不同民族创伤后应激反应模式比较的质性研究——汶川地震后对羌汉幸存者的访谈分析
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摘要
目的:探讨汶川地震中羌汉民族间创伤后应激反应模式的差异,并分析其原因,为有效地对灾害幸存者进行心理救助和干预提供依据。方法:以2008年5.12汶川地震的重灾区北川为例,运用目的性抽样的方法,分别对23个羌族和23个汉族幸存者进行了个案访谈,收集了他们对地震灾难的认知方式、反应模式和应对方式等方面的资料。结果:羌汉民族间在创伤后应激反应模式上具有差异,羌族幸存者倾向于更直接的表达情绪和行为;而汉族幸存者则倾向于含蓄内敛化。同时,两个民族在对灾难的归因方式及应对方式上也存在一些差异。结论:羌汉民族间创伤后应激反应模式存在差异,这种差异部分可能是由于民族文化差异造成的,同时,资源保存理论也提供了很好的解释。
Objective: To identify and explain the disaster response differences between the Qiang and Han ethnic groups.Methods: With purposeful sampling,a sample of 46 victims(23 from the Qiang ethnic group and 23 from the Han ethnic group) of Beichuan Country were interviewed with four questions,including the stressor,the response way,the attributional and coping style.Results: Ethnic groups differed in the posttraumatic stress response mode.The Qiang ethnic group tended to response in a direct and explicit way;while the Han ethnic group preferred to hide the emotion and behavior.They also differed in the style of attribution and coping.Conclusion: Ethnic groups differ in the posttraumatic stress response model.Additional analysis attempts to explain the difference in terms of cultural difference and conversation of resource theory.Lastly,culturally sensitive interventions should be paid more attention.
Objective: To identify and explain the disaster response differences between the Qiang and Han ethnic groups.Methods: With purposeful sampling,a sample of 46 victims(23 from the Qiang ethnic group and 23 from the Han ethnic group) of Beichuan Country were interviewed with four questions,including the stressor,the response way,the attributional and coping style.Results: Ethnic groups differed in the posttraumatic stress response mode.The Qiang ethnic group tended to response in a direct and explicit way;while the Han ethnic group preferred to hide the emotion and behavior.They also differed in the style of attribution and coping.Conclusion: Ethnic groups differ in the posttraumatic stress response model.Additional analysis attempts to explain the difference in terms of cultural difference and conversation of resource theory.Lastly,culturally sensitive interventions should be paid more attention.
引文
1 American Psychiatric Association.Diagnostic and statisticalmanual of mental disorders.Washington,DC:APA,1980
2 Dyregrov A,Kuterovac G,Barath A.Factor analysis of theimpact of event scale with children in war.ScandinavianJournal of Psychology,1996,37:339-350
3 Sack WH,Seeley JR,Him C,et al.Psychometric propertiesof the impact of events scale in traumatized Cambodianrefugee youth.Personality and Individual Differences,1998,25(1):57-67
4 Smith P,Perrin S,Dyregrov A,et al.Principal componentsanalysis of the impact of event scale with children in war.Personality and Individual Differences,2003,34(2):315-322
5 Smith P,Perrin S,Yule W,et al.War exposure among chil-dren from Bosnia-Hercegovina:Psychological adjustmentin a community sample.Journal of Traumatic Stress,2002,15(2):147-156
6 Thabet AA,Vostanis P.Post traumatic stress disorder reac-tions in children of war:A longitudinal study.Child Abuseand Neglect,2000,24(2):291-298
7 Otto MW,Henin A,Hirshfeld-Becker DR,et al.Posttrau-matic stress disorder symptoms following media exposure totragic events:Impact of 9/11 on children at risk for anxietydisorders.Journal of Anxiety Disorders,2007,21(7):888-902
