赴北川抗震救灾某部官兵急性心理应激障碍及影响因素调查
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摘要
目的探讨赴北川抗震救灾部队官兵急性应激障碍(acute stress disorder,ASD)发生情况、临床特征及相关危险因素。方法采用自编一般情况问卷、创伤后应激反应症状自评量表(post-traumatic stress symptoms self-rating scale,PCL-C)、领悟社会支持量表(perceived social support scale,PSSS)、应对方式问卷(coping style questionnaires,SCSQ)对126名赴北川抗震救灾部队某部官兵进行评定,结合半结构式访谈,确定ASD组和对照组,进行对照分析及相关因素分析。结果救灾官兵ASD患病率为13.49%,主要症状表现为:反复闯入性痛苦性回忆,噩梦,创伤事件场景的重现,强烈的心理痛苦烦恼,兴趣下降,睡眠障碍和情绪不稳定。ASD主要症状之间相互影响,积极的应对方式和良好的社会支持可减少ASD的发生。结论在急性应激阶段(1个月)部分抗震救灾官兵已存在ASD症状,应加强必要的心理评估和综合性的心理干预,减缓灾难所致的心理创伤,预防和减少ASD转化为创伤后应激障碍(post-traumatic Stress disorder,PTSD)。
Objective To investigate the occurrence circumstance of acute stress disorder(ASD),clinical features and related risk factors,in the officers and soldiers who had gone to Beichuan county to provide disaster relief.Methods We used the self-general questionnaire,post-traumatic stress symptoms self-rating scale(PCL-C),perceived social support scale(PSSS),and coping style questionnaires(SCSQ)to assess the 126 subjects,combining with semi-structured interviews to determine and compare the ASD group and control group,and then analyzed the related factors.Results The prevalence rate of ASD officers and soldiers was 13.49%,with main symptoms of repeatedly breaking into painful memories,nightmares,reproducing the scenes of traumatic events,strong trouble of psychological pain,decreased interest,sleep disorders and emotional instability.These main symptoms of ASD interacts each other,and were reduced with positive response and good social support.Conclusion In the phase of acute stress(one month),the officers and soldiers taking part in earthquake relief have symptoms of ASD,so we should strengthen the necessary psychological assessment and comprehensive psychological intervention means,in order to slow down psychological trauma after disaster,prevent and reduce the possibility that ASD turns into post-traumatic stress disorder(PTSD).
Objective To investigate the occurrence circumstance of acute stress disorder(ASD),clinical features and related risk factors,in the officers and soldiers who had gone to Beichuan county to provide disaster relief.Methods We used the self-general questionnaire,post-traumatic stress symptoms self-rating scale(PCL-C),perceived social support scale(PSSS),and coping style questionnaires(SCSQ)to assess the 126 subjects,combining with semi-structured interviews to determine and compare the ASD group and control group,and then analyzed the related factors.Results The prevalence rate of ASD officers and soldiers was 13.49%,with main symptoms of repeatedly breaking into painful memories,nightmares,reproducing the scenes of traumatic events,strong trouble of psychological pain,decreased interest,sleep disorders and emotional instability.These main symptoms of ASD interacts each other,and were reduced with positive response and good social support.Conclusion In the phase of acute stress(one month),the officers and soldiers taking part in earthquake relief have symptoms of ASD,so we should strengthen the necessary psychological assessment and comprehensive psychological intervention means,in order to slow down psychological trauma after disaster,prevent and reduce the possibility that ASD turns into post-traumatic stress disorder(PTSD).
引文
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[12]任辉,宫海燕,杨国愉,等.军事应激条件下军队医院护士心理健康状况与其应对方式社会支持的相关性研究[J].第三军医大学学报,2005,27(9):813-816.
[13]胡淑芳,何江萍,王惠利,等.社会支持和应对方式与军人心理健康相关性研究[J].人民军医,2003,46(4):188-190.
[14]Beutler L E,Moos R H,Lane G.Coping,treatmen planning,and treatment outcome:discussion[J].J Clin Psychol,2003,59(10):1151-1167.
[15]高岚,罗颖,汪向东,等.对受洪灾群体创伤后应激反应的调查[J].中华精神科杂志,2000,33(2):107-110.
[2]尹智,王东明,卢杰.震后灾难心一及其救援对策研究[J].防灾科技学院报,2007,9(3):13-16.
[3]Kilic C,Ulusoy M.Psychologicai effects of the November1999earth-quake in Turkeyan epidemiological study[J].Acta psychiatr scand,2003,108(3):2322-2328.
[4]陈树林,高雪屏,李凌江,等.PTSD症状自评量表的信效度初步评价[J].中国心理卫生杂志,2005,19(6):373-376.
[5]汪向东,王希林,马弘.心理卫生评定量表手册(增订版)[M].北京:中国心理卫生杂志社,1999:127-131,109-115.
[6]汪向东,赵丞智,新福尚隆,等.地震后创伤性应激障碍的发生率及影响因素[J].中国心理卫生杂志,1999,13(1):28-30.
[7]杨国愉,冯正直,任辉,等.军事应激条件下军人心理健康特点及其相关因素[J].解放军预防医学杂志,2004,22(1):25-29.
[8]徐唯,宋瑛,梁爱民,等.特大爆炸事故幸存者创伤后应激障碍的初步研究[J].中国心理卫生杂志,2003,17(9):603-606.
[9]汪向东,高岚,新福尚隆.灾害后的精神及行为障碍[J].中华精神科杂志,1999,32(3):186-188.
[10]Ducrocq F,Vaiva G,Cottencin O,et al.Post-traumatic stress,post-traumatic depression and major depressive episode:literature[J].Encephale,2001,27(2):159-168.
[11]Shalev A Y,Peri T,Canetti L,et al.Predictors of PTSD in injured trauma survivors:a prospective study[J].Am J Psychiatry,1996,153(2):219-225.
[12]任辉,宫海燕,杨国愉,等.军事应激条件下军队医院护士心理健康状况与其应对方式社会支持的相关性研究[J].第三军医大学学报,2005,27(9):813-816.
[13]胡淑芳,何江萍,王惠利,等.社会支持和应对方式与军人心理健康相关性研究[J].人民军医,2003,46(4):188-190.
[14]Beutler L E,Moos R H,Lane G.Coping,treatmen planning,and treatment outcome:discussion[J].J Clin Psychol,2003,59(10):1151-1167.
[15]高岚,罗颖,汪向东,等.对受洪灾群体创伤后应激反应的调查[J].中华精神科杂志,2000,33(2):107-110.
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