Boscarino Joseph A, Adams Richard E, Figley Charles R
Division of Health & Science Policy, The New York Academy of Medicine, New York, NY 10029-5293, USA.
Int J Emerg Ment Health. 2005 Winter;7(1):9-22.
Postdisaster crisis interventions have been viewed by many as the appropriate and immediate approach to enhance psychological well-being among persons affected by large-scale traumatic events. Yet, studies and systematic reviews have challenged the effectiveness of these efforts. This article provides the first rigorous scientific evidence to suggest that postdisaster crisis interventions in the workplace significantly reduced mental health disorders and symptoms up to 2 years after the initial interventions. Until now, studies have neither focused on the effectiveness and safety of brief mental health services following disasters, or traumatic events generally, nor examined the long-term impact of these interventions across a spectrum of outcomes using a rigorous research design. The focus of this study was to examine the impact of brief mental health crisis interventions received at the worksite following the World Trade Center disaster (WTCD) among a random sample of New York adults. The data for the present study come from a prospective cohort study of 1,681 adults interviewed by telephone at 1 year and 2 years after this event. Results indicate that worksite crisis interventions offered by employers following the WTCD had a beneficial impact across a spectrum of outcomes, including reduced risks for binge drinking, alcohol dependence, PTSD symptoms, major depression, somatization, anxiety, and global impairment, compared with individuals who did not receive these interventions. In addition, it appeared that 2-3 brief sessions achieved the maximum benefit for most outcomes examined. Implications for postdisaster crisis interventions efforts are discussed.
许多人认为灾后危机干预是增强受大规模创伤事件影响人群心理健康的适当且即时的方法。然而,研究和系统评价对这些努力的有效性提出了质疑。本文提供了首个严谨的科学证据,表明工作场所的灾后危机干预在首次干预后长达两年的时间里显著减少了心理健康障碍和症状。到目前为止,研究既没有关注灾难或一般创伤事件后简短心理健康服务的有效性和安全性,也没有使用严谨的研究设计来检验这些干预在一系列结果方面的长期影响。本研究的重点是在纽约成年人的随机样本中,考察世贸中心灾难(WTCD)后在工作场所接受的简短心理健康危机干预的影响。本研究的数据来自一项前瞻性队列研究,该研究在事件发生后的1年和2年通过电话对1681名成年人进行了访谈。结果表明,与未接受这些干预的个体相比,雇主在世贸中心灾难后提供的工作场所危机干预在一系列结果方面产生了有益影响,包括降低暴饮、酒精依赖、创伤后应激障碍症状、重度抑郁、躯体化、焦虑和整体功能损害的风险。此外,对于所考察的大多数结果而言,2至3次简短疗程似乎能带来最大益处。文中还讨论了对灾后危机干预工作的启示。