创伤后成长、创伤后应激障碍与车祸幸存者的适应力。
Posttraumatic growth, posttraumatic stress disorder and resilience of motor vehicle accident survivors.
机构信息
Department of Psychiatry, National Disaster Medical Center, Tokyo, Japan.
出版信息
Biopsychosoc Med. 2010 Jun 24;4:7. doi: 10.1186/1751-0759-4-7.
BACKGROUND
Although some previous studies have suggested that posttraumatic growth (PTG) is comprised of several factors with different properties, few have examined both the association between PTG and posttraumatic stress disorder (PTSD) and between PTG and resilience, focusing on each of the factors of PTG. This study aimed to examine the hypothesis that some factors of PTG, such as personal strength, relate to resilience, whereas other factors, such as appreciation of life, relate to PTSD symptoms among Japanese motor vehicle accident (MVA) survivors.
METHODS
This cross-sectional study was performed with 118 MVA survivors at 18 months post MVA. Data analyzed included self-reporting questionnaire scores on the Posttraumatic Growth Inventory (PTGI), the Impact of Event Scale- Revised (IES-R), and the Sense of Coherence (SOC) scale, which is one of the most widely used scales for measuring resilience. Correlations between scores on the PTGI and IES-R, the PTGI and SOC scale, and the IES-R and SOC scale were established by calculating Spearman's correlation coefficients.
RESULTS
PTGI was positively correlated with both SOC and PTSD symptoms, in spite of an inverse relationship between SOC and PTSD symptoms. Relating to others, new possibilities, and personal strength on the PTGI were correlated positively with SOC, and spiritual change and appreciation of life on the PTGI were positively correlated with PTSD symptoms.
CONCLUSIONS
Some factors of PTG were positively correlated with resilience, which can be regarded as an outcome of coping success, whereas other factors of PTG were positively correlated with PTSD symptoms, which can be regarded as signifying coping effort in the face of enduring distress. These findings contribute to our understanding of the psychological change experienced by MVA survivors, and to raising clinicians' awareness of the possibility that PTG represents both coping effort coexisting with distress and outcome of coping success.
背景
虽然一些先前的研究表明创伤后成长（PTG）由具有不同性质的几个因素组成，但很少有研究同时考察 PTG 与创伤后应激障碍（PTSD）之间的关系以及 PTG 与韧性之间的关系，而专注于 PTG 的各个因素。本研究旨在检验以下假设，即 PTG 的某些因素，如个人力量，与韧性有关，而其他因素，如对生活的欣赏，与日本机动车事故（MVA）幸存者的 PTSD 症状有关。
方法
这项横断面研究对 118 名 MVA 后 18 个月的幸存者进行了研究。分析的数据包括创伤后成长量表（PTGI）、修订后的事件影响量表（IES-R）和心理韧性量表（SOC）的自我报告问卷评分，SOC 量表是最常用于衡量韧性的量表之一。通过计算 Spearman 相关系数，建立了 PTGI 得分与 IES-R、PTGI 得分与 SOC 量表以及 IES-R 与 SOC 量表之间的相关性。
结果
PTGI 与 SOC 和 PTSD 症状均呈正相关，尽管 SOC 和 PTSD 症状之间呈负相关。PTGI 中的与他人相关、新的可能性和个人力量与 SOC 呈正相关，而精神变化和对生活的欣赏与 PTSD 症状呈正相关。
结论
PTG 的一些因素与韧性呈正相关，可以被视为应对成功的结果，而其他因素与 PTSD 症状呈正相关，可以被视为面对持久痛苦时的应对努力的标志。这些发现有助于我们理解 MVA 幸存者所经历的心理变化，并提高临床医生对 PTG 既代表与痛苦并存的应对努力，又代表应对成功结果的可能性的认识。
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