“5·12”地震后灾区民众应激状况与心理健康调查
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摘要
目的了解地震后灾区民众的心理状况。方法采用心理应激自评问卷(PSET)、症状自评量表(SCL-90)和简易应对方式问卷(SCSQ),对277名灾区民众进行心理调查。结果98.19%灾民出现各种应激反应症状,3.97%应激反应程度较高,主要以警觉性增高和创伤性体验为主;震后20d应激总分显著高于震后9d(t=-3.612,P=0),不同人群间应激总分差异有统计学意义(F=8.784,P=0),由高至低依次为高中生、伤员及家属、小学生、救援人员。SCL-90各因子分均显著高于全国常模(P<0.01),与同类研究相比,本次地震主要造成强迫、人际敏感、敌对和抑郁等心理问题,在性别、地区、时间段和人员类别方面,SCL-90大多数因子分差异有统计学意义(P<0.01)。在应对方式上,表现为应激反应和SCL-90高分组更多使用消极应对方式。相关分析发现,应激总分、消极应对方式与SCL-90各因子高度相关(P<0.01)。结论早期开展心理干预,针对性地处理主要心理问题,重点关注学生群体,及时疏泄不良情绪,鼓励他们采用主动有效的应对方式,以此减少或缓解应激所带来的损害,促进心理健康。而进一步探索并研制出适用于早期、针对性强、简便快捷的心理测量工具,结合疾病分类与诊断标准进行临床综合评估,是研究创伤后早期心理问题的有效方法。
Objective To investigate the conditions of stress reaction and mental health in victims of 5·12 earthquake.Methods 277 subjects were measured by psychological stress self-evaluation test(PEST),Symptom checklist(SCL) 90 and simplified coping style questionnaire(SCSQ).Results 98.19% victims had various stress reaction,3.97% had higher degree,whose main symptoms were hypervigilance and traumatic re-experience.The scores of PSET had differences significantly among the surviors,which presented the characteristics of high school sutdents >the wounded and families>primary school students>rescue personnel(P<0.01)and the stress reaction of 20 days after earthquake was higher than 9 days.Compared with norms and other similar study,SCL-90 were higher obviously,which main symptoms were obsesseive-compulsive,interpersonal sensitivity,hostility and depression.Among the various groups,the SCL-90 had differences significantly.As for coping style,the individuals who had higher score of PSET and SCL-90 used more negative coping.Linear correlation analysis indicated that stress,negative coping and SCL-90 had higher correlation.Conclusion To deal with main mental disorder,emphasis on the high-risk individuals and encourage the victims to regulate negative emotion with the effective coping is the most important in the early psychological intervention stage.Meanwhie,It is necessary to develop a simple screening scale for early diagnosis and intervention.And combined with criteria of classification and diagnosis will be an effective way to study the post-traumatic mental disorder.
Objective To investigate the conditions of stress reaction and mental health in victims of 5·12 earthquake.Methods 277 subjects were measured by psychological stress self-evaluation test(PEST),Symptom checklist(SCL) 90 and simplified coping style questionnaire(SCSQ).Results 98.19% victims had various stress reaction,3.97% had higher degree,whose main symptoms were hypervigilance and traumatic re-experience.The scores of PSET had differences significantly among the surviors,which presented the characteristics of high school sutdents >the wounded and families>primary school students>rescue personnel(P<0.01)and the stress reaction of 20 days after earthquake was higher than 9 days.Compared with norms and other similar study,SCL-90 were higher obviously,which main symptoms were obsesseive-compulsive,interpersonal sensitivity,hostility and depression.Among the various groups,the SCL-90 had differences significantly.As for coping style,the individuals who had higher score of PSET and SCL-90 used more negative coping.Linear correlation analysis indicated that stress,negative coping and SCL-90 had higher correlation.Conclusion To deal with main mental disorder,emphasis on the high-risk individuals and encourage the victims to regulate negative emotion with the effective coping is the most important in the early psychological intervention stage.Meanwhie,It is necessary to develop a simple screening scale for early diagnosis and intervention.And combined with criteria of classification and diagnosis will be an effective way to study the post-traumatic mental disorder.
引文
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[9]杨国斌,张艳梅,姚兵,等.116名四川地震伤员心理学情况调查与分析[J].医学研究生学报,2008,21(7):745.
[2]金华,吴文源,张明园.中国正常人SCL-90评定结果的初步分析[J].中国神经精神疾病杂志,1986,12(5):260.
[3]汪向东,王希林,马弘.心理卫生评定量表手册(增订版)[M].北京:中国心理卫生杂志出版社,1999:31.
[4]马军,刘永义,王志纲,等.SARS流行对社区人群心理卫生影响的调查分析[J].中国健康心理学杂志,2004,12(4):260.
[5]董惠娟,顾建华,杨彦波.印度洋地震海啸中国大陆受灾者心理状况调查与分析[J].中国综合临床,2007,23(2):147.
[6]Soldatos CR,Paparrigopoulos TJ,Pappa DA,et al.Earlypost-traumatic stress disorder in relation to acute stressreaction:An ICD-10 study among help seekers followingan earthquake[J].Psychiatry Res,2006,143(2-3):245.
[7]刘伟志,严进,沈兴华,等.“5.12”大地震茂县灾民急性应激反应的统计调查[J].解放军护理杂志,2008,25(6B):1.
[8]任凯,彭龙颜,邢济春,等.什邡地震灾区984名灾民心理健康调查[J].中国公共卫生管理,2008,24(3):243.
[9]杨国斌,张艳梅,姚兵,等.116名四川地震伤员心理学情况调查与分析[J].医学研究生学报,2008,21(7):745.
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