【作者】 粟文彬；

【导师】 徐德忠；

【作者基本信息】 第四军医大学 ， 流行病与卫生统计学， 2002， 硕士

【摘要】 军人的心理素质是部队战斗力的基本要素之一，心理对人体健康和疾病的影响已引起人们的高度重视。因此从身体、心理和社会适应三个方面做好新兵的健康保护，不仅可以提高新兵的心理素质，还可通过心理学干预降低训练伤的发生率。既往关于新兵心理健康的调查多为横断面研究，而基础训练前后的动态调查尚不多见，训练伤者训练前后的心理学特点及变化规律也报道不多。今年是实施新的《陆军军事训练与考核大纲》的第一年，我们应用国内外公认的具有较好信度和效度的症状自评量表(SCL-90)和艾森克个性成人问卷(EPQ)，对某部2002年度参加基础训练的新兵进行了前瞻性研究，调查了执行新大纲后基础训练前后新兵的心理健康状况变化，探讨了心理因素及个性与训练伤的关系，为新兵进行心理卫生教育和训练伤的心理干预提供依据。 方法 应用SCL-90和EPQ量表对参加基础训练的新兵进行调查，训练前后各测试1次。专科医生定期下部队筛检伤员，按照《中国人民解放军军事训练伤诊断分类标准》对发生的训练伤作出具体诊断。 结果 ①．SCL-90测试结果：训练前新兵SCL-90总分为125.28±32.32，农村兵强迫症状和精神病性因子分高于城市兵(P＜0.05)，独生子女组敌对因子分高于非独生子女组(P＜0.01)，不同文化程度间末见显著性差异(P＞0.05)。有心理问题的发生率为13.45％，回答率最高的阳性项目集中在人际关系敏感、强迫症状和焦虑。训练后SCL-90总分为111.05±27.32，各因子分及总分均显著低于训 第四罕医大单可士学位论文 练前。高中以上组抑郁、偏执因子分高于初中以下组（P＜0刀1），独生子女组躯 体化、抑郁、偏执因子分高于非独生子女组o＜0刀1），城乡新兵未见显著差异 （P＞0．05）。有心理问题的发生率（6．5％）低于训练前（Prto刀1），口答率最高 的阳性项目集中于强迫、躯体化和焦虑因子。②EPQ测试结果：训练前后 E分 均表现为城市兵高于农村兵、高中以上组高于初中以下组、独生子女组高于非独 生子女组（P＜0．of），vll练后新兵 N分降低（P＜0．of），L分增高（Prto．05），上 各组间均呈同样变化。③影响新兵心理健康状况因素的逐步口归分析显示，N 分与各因子都相关（回归系数为0刀13～0．025），L分与大部分因子相关，E分。 独生子女、文化程度、城乡来源与部分因子相关。④2002年度基础训练期间训 练伤的累积发生率为9石％。训练前受伤组和未受伤组各指标未见显著性差异叩 ＞0刀5人 受伤组 SCL习0 因子分 3 2 的因子频数分布主要分布于强迫症状 （ 3．79O）、人际关系敏感（10．340）、抑郁（10．34％）和精神病性（10．340）因 子；回答率较高的阳性项目主要分布于强迫、人际关系敏感。训练后受伤组强迫 症状、恐怖、敌对、偏执和总分较训练前降低（P＜0刀引，精神病性因子分高于 未受伤组（Pwto刀1X 因子分＞2 的回子频数分布主要分布于人际关系敏感 （l．79％〕、强迫症状门2．07％）、精神病性门2．07％）和躯体化（m34％＼ 回 答率较高的阳性项目分布于各因子。⑤训练前受伤组E分高于未受伤组（P＜ 0刀1），其余无差异（Ptoo刀5）：四种人格类型在受伤组和未受伤组之间分布无显。著性差异（XZ－1．34，P＞0＊5）。 结论：①实施新大纲后新兵训练后的心理健康状况没有下降，而是得到了 提高。针对不同组间训练前后出现的心理问题应该有目的的进行心理疏导和心理 卫生教育。影响新兵心理健康状况的因素有情绪的稳定程度、个性的掩饰性、 文化程度、是否独生子女及城乡来源。②训练后新兵的情绪趋向于稳定，掩饰 倾向增加。③执行新大纲后训练伤的发生率明显降低。④受伤组训练前发生频 率较高的因子是强迫症状、人际关系敏感和抑郁，本次调查没有发现。0理问题、 －2－ 第四军医大学呸士学位论文 人格与训练伤的因果联系。更多还原

【Abstract】 The psychological predisposition of army man was one of the fundamental elements of war force. More and more attentions were paid for the effects of mental health bring to health and diseases. So care for recruits in body, psychological and social adaptation can not only make their psychological predisposition better but also reduce the rate of military training injuries (MTI) by psychological intervention. There were some cross-section investigations about mental health of recruits, but there were few investigations as to compare recruits’ mental health status before and after basic military training. Also there was little report on recruits’ psychological characteristic change after MTI. This year is the first year of putting the ?outline of military training and test of army }>into practice. We chose the Symptom Checklist 90(SCL-90) and Esyenck Personality Questionnaire (EPQ) as a tool to evaluate the mental health status of recruits from a certain unit during their basic military training in 2002 as a follow up study. In our study, we investigate the changes of recruits’ mental health status and analysis the relationship between psychological factors and MTI, relationship between personality and MTI. Our research could provide clue to psychological education and psychological intervention for recruits to reduce the rate of MTI. Method Questionnaires contain SCL-90 and EPQ were used to investigate the recruits-4-before and after their basic military training. MTI diagnosis was made according to the {standard of military training injure diagnosis and classification )) by specialist doctor during basic military training.Results ?The .results of SCL-90 indexes as following. Before basic military training SCL-90 average total score of recruits was 125.28 ?2.32, recruits from countryside have got significant ( P<0. 05) higher scores in obsession and psychosis than those from city .Recruits from one-child family got significant higher (P<0. 01) scores in hostility than those from more than two children family. There did not find significant relationship between recruits’ educational level and their SCL-90 indexes. In this investigation we found that there were 13.45% recruits have some psychological problems, the most frequency positive answered items were relations with others, obsession and anxiety. While after basic military training SCL-90 average total score of recruits was 111.05 ?7.32 and indexes of SCL-90 scores were decreased. Recruits with high educational level (accept more than 12-years of education) got significant (P<0. 01) higher scores in depression and paranoia than those got less education. Recruits from one-child family got significant higher (P<0. 01) scores in bodied symptom, depression and paranoia than those from more than two children family. There were no significant differences of SCL-90 index scores between recruits form country and those from city. And we found that there was 6.5% recruits have got some psychological problems, this rate was significant (P<0. 01) lower than that of recruits before basic military training. The most frequency positive answered items were obsession, bodied symptom and anxiety items. (2) Results of EPQ : Before and after basic military training the scores of E value changed little, recruits form city got significant higher (P<0. 01) E scores than those from countryside, recruits with high educational level got significant (P<0. 01) higher E scores than those got less-5-education, recruits from one-child family got significant higher (P<0. 01) E scores than those from more than two children family. N scores of recruits were significantly (P<0. 01) decreased after basic military training. Lie scores of recruits were significantly (P<0. 05) increased after basic military training. And this trend could be found in all groups. (3) The step by step logistic regression to analysis the factors effect the status of recruits mental health showed that N scores were related with all factors of SCL-90(regression coefficient 0.013-0.025).Lie sco更多还原