汶川地震幸存者创伤后应激反应的症状结构
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摘要
目的:探讨灾后一年地震幸存者的创伤后应激反应的症状结构。方法:在汶川地震一年后通过723名极重灾区幸存者的PTSD症状自评量表(PCL)的评定数据对创伤后应激反应的5个理论模型进行了验证性因素分析。结果:包括闯入、回避、麻木和高警觉的四因素麻木模型具有最好的拟合度(χ2=715.823,CFI=0.982,RMSEA=0.086,AIC=795.823,BIC=979.159)。结论:5.12汶川地震一年后我国成人幸存者除了表现出典型的PTSD症状如闯入、回避和高警觉之外,还表现出麻木症状。
Objective: To explore the symptom structure of posttraumatic stress syndrome one year after of the earthquake disaster in China.Methods: Confirmatory factor analysis(CFA) was used to analyze the PCL scores of 723 survivors one year after of 5·12 Sichuan earthquake.Results: The four factor numbing model got the best fit index(χ2=715.823,CFI=0.982,RMSEA=0.086,AIC=795.823,BIC=979.159).Conclusion: This study showed that not only the classical PTSD symptoms,but also numbing exist in the survivors of 5·12 Sichuan earthquake.
Objective: To explore the symptom structure of posttraumatic stress syndrome one year after of the earthquake disaster in China.Methods: Confirmatory factor analysis(CFA) was used to analyze the PCL scores of 723 survivors one year after of 5·12 Sichuan earthquake.Results: The four factor numbing model got the best fit index(χ2=715.823,CFI=0.982,RMSEA=0.086,AIC=795.823,BIC=979.159).Conclusion: This study showed that not only the classical PTSD symptoms,but also numbing exist in the survivors of 5·12 Sichuan earthquake.
引文
1 Beck J,Grant D,Read J,et al.The impact of event scale-revised:Psychometric properties in a sample of motor vehi-cle accident survivors.Journal of Anxiety Disorders,2008,22(2):187-198
2 Taylor S,Kuch K,Koch W,et al.The structure of posttrau-matic stress symptoms.Journal of Abnormal Psychology,1998,107(1):154-160
3 Foa E,Zinbarg R,Rothbaum B.Uncontrollability and unpr-edictability in post-traumatic stress disorder:An animalmodel.Psychological Bulletin,1992,112(2):218-238
4 Buckley T,Blanchard E,Hickling E.A confirmatory factoranalysis of posttraumatic stress symptoms.Behaviour Re-search and Therapy,1998,36(11):1091-1099
5 King L,King D.Latent structure of the Mississippi Scale forcombat-related post-traumatic stress disorder:Explorato-ry and higher order confirmatory factor analyses.Assess-ment,1994,1(3):275-291
6 Shelby R,Golden-Kreutz D,Andersen B.Mismatch of po-sttraumatic stress disorder(PTSD)symptoms and DSM-IVsymptom clusters in a cancer sample:Exploratory factoranalysis of the PTSD Checklist-Civilian Version.Journal ofTraumatic Stress,2005,18(4):347-357
7 King D,Leskin G,King L,et al.Confirmatory factor analy-sis of the clinician-administered PTSD Scale:Evidence forthe dimensionality of posttraumatic stress disorder.Psycho-logical Assessment,1998,10(2):90-96
8 Asmundson G,Wright K,McCreary D,et al.Post-traumaticstress disorder symptoms in United Nations peacekeepers:An examination of factor structure in peacekeepers with andwithout chronic pain.Cognitive Behaviour Therapy,2003,32(1):26-37
9 DuHamel K,Ostrof J,Ashman T,et al.Construct validityof the posttraumatic stress disorder checklist in cancer sur-vivors:Analyses based on two samples.Psychological As-sessment,2004,16(3):255-266
10 McWilliams L,Cox B,Asmundson G.Symptom structure ofposttraumatic stress disorder in a nationally representativesample.Journal of Anxiety Disorders,2005,19(6):626-641
