【作者】 尹星； 张雨青； 刘正奎；

【Author】 YIN Xing~(1,2),ZHANG Yuqing~2,LIU Zhengkui~2 1.University of Chinese Academy of Sciences,Beijing,100049,China 2.Institute of Psychology,Chinese Academy of Sciences,Beijing,100101,China

【机构】 中国科学院大学； 中国科学院心理研究所；

【摘要】 创伤后应激障碍(PTSD)是个体经历或目击对生命有威胁或伤害事件后发生的一系列生理、心理应激反应所表现的综合症。根据DSMⅣ诊断标准,PTSD通常在事件发生一个月后才能被诊断出来,如何在创伤事件发生后更短时间内识别可能会出现PTSD的个体具有重要的临床意义。急性应激障碍(ASD)正是在其对PTSD具有预测功能的假设基础上提出。分离症状作为ASD核心症状,成为临床诊断的重要依据,但也受到部分研究者质疑。ASD对PTSD预测的稳定性,特别是它对PTSD预测的特异性和敏感性,是灾后心理创伤领域亟待解决的问题。本研究通过对"4.20"芦山地震发生后337名4 9年级学生进行追踪调查,考察ASD对PTSD的预测作用的性别差异。结果显示:(1)总体而言,震后两周个体的ASD得分可以显著预测一个月后PTSD得分(β=.51,p<.001);ASD症状中,闯入(β=.35,p<.001)和高警觉(β=.29,p<.001)能显著预测PTSD,分离(β一.03,p>.05)和回避(β一.05,p>.05)预测作用不显著;(2)对男生而言,震后两周ASD症状中,闯入(β=.36,p<.01)和回避(β一.27,p<.05)可以显著预测一个月后PTSD,闯入症状得分越高,个体的PTSD越严重,而回避症状得分越高,PTSD得分反而较低;分离(β=.09,p>.05)和高警觉(β=.22,p>0.5)对PTSD的预测作用不显著;(3)对女生而言,震后两周ASD症状中,闯入(β=.30,p<.01)和高警觉(β=.31,p<.01)对PTSD有显著地正向预测效果,闯入、高警觉症状得分越高,PTSD得分越高;而分离(β一.09,p>.05)和回避(β=.14,p>.05)则不能预测PTSD。上述结果表明,地震发生后两周个体的急性应激障碍能显著预测一个月后创伤后应激障碍,但是没有发现分离症状的预测作用;急性应激障碍具体症状的预测功能存在性别差异。本研究提示了灾后应急救援阶段心理援助和危机干预的有效切入点。更多还原

【Abstract】 Posttraumatic stress disorder(PTSD) is a serious condition that can develop after a person has experienced or witnessed a traumatic or terrifying event in which serious physical harm occurred or was threatened.According to diagnosing standard of DSM-IV,PTSD would be diagnosed at least one month after traumatic event.Acute stress disorder(ASD) is importance of clinical significance in the early diagnosis for PTSD.Dissociation as a core symptom of ASD is the significant diagnostic evidence of PTSD,but that is questioned by some researchers.The stability of ACD predictability,particularly the sensitivity and specificity is a very critical and urgent topic in posttraumatic field.Analyses examined the relationship between ASD and PTSD and gender difference of ASD predictive function by a longitudinal study with a sample of 337 children from grade 4 to grade 9 in disaster area after the "420" Lushan earthquake.The results indicate the following findings:(l)In general,The scores of ASD after two weeks have a significant effect on PTSD scores after a month(β=.51,p<.001.Sub-symptoms of ASD including re-experiencing(β=.35,p<.001 )had a statistical significant effect on PTSD as well as high arousal (β=.29,p<.001),but dissociation symptoms(β=-.03,p>.05) and avoidance(β=-.05,p>.05) had no significant prediction effects.(2)For boys,Sub-symptoms of ASD including re-experiencing(β=.36,p<.01) had a statistical significant effect on PTSD as well as avoidance (β=-.27,p<.05),but dissociation symptoms(β=.09,p>.05) and high arousal(β=.22,p>0.5) had no significant prediction effects.(3)For girls,Sub-symptoms of ASD including re-experiencing(β=.30,p<.01) had a statistical significant effect on PTSD as well as high arousal (β=.31,p<.01),but dissociation symptoms(β=-.09,p>.05) and avoidance(β=.14,p>.05) had no significant prediction effects.These results suggest that ASD probably predict PTSD one month later after the earthquake,while dissociative symptoms as a core symptom failed to predict; it also suggested the predictive function of ASD existed gender difference.Our findings have important implications for guiding psychological assistance and intervention.更多还原