摘要
目的调查创伤康复期患者创伤后应激障碍(post traumatic stress disorder,PTSD)发生率、心理健康水平与心理弹性的关系。方法采用创伤后应激障碍症状清单-平民版(PTSD checklist-civilian version,PCL-C)、成人心理弹性量表(resilience scale for adults,RSA)、症状自评量表(symptom checklist90,SCL-90)、艾森克人格问卷(eysenck personalityquestionnaire,EPQ)、应对方式问卷对重庆市3所三甲医院康复科2008年12月至2010年3月158名的创伤康复期患者进行问卷调查。以PTSD总分38分划界,将患者分为PTSD阳性组和阴性组。结果创伤康复期患者PTSD总分≥38分比例为34.18%,PTSD阳性组和阴性组在心理弹性(t=-4.744,P=0.000)、人格的神经质(t=3.549,P=0.001)及应对方式的合理化(t=2.502,P=0.013)方面差异有显著性。②创伤康复期患者SCL-90量表中躯体化、抑郁、焦虑、恐惧、偏执和精神性因子分均显著高于全国常模(P<0.05),SCL-90阳性组在心理弹性的自我认知和未来计划上得分显著低于阴性组(P<0.05),在EPQ的神经质因子得分显著高于阴性组(P<0.01),在应对方式上的自责、幻想、退避、合理化因子得分显著高于阴性组(P<0.05)。③PTSD总分与RSA总分显著负相关,与SCL-90总分、神经质和合理化应对方式3个因素显著正相关(r值分别为:-0.343、0.390、0.362和0.170),SCL-90总分和RSA总分共能解释PTSD总分的28.8%。结论创伤康复期患者创伤后应激障碍发生率较高,低心理弹性、低心理健康水平是PTSD的重要预测因素。
Objective To investigate the relationship of post traumatic stress disorder（PTSD）with mental health and resilience in patients during rehabilitation after trauma.Methods One hundred and seventy-nine rehabilitation patients after traumatic injury admitted in 3 high-grade hospitals from December 2008 to March 2010 were tested with PTSD checklist-civilian version（PCL-C）,Resilience Scale for Adult（RSA）,Self-report Symptom Checklist 90（SCL-90）,Eysenck Personality Questionnaire（EPQ）,and Copying Style Questionnaire.There were totally 158 valid questionnaires obtained,including 117 males and 41 females,130 married and 28 unmarried with an age ranging from 14 to 65（39.15±11.58）.Results The average PTSD score of this cohort was 34.72±11.89.Among them,there were 54 patients（34.18%）with a score not lower than 38 who were identified as PTSD positive group,and the left 104 were PTSD negative group.Significant difference was found in mental resilience（t=-4.744,P=0.000）,psychoticism（t=3.549,P=0.001）,coping styles rationalization（t=2.502,P=0.013）between PTSD positive and negative groups（P〈0.05）.Compared with the norms,evaluative indexes scores of SCL-90 including somatization,depression,anxiety,fear,crankiness and psychosis were higher（P〈0.05）.The scores on self-cognition and planning in RSA in SCL-90 positive group were lower,nervousness in personality and self-blame,delusion,withdraw and rationalization in copying style were higher than those in negative group（P〈0.05,0.01）.Correlation analysis showed total scores of PTSD were negatively related with total RSA scores,and positively related with SCL-90 score,nervousness and coping style rationalization,separately.Regression results showed that those 4 factors explained 28.8% of total score of PTSD.Conclusion The prevalence rate of PTSD is high in the rehabilitation patients following traumatic injury.Low resilience and mental heath are the main predictors for PTSD.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2010年第18期2006-2009,共4页
Journal of Third Military Medical University
基金
国家高技术研究发展计划(863计划
2008AA022602)
第三军医大学预研基金项目(2009XYY13)~~
关键词
应激障碍
创伤后
康复
心理学
临床
心理弹性
stress disorders
post-traumatic
rehabilitation
psychology
clinical
resilience
