et a1.Posttraumatic stress disorder amongadolescent earthquake victims in Taiwan.Journal of American Academy of Child and Adolescent Psychiatry.2002,4l:875-881.
[13]吴坎坎,张雨青和Peter TZC.灾后民众创伤后应激障碍(PTSD)与事件冲击量表(IES)的发展与应用[J].心理科学进展,2009,17(3):495-498.
[14]王焕林,崔庶.中国军人心理创伤后应激障碍的流行学调查[J].中华精神科杂志,1996,29(2):69-72.
[15]刘贤臣,马登贷.心理创伤后应激障碍自评量表的编制和信度研究[J].中国行为医学科学,1998,7(2):93-96.
[16]何恩忠.心理创伤后应激障碍46例临床分析[J].安徽医学,1998,19(5):78.
[17]杨亚黎,粟卫国.克拉玛依市火灾死难儿童双亲的心理反应[M].中国医学伦理学,1999,6:28-29.
[18]赵丞智,李俊福,王明山等.地震后17个月受灾青少年PTSD及其相关因素[J].中国心理卫生杂志,2001,15(3):145-147.
[19] Wickrama KAS,kaspar V.Family context of mental health risk ,in Tsunami-exposed adolescents:Findings from a pilot study in Sri Lanka . Social Science and Medicine,2007,64(3):713-723.
[20] Ylrbik O,Akbiyik DI,Kirmizigul P,Hmen T.Post-traumatic stress disorder symptoms in children after the 1999 Marmara earthquake in Turkey . International Journal lf Mental Health,2004,33(1):46-58.
[21]范一鸣,孙源泉,官瑞莹,等.异地复学震区中小学生PTSD及心理健康状况的调查[J].心理科学进展,2009,17(3): 393-397.
[22]向莹君,熊国玉,董毅强,等.汶川地震灾区1960名中学生创伤后应激障碍症状调查[J].中国心理卫生杂志,2010,24(1):17-20.
[23] Sharan P. Chaudhary G. Kavathekar S A. et al. 1996. Preliminary report of psychiatric disorders in survivors of a severe earthquake.Am JPsychiatry,153(4):556-558.
[24]沃建中.灾后心理危机研究[M].北京航空航天大学出版社,2008,9:6.
[25] Yehuda R,McFarlance A.C;Confilict between current knowledge about posttraumatic stress disorder and its original conceptual basis.Am J Psychiatry.1995;152:1705-1713.
[26]李凌江,于欣.创伤后应激障碍防治指南[M].人民卫生出版社,2010
[27] Kilpatrick D,Satmders B.Veronen L.et aL Rape’in America:A report to the nation.Arlington:National Victims Center.1987:36-41.
[28] Breslau N.epidemiologic studies of trauma,posttraumatic stress disorder and other psychiatric disorder [J].Can J psychiatry,2002,47:923-929.
[29] Solomon,Z;Mikulincer,M; Psychological sequelae of war: a two year follow-up study of Israeli combat stress reaction casualties. Joural of Nervous and mental Disease, 1988;178,264-269.
[30]赵丞智,李俊福,王明山,等.地震后来17个月受灾青少年PTSD及其相关因素[J].中国心理卫生杂志,2001.15(3):145-147.
[31] Priebe s, Grappasonni I,Mari M,et al.Posttraumatic stess disordet six months aftrt an earthquake:Findings from acommunity sample in a rural region in ltaly[J].Soc Psychiatry Psychiatr Epidemiol,2009,44,393-397.
[32]罗兴伟,高雪屏,蔡太生,等.汶川地震亲历者心理健康状况调查[J].中国临床心理杂志,2008,6(16):571-573.
[33] Hsien WK,Wu SJ,Ma TC,Chiu MC,Chou SY.Posttrau-matic symptoms were worst among quake victims with injuries following the Chi-chi quake in Taiwan.Journal of Psychosomatic Research,2007,62:495-500.
[34]柳武妹,武方,郑裕鸿,等.震后6个月都江堰地区青少年创伤后应激症状及相关因素[J].中国心理卫生杂志,2010,24(9):647-651.