8 Yule W,Bruggencate ST,Joseph S.Principal componentsanalysis of the impact of events scale in adolescents whosurvived a shipping disaster.Personality and Individual Dif-ferences,1994,16(5):685-691
9 Giannopoulou I,Strouthos M,Smith P,et al.Post-traumaticstress reactions of children and adolescents exposed to theAthens 1999 earthquake.European Psychiatry,2006,21(3):160-166
10 Groome D,Soureti A.Post-traumatic stress disorder andanxiety symptoms in children exposed to the 1999 Greekearthquake.British Journal of Psychology,2004,95(3):387-397
11 Hsu CC,Chong MY,Yang P,et al.Posttraumatic stress dis-order among adolescent earthquake victims in taiwan.Jour-nal of American Academy of Child and Adolescent Psychi-atry,2002,41(7):875-881
12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.中国临床心理学杂志,2008,16(6):571-573
13孙源泉,范一鸣,王鹏,等.震区丧亲儿童羞怯、创伤后应激障碍症状和心理健康之间的关系.中国临床心理学杂志,2009,17(4):484-486
14 Neria Y,Nandi A,Galea S.Post-traumatic stress disorderfollowing disasters:a systematic review.PsycholMed,2008,38(4):467-480
15 Carr VJ,Lewin TJ,Webster RA,et al.Psychosocial seque-lae of the 1989 Newcastle earthquake:I.Community disas-ter experiences and psychological morbidity 6 months post-disaster.PsycholMed,1995,25(3):539-551
16 Norris FH,Alegria M.Mental health care for ethnic minority individuals and communities in the aftermath of disastersand mass violence.CNS Spectrums,2005,10(2):1-9
17 Hobfoll SE,Canetti-Nisim D,Johnson RJ,et al.The assoc-iation of exposure,risk,and resiliency factors with PTSDamong Jews and Arabs exposed to repeated acts of terrorismin israel.Journal of Traumatic Stress,2008,21(1):9-21
18 Dohrenwend BP,Turner JB,Turse NA,et al.War-relatedposttraumatic stress disorder in black,hispanic,and major-ity white vietnam veterans:The roles of exposure and vuln-erability.Journal of Traumatic Stress,2008,21(2):133-141
19 Webster RA,McDonald R,Lewin TJ,et al.Effects of a nat-ural disaster on immigrants and host population.Journal ofNervous and Mental Disease,1995,183(6):390-397
20 Marsella AJ,Christopher MA.Ethnocultrual considerationsin disasters:An overview of research issues and directions.Psychiatric Clinics of North America,2004,27:521-539
21 Perilla JL,Norris FH,Lavizzo EA.Ethnicity,culture,anddisaster response:Identifying and explaining ethnic differ-ences in PTSD six months after Hurricane Andrew.Journalof Social and Clinical Psychology,2002,21:20-45
22 Hobfoll SE.Conservation of resources:A new attempt atconceptualizing stress.American Psychologist,1989,44:513-524
23 Hobfoll SE.Stress,culture and community:The psychologyand philosophy of stress.NewYork:Plenum,1998
24 Dohrenwend BP.Part 2.Hypotheses about stress processeslinking social class to various types of psychopathology.American Journal of Community Psychology,1981,9:146-159
25 Kessler RC,McLeod JD,Wethington E.The costs of caring:A perspective on the relationship between sex and psycho-logical distress.In Sarason IG,Sarason CR.Social support:Theory,research and application.The Hague:Martinus,1985.491-506
26 Galea S,Ahern J,Resnick H,et al.Psychological sequelaeof the September 11 terrorist attacks in New York City.NewEngland Journal of Medicine,2002,346:982-987
27 Norris FH,Kaniasty K.Received and perceived social sup-port in times of stress:A test of the social support deterio-ration deterrence model.Journal of Personality and SocialPsychology,1996,71:498-511
28 MacDonald C,Chamberlin K,Long N.Race,combat,andPTSD in a community sample of New Zealand Vietnam warveterans.Journal of Traumatic Stress,1997,10:117-124
