Seino Kaoruko, Takano Takehito, Mashal Taufiq, Hemat Shafiqullah, Nakamura Keiko
International Health, Division of Public Health, Graduate School of Tokyo Medical and Dental University, 1-5-45 Bunkyo, Tokyo 113-8519, Japan.
Health Qual Life Outcomes. 2008 Apr 23;6:29. doi: 10.1186/1477-7525-6-29.
In the period following wars and other forms of armed conflict, health and quality of life of mothers is a major concern as they have the closest contact with children. The present study was performed to examine the impact of exposure to events related to armed conflicts on post traumatic stress disorder (PTSD) among women raising children, and to identify factors that alleviate the negative consequences of exposure to traumatic events.
A structured interview survey was conducted in Kabul Province, Afghanistan, in 2006. The subjects were the mothers of children less than 5 years old randomly selected from 1400 households in Kabul Province, Afghanistan. Symptoms of PTSD were assessed according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Exposure to traumatic events related to armed conflict, experience of hardship with regard to basic needs, resources that the subjects seek for mental health support, and socioeconomic variables were evaluated. Logistic regression analysis was performed to determine the association between PTSD symptoms and predictor variables.
The prevalence rate of PTSD among 1172 women participated in this study was 29.8%. The most prevalent symptom was arousal (74.8%), followed by re-experiencing (54.9%) and avoidance (33.7%). The prevalence rate of PTSD symptoms among subjects who reported having experienced at least one event related to armed conflict (52.7%) was significantly higher than that among those who reported no such experiences (9.6%). Experience of food shortage was independently associated with PTSD. Seeking support for mental health was related to lower prevalence of PTSD symptoms among those who reported no direct experience of events related to armed conflict. However, no such relationship was observed with PTSD symptoms among those who reported having direct experience of events related to armed conflict.
Direct exposure to traumatic events was significantly associated with PTSD symptoms among women raising children. For those who had experienced armed conflict-related events, food security mitigated the occurrence of PTSD symptoms; however, support seeking behavior did not show a significant mitigating influence on PTSD. Means to alleviate the negative influence of exposure to armed conflicts on the quality of life of women should be developed from the viewpoint of quality of mental health support and avoidance of material hardship.
在战争及其他形式的武装冲突之后的时期，母亲的健康和生活质量成为一个主要关注点，因为她们与孩子有着最密切的接触。本研究旨在调查接触与武装冲突相关事件对抚养孩子的女性创伤后应激障碍（PTSD）的影响，并确定减轻接触创伤性事件负面影响的因素。
2006年在阿富汗喀布尔省进行了一项结构化访谈调查。研究对象是从阿富汗喀布尔省1400户家庭中随机选取的5岁以下儿童的母亲。根据《精神疾病诊断与统计手册》第四版（DSM-IV）的标准评估PTSD症状。评估了接触与武装冲突相关的创伤性事件、基本需求方面的艰难经历、受试者寻求心理健康支持的资源以及社会经济变量。进行逻辑回归分析以确定PTSD症状与预测变量之间的关联。
参与本研究的1172名女性中，PTSD的患病率为29.8%。最常见的症状是觉醒（74.8%），其次是重新体验（54.9%）和回避（33.7%）。报告至少经历过一次与武装冲突相关事件的受试者中PTSD症状的患病率（52.7%）显著高于报告无此类经历的受试者（9.6%）。食物短缺经历与PTSD独立相关。对于那些报告没有直接经历与武装冲突相关事件的人，寻求心理健康支持与较低的PTSD症状患病率相关。然而，对于那些报告有直接经历与武装冲突相关事件的人，未观察到与PTSD症状有此类关系。
直接接触创伤性事件与抚养孩子的女性的PTSD症状显著相关。对于那些经历过与武装冲突相关事件的人，粮食安全减轻了PTSD症状的发生；然而，寻求支持的行为对PTSD并未显示出显著的缓解影响。应从心理健康支持质量和避免物质困难的角度出发，制定减轻接触武装冲突对女性生活质量负面影响的方法。