[35]马宁,何鸣,梁光明,等.震后9个月部分受灾群众精神痛苦现况调查[J].中国心理卫生杂志,2010,24(7):509-514.
[36]赵高峰,杨彦春,张强,等.汶川地震重灾区社区居民创伤后应激障碍发生率及影响因素[J].中国心理卫生杂志.2009,23(7):478:482
[37]施琪嘉,Wolfgang Send.心理创伤治疗原则[M].中国心理治疗对话.心理创伤(第1辑).2008.
[38]徐凯文等译.心理创伤的治疗指南[M].中国轻工业出版社,2009.
[39]宁维卫等.震后心理教育的理论与实践[M].四川出版集团四川人民出版社,2009.
[40]严文华,李骥.地震后儿童和青少年团体心理游戏培训手册[M].华东师范大学出版社,2008.
[41]施琪嘉,Wolfgang Send.埃森创伤问卷[M].中国心理治疗对话.心理创伤(第1辑).2008.
[42]陈昌惠.症状自评量表(SCL - 90).汪向东,王希林,马弘,编著.心理卫生评定量表手册.中国心理卫生杂志, 1999 (增刊) : 31-35.
[43]解亚宁.简易应对方式问卷.汪向东,王希林,马弘,编著.心理卫生评定量表手册.中国心理卫生杂志, 1999 (增刊) : 100-102.
[44]赵国秋,汪永光,王义强,等.汶川地震后急性应激障碍发生率及影响因素[J].中华预防医学杂志,2008,4(11):802-805.
[45]杨艳芳,叶运莉,李婷,等.汶川地震重灾区中学生震后心理状况[J].中华预防医学杂志,2010,44(2):134-139
[46]黄河清,杨惠琴,韩布新,等.汶川地震后不同灾情地区老年人创伤后应激障碍发生率及影响因素[J].中国老年学杂志,2009,29(10):1275-1277
[47]李桂萍,黄春娟,叶雪花,等.躯体形式障碍患者心理支持与放松疗法的疗效观察[J].护理与康复,2006,5(5):371-372.
[48]邬晓娟,周娟,周肖榕,等.5.12地震后PTSD症状严重性和社会支持之间的相关性研究.神经损伤与功能重建[J].2010,5(4):285-287
[49]卢建平,汶川地震灾后的儿童心理危机干预问题及建议[J].中国神经精神疾病杂志.2008, (9):521-522
[50]尚蕾,王择青.PTSD及其预测因素[J].中国临床康复.2005,76(9):27-129
[51]伍志刚,刘爱忠,谭红专,等.洪灾后成人PTSD及其危险因素的研究[J].中国临床心理学杂志.2003,11(3):173-175
[52]廖定烈译.第九章灾难周年反应:心理卫生的相关问题及介入处理[J/OL].中华精神卫生网. 2008,5-19.
[53]周锡银,刘志荣等.羌族/民族知识丛书.民族出版社,1993
[54]李松蔚,牟文婷,徐凯文,等.震后3个月不同安置社区中轻度受灾者的创作后应激症状和抑郁症状[J].中国心理卫生杂志,2010,24(9):652-656
[55]陈树林,李凌江,卢原,等.洪灾区儿童创伤性应激障碍的流行病学研究[J].中国公共卫生,2003,19(4):744
[56]汪向东,赵承智,新福尚隆,等.地震后创伤后应激障碍的发生率及其影响因素[J].中国心理卫生杂志,1999.13(7):28-30
[57]张宁,张雨青,吴坎坎,等.汶川地震幸存者的创伤后应激障碍及其影响因素[J].中国临床心理学杂志,2010,18(1):69-72
[58] Grannopowlou I ,Strouth M ,Smith P,et,al.Post-tranmatic stress reations of children and adolescents exposed to the ATHENS 1999 earthquake[J].Eur Psychiatry ,2006, 21(3):160-166
[59]辛玖岭,祝卓宏,王力,等.汶川地震重灾区青少年创伤后应激障碍及其相关因素.中国临床心理学杂志,2010,18(1):63-65
[60] Roussos A ,Goenjian AK ,Steinberg AM,et,al. Posttraumatic Strees and Depreesive Reactions Among Children and Adolescents After the 1999 Earthquake in Ano Liosia, Greece [J] , Am J psychiatry, 2005,162(3):530-537
[61]刘之月,马道川,董毅强,等.汶川地震灾区中学生心理健康状况调查[J].中华流行病学杂志,2009,30(7):575-576
[62]刘斌志.地震后灾区儿童心理应激障碍表现及疏导对策[J].中国公共卫生,2008,24(10):1153-1154
[63]马丽.地震后青少年学生心理辅导策略[J].中小学心理健康教育,2008:6-7
[64]司徒明镜,张毅,邹可,等.汶川大地震灾区儿童青少年心理健康状况调查[J].四川大学学报(医学版),2009,40(4):712-715
[65] Adams R,Boscarino J.Predictors of PTSDang delayed PTSD After Disaster:the lmpact of Exposure and Psy-chosocial Resources[J].J Merv Ment Dise,2006,194(7):485-493.