11 Palmieri P,Weathers F,Difede J,et al.Confirmatory factoranalysis of the PTSD Checklist and the Clinician-Adminis-tered PTSD Scale in disaster workers exposed to the WorldTrade Center Ground Zero.Journal of Abnormal Psychology,2007,116(2):329-341
12 Suvak M,Maguen S,Litz B,et al.Indirect exposure to theSeptember 11 terrorist attacks:Does symptom structure re-semble PTSD?Journal of Traumatic Stress,2008,21(1):30-
3913 Rasmussen A,Smith H,Keller A.Factor structure of PTSDsymptoms among West and Central African refugees.Jour-nal of Traumatic Stress,2007,20(3):271-280
14 Malta LS,Wyka KE,Giosan C,et al.Numbing symptomsas predictors of unremitting posttraumatic stress disorder.Journal of Anxiety Disorders,2009,23(2):223-229
15 Asmundson GJG,Stapleton JA,Taylor S.Are avoidance andnumbing distinct PTSD symptom clusters?Journal of Trau-matic Stress,2004,17(6):467-475
16 Simms L,Watson D,Doebbelling B.Confirmatory factoranalyses of posttraumatic stress symptoms in deployed andnondeployed veterans of the Gulf War.Journal of AbnormalPsychology,2002,111(4):637-647
17 Baschnagel J,O’Connor R,Colder C,et al.Factor structureof posttraumatic stress among Western New York undergr-aduates following the September 11th terrorist attack on theWorld Trade Center.Journal of Traumatic Stress,2005,18(6):677-684
18 Krause E,Kaltman S,Goodman L,et al.Longitudinal factorstructure of posttraumatic stress symptoms related to inti-mate partner violence.Psychological Assessment,2007,19(2):165-175
19 Carragher N,Mills K,Slade T,et al.Factor structure ofposttraumatic stress disorder symptoms in the Australiangeneral population.Journal of Anxiety Disorders,2010,2(5):520-527
20王孟成,戴晓阳,万娟.创伤后应激障碍的因子结构:对地震灾区青少年PCL数据的分析.中国临床心理学杂志,2009,17(4):38-41
21杨晓云,杨宏爱,刘启贵,等.创伤后应激检查量表平民版的效度、信度及影响因素的研究.中国健康心理学杂志,2007,15(1):6-9
22 Taylor S,Fedoroff I,Koch W,et al.Posttraumatic stressdisorder arising after road traffic collisions:Patterns of re-sponse to cognitive-behavior therapy.Journal of Consultingand Clinical Psychology,2001,69(3):541-551
23 Taylor S,Thordarson D,Maxfield L,et al.Comparative effi-cacy,speed,and adverse effects of three PTSD treatments:Exposure therapy,EMDR,and relaxation training.Journalof Consulting and Clinical Psychology,2003,71(2):330-
33724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.中国临床心理学杂志,2010,18(1):69-72
25朱明婧,张兴利,汪艳,等.汶川地震孤儿的创伤后应激障碍和自我意识.中国临床心理学杂志,2010,18(1):73-75
26冯春,辛勇,吴坎坎,等.地震后灾区乡镇基层干部心理健康状况的调查.中国临床心理学杂志,2010,18(1):88-90
2 Taylor S,Kuch K,Koch W,et al.The structure of posttrau-matic stress symptoms.Journal of Abnormal Psychology,1998,107(1):154-160
3 Foa E,Zinbarg R,Rothbaum B.Uncontrollability and unpr-edictability in post-traumatic stress disorder:An animalmodel.Psychological Bulletin,1992,112(2):218-238
4 Buckley T,Blanchard E,Hickling E.A confirmatory factoranalysis of posttraumatic stress symptoms.Behaviour Re-search and Therapy,1998,36(11):1091-1099
5 King L,King D.Latent structure of the Mississippi Scale forcombat-related post-traumatic stress disorder:Explorato-ry and higher order confirmatory factor analyses.Assess-ment,1994,1(3):275-291
6 Shelby R,Golden-Kreutz D,Andersen B.Mismatch of po-sttraumatic stress disorder(PTSD)symptoms and DSM-IVsymptom clusters in a cancer sample:Exploratory factoranalysis of the PTSD Checklist-Civilian Version.Journal ofTraumatic Stress,2005,18(4):347-357
