个人和环境因素对 PTSD 后奥地利二战幸存者心理健康的影响：是韧性吗？
Influence of personal and environmental factors on mental health in a sample of Austrian survivors of World War II with regard to PTSD: is it resilience?
机构信息
Faculty of Psychology, University of Vienna, Liebiggasse 5, Vienna, A-1010, Austria.
出版信息
BMC Psychiatry. 2013 Feb 4;13:47. doi: 10.1186/1471-244X-13-47.
BACKGROUND
War-related traumata in childhood and young-adulthood may have long-lasting negative effects on mental health. The focus of recent research has shifted to examine positive adaption despite traumatic experiences, i.e. resilience. We investigated personal and environmental factors associated with resilience in a sample of elderly Austrians (N = 293) who reported traumatic experiences in early life during World War II and subsequent occupation (1945-1955).
METHODS
After reviewing different concepts of resilience, we analysed our data in a 3-phased approach: Following previous research approaches, we first investigated correlates of PTSD and non-PTSD. Secondly, we compared a PTSD positive sample (sub-threshold and full PTSD, n = 42) with a matched control sample regarding correlates of resilience and psychometrically assessed resilience (CD-RISC). Thirdly, we examined factors of resilience, discriminating between psychologically healthy participants who were exposed to a specific environmental stressor (having lived in the Soviet zone of occupation during 1945-1955) from those who were not.
RESULTS
A smaller number of life-time traumata (OR = 0.73) and a medium level of education (OR = 2.46) were associated with better outcome. Matched PTSD and non-PTSD participants differed in psychometrically assessed resilience mainly in aspects that were directly related to symptoms of PTSD. Psychologically healthy participants with an environmental stressor in the past were characterized by a challenge-oriented and humorous attitude towards stress.
CONCLUSIONS
Our results show no clear picture of factors constituting resilience. Instead, most aspects of resilience rather appeared to be concomitants or consequences of PTSD and non-PTSD. However, special attention should be placed on a challenge-oriented and humorous attitude towards stress in future definitions of resilience.
背景
儿童和青年时期与战争相关的创伤可能对心理健康产生持久的负面影响。最近的研究重点已转移到研究在经历创伤后如何积极适应，即韧性。我们调查了在报告二战期间和随后的占领期间（1945-1955 年）早期生活创伤的奥地利老年人样本（N=293）中与韧性相关的个人和环境因素。
方法
在回顾了韧性的不同概念后，我们在三阶段方法中分析了我们的数据：根据先前的研究方法，我们首先调查了 PTSD 和非 PTSD 的相关因素。其次，我们比较了 PTSD 阳性样本（阈下和完全 PTSD，n=42）与匹配的对照样本在韧性相关因素和心理测量评估的韧性（CD-RISC）方面的差异。第三，我们检查了韧性的因素，将经历特定环境压力源（1945-1955 年居住在苏联占领区）的心理健康参与者与未经历的参与者区分开来。
结果
较少的终生创伤（OR=0.73）和中等水平的教育（OR=2.46）与较好的结果相关。在心理测量评估的韧性方面，匹配的 PTSD 和非 PTSD 参与者存在差异，主要表现在与 PTSD 症状直接相关的方面。过去有环境压力源的心理健康参与者的特点是对压力具有挑战导向和幽默态度。
结论
我们的结果没有显示构成韧性的因素的清晰图景。相反，韧性的大多数方面似乎更像是 PTSD 和非 PTSD 的伴随物或后果。然而，在未来对韧性的定义中，应特别关注对压力的挑战导向和幽默态度。
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