[66]李美园.地震灾区的应激障碍筛查与早期干预[J].护理与康复,2009,8(2):140-141.
[2]宁维卫等.震后心理教育的理论与实践[M].四川出版集团四川人民出版社,2009.
[3]张本,王学义,孙贺祥,等.唐山大地震所致孤儿心理创伤后应激障碍的调查[J].中华精神科杂志,2000,33(2):111-114
[4]赵丞智,汪向东,高岚,等.张北尚义地震后创伤后应激障碍随访研究[J].中国心理卫生杂志.2000,14(6):361-36
[5]侯彩兰,李凌江,张燕,等.矿难后2个月和10个月创伤后应激障碍的发生率及相关因素[J].中南大学学报(医学版),2008,33(4):280-283
[6]惠武利,施旺红,徐德忠,等.烟台海难援救军人创伤后应激障碍发生者SCL-90分析[J].第四军医大学学报,2001,22(19):1818-1820
[7]徐勇,张克让,薛云珍,等. SARS的一线医务人员创伤后应激反应研究[J].护理研究:下半月,2004,18(1):179-181
[8]沈兴华,叶小飞,彭云丽,等.地震震区茂县儿童、中学生震后急性应激心理反应及干预研究.中国健康心理学杂志,2009,17(4):481-483
[9]陶靖,赖念华,樊富珉,等.重新异地安置对地震后青少年的影响:灾后青少年的现状和对相关志愿活动的反思[C].北京市社会心理学会2009年学术年会-5.12汉川大地震纪念专题,2009
[10] GoenjinanAK,Molina L ,Steinberg AM,et al. Posttraumatic stress and depressive reactions among Nicaraguan adolescents after Hurricane Mitch . American Journal of Psychiatry,2001,158(5):788-794.
[11]何鸣,杨德森.翻车事故幸存者中精神创伤后应激障碍[J].中国心理卫生杂志,1993,7(4):148-151.
[12] Hsu C.Chong M,Yang P.et a1.Posttraumatic stress disorder amongadolescent earthquake victims in Taiwan.Journal of American Academy of Child and Adolescent Psychiatry.2002,4l:875-881.
[13]吴坎坎,张雨青和Peter TZC.灾后民众创伤后应激障碍(PTSD)与事件冲击量表(IES)的发展与应用[J].心理科学进展,2009,17(3):495-498.
[14]王焕林,崔庶.中国军人心理创伤后应激障碍的流行学调查[J].中华精神科杂志,1996,29(2):69-72.
[15]刘贤臣,马登贷.心理创伤后应激障碍自评量表的编制和信度研究[J].中国行为医学科学,1998,7(2):93-96.
[16]何恩忠.心理创伤后应激障碍46例临床分析[J].安徽医学,1998,19(5):78.
[17]杨亚黎,粟卫国.克拉玛依市火灾死难儿童双亲的心理反应[M].中国医学伦理学,1999,6:28-29.
[18]赵丞智,李俊福,王明山等.地震后17个月受灾青少年PTSD及其相关因素[J].中国心理卫生杂志,2001,15(3):145-147.
