Mitani Satoko
Kyoto Prefectural University of Medicine, Graduate School of Medical Science Kamigyo-ku, Kyoto 606-8566 Japan.
Prehosp Disaster Med. 2008 May-Jun;23(3):s20-6.
The Impact of Event Scale Revised (IES-R) has been used in various epidemiological studies to assess the prevalence of post-traumatic stress disorder (PTSD). Previous studies using the IES-R Japanese version to assess the mental health of firefighters were based on the premise that firefighters had experienced a traumatic event(s) as a matter of course. However, use of the IES-R-J does not indicate whether or not a traumatic event was experienced. The purpose of this study is to clarify the differences between: (1) IES-R-J high and low score groups; and (2) those who report symptoms similar to those of PTSD with and without having been being exposed to a traumatic event.
Questionnaire packets distributed to all 157 workers in a Japanese fire station included the IES-R, the Japan Brief Job Stress Questionnaire, a questionnaire regarding traumatic event experiences, and demographic questions. Participants who scored > or = 25 points on the IES-R-J scale were defined as the PTSD high risk (HR) group; those with scores < 25 points as the PTSD low risk (LR) group.
One hundred thirty-one of the 157 subjects (83.4%) responded to the questionnaire; three were excluded from the analysis because of missing data. The mean total IES-R-J score was 14.9 +/- 15.2. Twenty-eight subjects scored in the PTSD HR group (> or = 25); 100 scored in the LR group (< 25). A total of 54 (42.2%) participants had experienced a traumatic event; 57.8% had not. In the HR group, 14 subjects had experienced a traumatic event and 14 had not. Participants who had experienced a traumatic event reported a higher incidence of intrusion/re-experience symptoms than did those who had not experienced a traumatic event. The level of social support significantly affected the risk for PTSD. Firefighters who scored > or = 25 on the IES-R-J and, thus, considered to be at high risk for the development of PTSD, were less confident about their health, experienced more job stressors and had less social support than did those whose IES-R-J scores were < 25. Having experienced a traumatic event was reported by only 42% of all the participants and by only 50% of those in the high risk PTSD group.
Although the IES-R is an easily-administered tool useful in epidemiological studies evaluating psychological stress, it is recommended that the questionnaire be amended to include a question regarding the existence of a threatened experience or event and to analyze the data using positive and negative predictive value methodology.
事件影响量表修订版（IES-R）已在各类流行病学研究中用于评估创伤后应激障碍（PTSD）的患病率。此前使用IES-R日文版评估消防员心理健康的研究基于这样一个前提，即消防员理所当然地经历过创伤性事件。然而，使用IES-R-J并不能表明是否经历过创伤性事件。本研究的目的是阐明以下两者之间的差异：（1）IES-R-J高分和低分群体；（2）报告有类似PTSD症状但经历过和未经历过创伤性事件的人群。
向日本一个消防站的所有157名工作人员发放问卷包，其中包括IES-R、日本简短工作压力问卷、一份关于创伤性事件经历的问卷以及人口统计学问题。IES-R-J量表得分大于或等于25分的参与者被定义为PTSD高风险（HR）组；得分低于25分的为PTSD低风险（LR）组。
157名受试者中有131名（83.4%）回复了问卷；3名因数据缺失被排除在分析之外。IES-R-J总得分的平均值为14.9±15.2。28名受试者属于PTSD HR组（大于或等于25分）；100名属于LR组（低于25分）。共有54名（42.2%）参与者经历过创伤性事件；57.8%未经历过。在HR组中，14名受试者经历过创伤性事件，14名未经历过。经历过创伤性事件的参与者报告的侵入/再体验症状发生率高于未经历过创伤性事件的参与者。社会支持水平对PTSD风险有显著影响。IES-R-J得分大于或等于25分、因此被认为PTSD发生风险高的消防员对自己健康的信心较低，经历的工作压力源更多，社会支持更少，而IES-R-J得分低于25分的消防员则相反。所有参与者中只有42%报告经历过创伤性事件，PTSD高风险组中这一比例仅为50%。
尽管IES-R是一种易于实施的工具，在评估心理压力的流行病学研究中很有用，但建议对问卷进行修订，纳入一个关于是否存在威胁性经历或事件的问题，并使用阳性和阴性预测值方法分析数据。