7 King D,Leskin G,King L,et al.Confirmatory factor analy-sis of the clinician-administered PTSD Scale:Evidence forthe dimensionality of posttraumatic stress disorder.Psycho-logical Assessment,1998,10(2):90-96
8 Asmundson G,Wright K,McCreary D,et al.Post-traumaticstress disorder symptoms in United Nations peacekeepers:An examination of factor structure in peacekeepers with andwithout chronic pain.Cognitive Behaviour Therapy,2003,32(1):26-37
9 DuHamel K,Ostrof J,Ashman T,et al.Construct validityof the posttraumatic stress disorder checklist in cancer sur-vivors:Analyses based on two samples.Psychological As-sessment,2004,16(3):255-266
10 McWilliams L,Cox B,Asmundson G.Symptom structure ofposttraumatic stress disorder in a nationally representativesample.Journal of Anxiety Disorders,2005,19(6):626-641
11 Palmieri P,Weathers F,Difede J,et al.Confirmatory factoranalysis of the PTSD Checklist and the Clinician-Adminis-tered PTSD Scale in disaster workers exposed to the WorldTrade Center Ground Zero.Journal of Abnormal Psychology,2007,116(2):329-341
12 Suvak M,Maguen S,Litz B,et al.Indirect exposure to theSeptember 11 terrorist attacks:Does symptom structure re-semble PTSD?Journal of Traumatic Stress,2008,21(1):30-
3913 Rasmussen A,Smith H,Keller A.Factor structure of PTSDsymptoms among West and Central African refugees.Jour-nal of Traumatic Stress,2007,20(3):271-280
14 Malta LS,Wyka KE,Giosan C,et al.Numbing symptomsas predictors of unremitting posttraumatic stress disorder.Journal of Anxiety Disorders,2009,23(2):223-229
15 Asmundson GJG,Stapleton JA,Taylor S.Are avoidance andnumbing distinct PTSD symptom clusters?Journal of Trau-matic Stress,2004,17(6):467-475
16 Simms L,Watson D,Doebbelling B.Confirmatory factoranalyses of posttraumatic stress symptoms in deployed andnondeployed veterans of the Gulf War.Journal of AbnormalPsychology,2002,111(4):637-647
17 Baschnagel J,O’Connor R,Colder C,et al.Factor structureof posttraumatic stress among Western New York undergr-aduates following the September 11th terrorist attack on theWorld Trade Center.Journal of Traumatic Stress,2005,18(6):677-684
18 Krause E,Kaltman S,Goodman L,et al.Longitudinal factorstructure of posttraumatic stress symptoms related to inti-mate partner violence.Psychological Assessment,2007,19(2):165-175
19 Carragher N,Mills K,Slade T,et al.Factor structure ofposttraumatic stress disorder symptoms in the Australiangeneral population.Journal of Anxiety Disorders,2010,2(5):520-527
20王孟成,戴晓阳,万娟.创伤后应激障碍的因子结构:对地震灾区青少年PCL数据的分析.中国临床心理学杂志,2009,17(4):38-41
21杨晓云,杨宏爱,刘启贵,等.创伤后应激检查量表平民版的效度、信度及影响因素的研究.中国健康心理学杂志,2007,15(1):6-9
22 Taylor S,Fedoroff I,Koch W,et al.Posttraumatic stressdisorder arising after road traffic collisions:Patterns of re-sponse to cognitive-behavior therapy.Journal of Consultingand Clinical Psychology,2001,69(3):541-551
23 Taylor S,Thordarson D,Maxfield L,et al.Comparative effi-cacy,speed,and adverse effects of three PTSD treatments:Exposure therapy,EMDR,and relaxation training.Journalof Consulting and Clinical Psychology,2003,71(2):330-
33724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.中国临床心理学杂志,2010,18(1):69-72
25朱明婧,张兴利,汪艳,等.汶川地震孤儿的创伤后应激障碍和自我意识.中国临床心理学杂志,2010,18(1):73-75
26冯春,辛勇,吴坎坎,等.地震后灾区乡镇基层干部心理健康状况的调查.中国临床心理学杂志,2010,18(1):88-90
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