[19] Wickrama KAS,kaspar V.Family context of mental health risk ,in Tsunami-exposed adolescents:Findings from a pilot study in Sri Lanka . Social Science and Medicine,2007,64(3):713-723.
[20] Ylrbik O,Akbiyik DI,Kirmizigul P,Hmen T.Post-traumatic stress disorder symptoms in children after the 1999 Marmara earthquake in Turkey . International Journal lf Mental Health,2004,33(1):46-58.
[21]范一鸣,孙源泉,官瑞莹,等.异地复学震区中小学生PTSD及心理健康状况的调查[J].心理科学进展,2009,17(3): 393-397.
[22]向莹君,熊国玉,董毅强,等.汶川地震灾区1960名中学生创伤后应激障碍症状调查[J].中国心理卫生杂志,2010,24(1):17-20.
[23] Sharan P. Chaudhary G. Kavathekar S A. et al. 1996. Preliminary report of psychiatric disorders in survivors of a severe earthquake.Am JPsychiatry,153(4):556-558.
[24]沃建中.灾后心理危机研究[M].北京航空航天大学出版社,2008,9:6.
[25] Yehuda R,McFarlance A.C;Confilict between current knowledge about posttraumatic stress disorder and its original conceptual basis.Am J Psychiatry.1995;152:1705-1713.
[26]李凌江,于欣.创伤后应激障碍防治指南[M].人民卫生出版社,2010
[27] Kilpatrick D,Satmders B.Veronen L.et aL Rape’in America:A report to the nation.Arlington:National Victims Center.1987:36-41.
[28] Breslau N.epidemiologic studies of trauma,posttraumatic stress disorder and other psychiatric disorder [J].Can J psychiatry,2002,47:923-929.
[29] Solomon,Z;Mikulincer,M; Psychological sequelae of war: a two year follow-up study of Israeli combat stress reaction casualties. Joural of Nervous and mental Disease, 1988;178,264-269.
[30]赵丞智,李俊福,王明山,等.地震后来17个月受灾青少年PTSD及其相关因素[J].中国心理卫生杂志,2001.15(3):145-147.
[31] Priebe s, Grappasonni I,Mari M,et al.Posttraumatic stess disordet six months aftrt an earthquake:Findings from acommunity sample in a rural region in ltaly[J].Soc Psychiatry Psychiatr Epidemiol,2009,44,393-397.
[32]罗兴伟,高雪屏,蔡太生,等.汶川地震亲历者心理健康状况调查[J].中国临床心理杂志,2008,6(16):571-573.
[33] Hsien WK,Wu SJ,Ma TC,Chiu MC,Chou SY.Posttrau-matic symptoms were worst among quake victims with injuries following the Chi-chi quake in Taiwan.Journal of Psychosomatic Research,2007,62:495-500.
[34]柳武妹,武方,郑裕鸿,等.震后6个月都江堰地区青少年创伤后应激症状及相关因素[J].中国心理卫生杂志,2010,24(9):647-651.
[35]马宁,何鸣,梁光明,等.震后9个月部分受灾群众精神痛苦现况调查[J].中国心理卫生杂志,2010,24(7):509-514.
[36]赵高峰,杨彦春,张强,等.汶川地震重灾区社区居民创伤后应激障碍发生率及影响因素[J].中国心理卫生杂志.2009,23(7):478:482
[37]施琪嘉,Wolfgang Send.心理创伤治疗原则[M].中国心理治疗对话.心理创伤(第1辑).2008.
[38]徐凯文等译.心理创伤的治疗指南[M].中国轻工业出版社,2009.
[39]宁维卫等.震后心理教育的理论与实践[M].四川出版集团四川人民出版社,2009.
[40]严文华,李骥.地震后儿童和青少年团体心理游戏培训手册[M].华东师范大学出版社,2008.
[41]施琪嘉,Wolfgang Send.埃森创伤问卷[M].中国心理治疗对话.心理创伤(第1辑).2008.
[42]陈昌惠.症状自评量表(SCL - 90).汪向东,王希林,马弘,编著.心理卫生评定量表手册.中国心理卫生杂志, 1999 (增刊) : 31-35.