29 Wang L,Zhang YQ,Wang WZ,et al.Symptoms of posttra-umatic stress disorder among adult survivors three montsafter the Sichuan earthquake in China.Journal of TraumaitcStress,2009,22(5):444-450
30 Kun P,Han SC,Chen XC,et al.Prevalence and risk fact-ors for post-traumatic stress disorder:A cross-sectionalstudy among survivors of the Wenchuan 2008 earthquakein China.Depression and Anxiety,2009,26:1134-1140
31黄河清,杨惠琴,韩布新.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.中国老年学杂志,2009,10:1275-1277
32北川政务网.北川羌族自治县人口.http://beichuan.my.gov.cn/bcx/1658169087802474496/20080617/305295.html,2008-06-17
33 Patton MQ.Qualitative evaluation and research methods.Newbury Park,CA:Sage Publications,1990
34 Colaizzi P.Psychological research as the phenomenologistsview it.In Vaile R,King M.Existential-phenomenologicalalternatives for psychology.New York:Oxford UniversityPress,1978.48-71
35 Wang X,Gao L,Shinfuku N,et al.Longitudinal study ofearthquake-related PTSD in a randomly selected communitysample in north China.America journal of psychiatry,2000,157:1260-1266
2 Dyregrov A,Kuterovac G,Barath A.Factor analysis of theimpact of event scale with children in war.ScandinavianJournal of Psychology,1996,37:339-350
3 Sack WH,Seeley JR,Him C,et al.Psychometric propertiesof the impact of events scale in traumatized Cambodianrefugee youth.Personality and Individual Differences,1998,25(1):57-67
4 Smith P,Perrin S,Dyregrov A,et al.Principal componentsanalysis of the impact of event scale with children in war.Personality and Individual Differences,2003,34(2):315-322
5 Smith P,Perrin S,Yule W,et al.War exposure among chil-dren from Bosnia-Hercegovina:Psychological adjustmentin a community sample.Journal of Traumatic Stress,2002,15(2):147-156
6 Thabet AA,Vostanis P.Post traumatic stress disorder reac-tions in children of war:A longitudinal study.Child Abuseand Neglect,2000,24(2):291-298
7 Otto MW,Henin A,Hirshfeld-Becker DR,et al.Posttrau-matic stress disorder symptoms following media exposure totragic events:Impact of 9/11 on children at risk for anxietydisorders.Journal of Anxiety Disorders,2007,21(7):888-902
8 Yule W,Bruggencate ST,Joseph S.Principal componentsanalysis of the impact of events scale in adolescents whosurvived a shipping disaster.Personality and Individual Dif-ferences,1994,16(5):685-691
9 Giannopoulou I,Strouthos M,Smith P,et al.Post-traumaticstress reactions of children and adolescents exposed to theAthens 1999 earthquake.European Psychiatry,2006,21(3):160-166
10 Groome D,Soureti A.Post-traumatic stress disorder andanxiety symptoms in children exposed to the 1999 Greekearthquake.British Journal of Psychology,2004,95(3):387-397
11 Hsu CC,Chong MY,Yang P,et al.Posttraumatic stress dis-order among adolescent earthquake victims in taiwan.Jour-nal of American Academy of Child and Adolescent Psychi-atry,2002,41(7):875-881
12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.中国临床心理学杂志,2008,16(6):571-573
13孙源泉,范一鸣,王鹏,等.震区丧亲儿童羞怯、创伤后应激障碍症状和心理健康之间的关系.中国临床心理学杂志,2009,17(4):484-486
14 Neria Y,Nandi A,Galea S.Post-traumatic stress disorderfollowing disasters:a systematic review.PsycholMed,2008,38(4):467-480
15 Carr VJ,Lewin TJ,Webster RA,et al.Psychosocial seque-lae of the 1989 Newcastle earthquake:I.Community disas-ter experiences and psychological morbidity 6 months post-disaster.PsycholMed,1995,25(3):539-551
