Khamis Vivian
College of Education, Department of Special Education, United Arab Emirates University, P.O. Box 17551, Al-Ain, Abu Dhabi, United Arab Emirates.
Soc Sci Med. 2008 Oct;67(8):1199-207. doi: 10.1016/j.socscimed.2008.06.013. Epub 2008 Jul 25.
This study was designed to assess the occurrence of post-traumatic stress disorder (PTSD) and psychiatric disorders (i.e., anxiety and depression) in Palestinian adolescents following intifada-related injuries. It was hypothesized that a combination of pre-trauma variables (e.g., age, geographic location), trauma-specific variables such as trauma recency, type of trauma (deliberately violent vs. accidental), and post-trauma variables (e.g., social support, coping strategies, belief in fate) would be predictive of these psychological sequelae. The participants were 179 boys who were injured during Al-Aqsa intifada and as a result sustained a permanent physical disability. They ranged in age from 12 to 18 years (M=16.30, SD=1.64). Questionnaires were administered in an interview format with adolescents at home. Approximately 76.5% of the injured victims qualify as having PTSD and that the disorder had a heterogeneous course, with excess risk for chronic symptoms and comorbidity with other psychiatric disorders such as anxiety and depression. Among all the predictors in the PTSD, anxiety and depression models, only geographical location, fatalism, and negative coping were significant predictors. In conclusion, post-traumatic reactions and psychiatric disorders in adolescents involved in armed conflict injuries can persist for several months. Given the apparent significant relationship between psychological sequelae of intifada-related injuries and certain predictors (i.e., negative coping style and fatalism), treatments such as trauma-focused cognitive behaviour therapy may yield positive results. Negative coping and fatalism should be addressed more directly during therapy.
本研究旨在评估巴勒斯坦青少年在与起义相关的受伤后创伤后应激障碍（PTSD）及精神障碍（即焦虑和抑郁）的发生情况。研究假设创伤前变量（如年龄、地理位置）、创伤特异性变量（如创伤发生的近期性、创伤类型，蓄意暴力创伤与意外创伤）以及创伤后变量（如社会支持、应对策略、对命运的信念）的组合将可预测这些心理后遗症。参与者为179名在阿克萨起义期间受伤并因此导致永久性身体残疾的男孩。他们的年龄在12至18岁之间（M = 16.30，SD = 1.64）。通过在家中对青少年进行访谈的形式发放问卷。约76.5%的受伤受害者符合创伤后应激障碍的诊断标准，且该障碍病程具有异质性，存在慢性症状及与焦虑和抑郁等其他精神障碍共病的额外风险。在创伤后应激障碍、焦虑和抑郁模型的所有预测因素中，只有地理位置、宿命论和消极应对是显著的预测因素。总之，参与武装冲突受伤的青少年的创伤后反应和精神障碍可能会持续数月。鉴于与起义相关受伤的心理后遗症与某些预测因素（即消极应对方式和宿命论）之间存在明显的显著关系，诸如以创伤为焦点的认知行为疗法等治疗方法可能会产生积极效果。在治疗期间应更直接地处理消极应对和宿命论问题。