[43]解亚宁.简易应对方式问卷.汪向东,王希林,马弘,编著.心理卫生评定量表手册.中国心理卫生杂志, 1999 (增刊) : 100-102.
[44]赵国秋,汪永光,王义强,等.汶川地震后急性应激障碍发生率及影响因素[J].中华预防医学杂志,2008,4(11):802-805.
[45]杨艳芳,叶运莉,李婷,等.汶川地震重灾区中学生震后心理状况[J].中华预防医学杂志,2010,44(2):134-139
[46]黄河清,杨惠琴,韩布新,等.汶川地震后不同灾情地区老年人创伤后应激障碍发生率及影响因素[J].中国老年学杂志,2009,29(10):1275-1277
[47]李桂萍,黄春娟,叶雪花,等.躯体形式障碍患者心理支持与放松疗法的疗效观察[J].护理与康复,2006,5(5):371-372.
[48]邬晓娟,周娟,周肖榕,等.5.12地震后PTSD症状严重性和社会支持之间的相关性研究.神经损伤与功能重建[J].2010,5(4):285-287
[49]卢建平,汶川地震灾后的儿童心理危机干预问题及建议[J].中国神经精神疾病杂志.2008, (9):521-522
[50]尚蕾,王择青.PTSD及其预测因素[J].中国临床康复.2005,76(9):27-129
[51]伍志刚,刘爱忠,谭红专,等.洪灾后成人PTSD及其危险因素的研究[J].中国临床心理学杂志.2003,11(3):173-175
[52]廖定烈译.第九章灾难周年反应:心理卫生的相关问题及介入处理[J/OL].中华精神卫生网. 2008,5-19.
[53]周锡银,刘志荣等.羌族/民族知识丛书.民族出版社,1993
[54]李松蔚,牟文婷,徐凯文,等.震后3个月不同安置社区中轻度受灾者的创作后应激症状和抑郁症状[J].中国心理卫生杂志,2010,24(9):652-656
[55]陈树林,李凌江,卢原,等.洪灾区儿童创伤性应激障碍的流行病学研究[J].中国公共卫生,2003,19(4):744
[56]汪向东,赵承智,新福尚隆,等.地震后创伤后应激障碍的发生率及其影响因素[J].中国心理卫生杂志,1999.13(7):28-30
[57]张宁,张雨青,吴坎坎,等.汶川地震幸存者的创伤后应激障碍及其影响因素[J].中国临床心理学杂志,2010,18(1):69-72
[58] Grannopowlou I ,Strouth M ,Smith P,et,al.Post-tranmatic stress reations of children and adolescents exposed to the ATHENS 1999 earthquake[J].Eur Psychiatry ,2006, 21(3):160-166
[59]辛玖岭,祝卓宏,王力,等.汶川地震重灾区青少年创伤后应激障碍及其相关因素.中国临床心理学杂志,2010,18(1):63-65
[60] Roussos A ,Goenjian AK ,Steinberg AM,et,al. Posttraumatic Strees and Depreesive Reactions Among Children and Adolescents After the 1999 Earthquake in Ano Liosia, Greece [J] , Am J psychiatry, 2005,162(3):530-537
[61]刘之月,马道川,董毅强,等.汶川地震灾区中学生心理健康状况调查[J].中华流行病学杂志,2009,30(7):575-576
[62]刘斌志.地震后灾区儿童心理应激障碍表现及疏导对策[J].中国公共卫生,2008,24(10):1153-1154
[63]马丽.地震后青少年学生心理辅导策略[J].中小学心理健康教育,2008:6-7
[64]司徒明镜,张毅,邹可,等.汶川大地震灾区儿童青少年心理健康状况调查[J].四川大学学报(医学版),2009,40(4):712-715
[65] Adams R,Boscarino J.Predictors of PTSDang delayed PTSD After Disaster:the lmpact of Exposure and Psy-chosocial Resources[J].J Merv Ment Dise,2006,194(7):485-493.
[66]李美园.地震灾区的应激障碍筛查与早期干预[J].护理与康复,2009,8(2):140-141.
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