茂县城区百姓与救灾部队震后7～9周创伤后应激障碍症状比较
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摘要
目的探讨地震灾区茂县城区百姓与救灾部队震后7~9周具有创伤后应激障碍(PTSD)样症状反应程度。方法应用17个条目的PCL(根据《美国精神疾病诊断分类标准》第4版修订(DSM-Ⅳ)对创伤后应激障碍(PTSD)的诊断症状标准制定),对条目进行通俗性表达,使军人和老百姓能够理解,也符合对地震后老百姓和救灾军人PTSD的调查,但PCL每个条目的基本意思不变,按照1~4的4级评分,对百姓通过深入棚区逐棚进行走访调查,对多支救灾部队先进行分层抽样,再进行整群调查;统计时分别按照每个条目的得分、17个条目的总分、17个条目分成的3类症状总分进行,PTSD的症状反应标准是总分达到40分。结果茂县震后7~9周被调查的灾民符合PTSD症状反应诊断的阳性率较高(28.37%),部队官兵符合PTSD症状反应诊断的阳性率较低(3.9%),两者差异具有非常显著的统计学意义(χ2=63.28,P<0.0001)。结论地震后2个月恰恰是重灾区灾民创伤后应激障碍的形成期,需要进行较长期的跟踪调查,对重点人员要进行及时的干预,以减少创伤后应激障碍的发生。部队官兵预防PTSD发生的重点人群是参加过清理尸体,多次经历危险,劳动强度又比较大的人员。
Objective To investigate the transformation of PTSD symptoms between people lived in urban area of Maoxian county and relief soldiers after 7 to 9 weeks since earthquake.Methods Applied 17 entries of PCL(being formulated according to fourth edition of Diagnosis standards for mental disorder for PTSD' diagnosis) and explained the entries with common words to make it easily understood by common people and soldiers,and also made it applicable for the appraisal of PTSD symptoms of them,and made all the entries remain their basic standard criterion.Then with four levels to grade symptoms of common people who lived in sheds by inquiring them one by one,and sampled the relief troops layeredly and perform a group survey.When analyzing the data,we consider every score of the 17 entries,total score of 17 entries and score of three classified symptoms from the 17 entries respectively,the score for PTSD diagnosis was 40.Results After 7 to 9 weeks since Maoxian country earthquake,the peoples suffered from PTSD with a higher incidence(28.37%),but soldiers had a lower one(3.9%),there was a significant difference between the two groups(χ2=63.28,P<0.0001).Conclusion Two months after the earthquake is the period of conformation of PTSD.we should implement tracking investigation and perform psychological intervention to the people in need to lower the incidence of PTSD.In troop,those experienced corps processing,dangerous situation and undergoing heavy work should be paid more attention to prevent the coming up of PTSD.
Objective To investigate the transformation of PTSD symptoms between people lived in urban area of Maoxian county and relief soldiers after 7 to 9 weeks since earthquake.Methods Applied 17 entries of PCL(being formulated according to fourth edition of Diagnosis standards for mental disorder for PTSD' diagnosis) and explained the entries with common words to make it easily understood by common people and soldiers,and also made it applicable for the appraisal of PTSD symptoms of them,and made all the entries remain their basic standard criterion.Then with four levels to grade symptoms of common people who lived in sheds by inquiring them one by one,and sampled the relief troops layeredly and perform a group survey.When analyzing the data,we consider every score of the 17 entries,total score of 17 entries and score of three classified symptoms from the 17 entries respectively,the score for PTSD diagnosis was 40.Results After 7 to 9 weeks since Maoxian country earthquake,the peoples suffered from PTSD with a higher incidence(28.37%),but soldiers had a lower one(3.9%),there was a significant difference between the two groups(χ2=63.28,P<0.0001).Conclusion Two months after the earthquake is the period of conformation of PTSD.we should implement tracking investigation and perform psychological intervention to the people in need to lower the incidence of PTSD.In troop,those experienced corps processing,dangerous situation and undergoing heavy work should be paid more attention to prevent the coming up of PTSD.
引文
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[6]Blanchard Edward B.Jacqueline Jones-Alexander,Buckley Todd C,et al.Psychometric Properties of The PTSD Chechlist.behav[J].Res.Ther,1996,34(8):669-673
[7]Goenjian A K,Karayan I,Pynoos R S,et al.Outcome of psy-chotherapy among early adolescents after trauma[J].Am J Psychia-try,1997,154:536-542
[8]尹智,王东明,卢杰.震后灾难心理及其对策研究[J].防灾科技学院学报,2007,9(3):13-16
[2]Kowalskia Kathleen M.Anie Kalayjianb.Responding to mass emo-tional trauma:a mental health outreach program for Turkey earth-quake victims[J].Safety Science,2001,39:71-81
[3]NAOTAKA SHINFUKU.Disaster mental health:lessons learnedfrom the Hanshin Awaji earthquake[J].World Psychiatry,2002,1(3):158-159
[4]张本,王学义.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
[5]张本,王学义.唐山大地震所致创伤后应激障碍的抽样调查研究[J].中华精神科杂志,1999,32(2):106-108
[6]Blanchard Edward B.Jacqueline Jones-Alexander,Buckley Todd C,et al.Psychometric Properties of The PTSD Chechlist.behav[J].Res.Ther,1996,34(8):669-673
[7]Goenjian A K,Karayan I,Pynoos R S,et al.Outcome of psy-chotherapy among early adolescents after trauma[J].Am J Psychia-try,1997,154:536-542
[8]尹智,王东明,卢杰.震后灾难心理及其对策研究[J].防灾科技学院学报,2007,9(3):13-16
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