【摘要】 目的探索"5·12"汶川地震发生后,灾区成年人发生创伤后应激障碍(post-traumatic stress disorder,PTSD)的危险因素,并进行认知模式、社会支持与PTSD的相关性分析。方法对来自地震极重灾区的10046名成年人进行人口学背景、地震经历调查,并使用PTSD症状检查量表(PTSD symptom checklist,PCL-17)对其进行评估,评估结果PCL-17≥50为可能PTSD患者。采用创伤后认知量表(posttraumatic cognition inventory,PTCl)评定个体的认知模式,社会支持量表(social support rating scale,SSRS)评定个体的全面社会支持状况。结果共有9342名个体的调查资料填写完整,最终纳入统计分析。年龄19～75岁,平均为(43.68±13.54)岁;男女比例为4216(45.1%):5126(54.9%)。已婚8243人(88.2%),未婚729人(7.8%),离异171人(1.8%),丧偶199人(2.1%)。受教育程度分别为初中以下5668人(60.7%),高中以上3389人(36.3%),不详285人(3.1%)。职业为警察350人(3.7%),工人823人(8.8%),农民1469人(15.7%),公务员616人(6.6%),教师244人(2.6%),其它5840人(54.6%)。入组个体中有137人(1.5%)被掩埋,512人(5.5%)受伤,22人(0.2%)被截肢。地震中有家人受伤或死亡者为1521人(16.3%)。PCL-17评分>50分者424人(4.5%)。不同婚姻状况之间的PCL-17评分有差异(F=8.669,P<0.05),离异及丧偶者PCL-17评分较高;警察与其他职业相比,PTSD患病率差异有统计学意义(χ2=223.490,P<0.05);文化程度不同,PCL-17评分也不同(F=7.425,P<0.05)。通过Logistic回归分析发现:离异及丧偶者、警察、地震中被掩埋者、亲人严重受伤、房屋损害严重、看到其他人被埋/受伤甚或死亡者、社会支持较少等因素均是PCL-17评分较高的高危因素。相关分析显示创伤后应激症状与个人认知模式和社会支持有相关性,认知模式与创伤后应激症状呈正相关(总分r=0.607,P<0.001),社会支持与其呈负相关(总分r=-0.068,P<0.001)。结论离异及丧偶者、警察、被掩埋者、截肢者及亲眼看见他人受伤或死亡是个体患PTSD的高危因素。个人认知模式和社会支持与PTSD的患病具有相关性。更多还原

【Abstract】 Objective To explore the risk factors of PTSD for adults after the Wenchuan earthquake in Sichuan,and to analyze the correlations between PTSD and cognitive model and social support.Methods A total of 10046 adults were selected from the serious earthquake region.The demographic data and earthquake experiences were recorded and the PTSD checklist(PCL-17) was evaluated.Subjects with a PCL-17 score greater than 50 were considered as possible PTSD cases,and subsequently underwent a correlate analysis with PTCl and SSRS.Results Among the 10046 retrieved questionnaires,9342 were valid.In the 9342 subjects,the age was from 19 to 75 years old,and the mean age was(43.68±13.54) years;male to female ratio was 45.1:54.9.Marital status:married 88.2%,unmarried 7.8%,divorced 1.8%,widowed 2.1%.Educational level:Junior middle school and the following 60.7%,high school and above 36.3%,unknown 3.1%.Occupation:police 3.7%,workers 8.8%,farmers 1.57%,civil servants 6.6%,teachers 2.6%,and the others 54.6%.There were 137(1.5%)subjects buried,512(5.5%) wounded and 22(0.2%) amputated during the earthquake.1521(16.3%)subjects have a family wounded or death during the earthquake.There were 424(4.5%) individuals among 9342 subjects got a PCL-17 score greater than 50.Our results show there were significant different of PCL-17 score among different marriage status(F=8.669,P<0.05).The divorce and widower/widow rates were higher in possible PTSD group.Police group got the highest PCL-17 score in all careers,the result show significant difference between police and other careers groups(χ2=223.490,P<0.05).Our results also show there were different of PCL-17 score among different educational level(F=7.425,P<0.05).Logistic regression analysis showed the factors,divorced and widowed,police,buried,whose parents severely injured,whose house being destroyed,witnessed someone buried/wounded or dying during the earthquake,lower social support,were significant correlated with the higher scores of the PCL-17.There was a correlation between PTSD and personal cognitive model and social support,correlation coefficient was respectively:cognitive model(r=0.607,P<0.001);social support(r=-0.068,P<0.001).Conclusion Divorced and widowed,police,buried,the amputees and witnessed someone wounded or dying during the earthquake are high risk factors for PTSD.Personal cognitive model and social support are associated with PTSD.更多还原