16 Norris FH,Alegria M.Mental health care for ethnic minority individuals and communities in the aftermath of disastersand mass violence.CNS Spectrums,2005,10(2):1-9
17 Hobfoll SE,Canetti-Nisim D,Johnson RJ,et al.The assoc-iation of exposure,risk,and resiliency factors with PTSDamong Jews and Arabs exposed to repeated acts of terrorismin israel.Journal of Traumatic Stress,2008,21(1):9-21
18 Dohrenwend BP,Turner JB,Turse NA,et al.War-relatedposttraumatic stress disorder in black,hispanic,and major-ity white vietnam veterans:The roles of exposure and vuln-erability.Journal of Traumatic Stress,2008,21(2):133-141
19 Webster RA,McDonald R,Lewin TJ,et al.Effects of a nat-ural disaster on immigrants and host population.Journal ofNervous and Mental Disease,1995,183(6):390-397
20 Marsella AJ,Christopher MA.Ethnocultrual considerationsin disasters:An overview of research issues and directions.Psychiatric Clinics of North America,2004,27:521-539
21 Perilla JL,Norris FH,Lavizzo EA.Ethnicity,culture,anddisaster response:Identifying and explaining ethnic differ-ences in PTSD six months after Hurricane Andrew.Journalof Social and Clinical Psychology,2002,21:20-45
22 Hobfoll SE.Conservation of resources:A new attempt atconceptualizing stress.American Psychologist,1989,44:513-524
23 Hobfoll SE.Stress,culture and community:The psychologyand philosophy of stress.NewYork:Plenum,1998
24 Dohrenwend BP.Part 2.Hypotheses about stress processeslinking social class to various types of psychopathology.American Journal of Community Psychology,1981,9:146-159
25 Kessler RC,McLeod JD,Wethington E.The costs of caring:A perspective on the relationship between sex and psycho-logical distress.In Sarason IG,Sarason CR.Social support:Theory,research and application.The Hague:Martinus,1985.491-506
26 Galea S,Ahern J,Resnick H,et al.Psychological sequelaeof the September 11 terrorist attacks in New York City.NewEngland Journal of Medicine,2002,346:982-987
27 Norris FH,Kaniasty K.Received and perceived social sup-port in times of stress:A test of the social support deterio-ration deterrence model.Journal of Personality and SocialPsychology,1996,71:498-511
28 MacDonald C,Chamberlin K,Long N.Race,combat,andPTSD in a community sample of New Zealand Vietnam warveterans.Journal of Traumatic Stress,1997,10:117-124
29 Wang L,Zhang YQ,Wang WZ,et al.Symptoms of posttra-umatic stress disorder among adult survivors three montsafter the Sichuan earthquake in China.Journal of TraumaitcStress,2009,22(5):444-450
30 Kun P,Han SC,Chen XC,et al.Prevalence and risk fact-ors for post-traumatic stress disorder:A cross-sectionalstudy among survivors of the Wenchuan 2008 earthquakein China.Depression and Anxiety,2009,26:1134-1140
31黄河清,杨惠琴,韩布新.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.中国老年学杂志,2009,10:1275-1277
32北川政务网.北川羌族自治县人口.http://beichuan.my.gov.cn/bcx/1658169087802474496/20080617/305295.html,2008-06-17
33 Patton MQ.Qualitative evaluation and research methods.Newbury Park,CA:Sage Publications,1990
34 Colaizzi P.Psychological research as the phenomenologistsview it.In Vaile R,King M.Existential-phenomenologicalalternatives for psychology.New York:Oxford UniversityPress,1978.48-71
35 Wang X,Gao L,Shinfuku N,et al.Longitudinal study ofearthquake-related PTSD in a randomly selected communitysample in north China.America journal of psychiatry,2000,157:1260-1266
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