Zhang Weiqing, Liu Hui, Jiang Xiaolian, Wu Dongmei, Tian Yali
West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan Province, China ; Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
West China Second Hospital, Sichuan University, Chengdu, Sichuan Province, China.
PLoS One. 2014 Feb 7;9(2):e88263. doi: 10.1371/journal.pone.0088263. eCollection 2014.
BACKGROUND/OBJECTIVES: Post-traumatic stress disorder is a common psychological maladaptation among adolescents after undergoing an earthquake. Knowledge about the prevalence and maintenance of post-traumatic stress disorder symptoms and the changes of its predictors over time can help medical providers assist adolescent survivors with mitigating long-term impacts. This study examined the changes in posttraumatic stress disorder symptoms and its relationship with coping skill and locus of control among adolescent earthquake survivors in China.
METHODOLOGY/FINDINGS: The study used an observational longitudinal design. A total of 1420 adolescents were evaluated twice after the earthquake by using the Post-traumatic stress disorder Checklist-Civilian Version, The Internality, Powerful others and Chance scale and the Coping Styles Scale. The results indicated that the mean scores of posttraumatic stress disorder symptoms were decreased significantly and the positive rates of posttraumatic stress disorder symptoms also declined remarkably at 17 months compared to the 3 months post-earthquake. Internality locus of control and problem solving coping skill were effective resilient factors for the development and maintenance of posttraumatic stress disorder symptoms, while chance locus of control was a powerful risk factor of posttraumatic stress disorder symptoms as well as being female, being injured and property loss.
CONCLUSIONS/SIGNIFICANCE: Continuous screening is recommended to identify adolescent earthquake survivors with posttraumatic stress disorder symptoms. More attention should be paid to adolescent survivors who are prone to adopt passive coping strategies responding to trauma events and who own external causal attribution.
背景/目的:创伤后应激障碍是青少年经历地震后常见的心理适应不良。了解创伤后应激障碍症状的患病率、持续情况及其预测因素随时间的变化,有助于医疗服务提供者帮助青少年幸存者减轻长期影响。本研究调查了中国青少年地震幸存者创伤后应激障碍症状的变化及其与应对技巧和控制点的关系。
方法/结果:本研究采用观察性纵向设计。共1420名青少年在地震后接受了两次评估,使用创伤后应激障碍检查表-平民版、内控性、有势力的他人及机遇量表和应对方式量表。结果表明,与地震后3个月相比,17个月时创伤后应激障碍症状的平均得分显著降低,创伤后应激障碍症状的阳性率也显著下降。内控性控制点和解决问题的应对技巧是创伤后应激障碍症状发生和持续的有效复原因素,而机遇控制点是创伤后应激障碍症状的强大危险因素,此外女性、受伤和财产损失也是危险因素。
结论/意义:建议持续筛查以识别有创伤后应激障碍症状的青少年地震幸存者。应更多关注那些在应对创伤事件时倾向于采用被动应对策略以及具有外部因果归因的青少年幸存者。