Thordardottir Edda Bjork, Hansdottir Ingunn, Shipherd Jillian C, Valdimarsdottir Unnur Anna, Resnick Heidi, Elklit Ask, Gudmundsdottir Ragnhildur, Gudmundsdottir Berglind
*Centre of Public Health Sciences, Faculty of Medicine, and †Faculty of Psychology, School of Health Sciences, University of Iceland, Reykjavik, Iceland; ‡National Center for PTSD, Women's Health Sciences Division (116B-3), VA Boston Healthcare System; §Department of Psychiatry, Boston University School of Medicine; ∥Department of Epidemiology, Harvard School of Public Health, Boston, MA; ¶Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC; #Department of Psychology, University of Southern Denmark, Odense, Denmark; **Department of Psychology, University of Ulster, Londonderry, Northern Ireland; ††Mental Health Services, Landspitali-The National University Hospital of Iceland; and ‡‡Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
J Nerv Ment Dis. 2016 Apr;204(4):298-305. doi: 10.1097/NMD.0000000000000475.
Few natural disaster studies have assessed factors associated with posttraumatic stress disorder (PTSD) beyond a decade after trauma. Using North's disaster model as a framework, the aim of this study was to identify factors associated with clinically significant posttraumatic stress symptoms (CS-PTSDS) in avalanche survivors (n = 399) 16 years after the disaster. Completed self-report questionnaires were received from 286 (72%) survivors. CS-PTSDS were assessed with the Posttraumatic Diagnostic Scale. Predictors of CS-PTSDS in a multivariate analysis were secondary sequelae factors of lack of social support (adjusted relative risk [RR], 2.90; 95% confidence interval [CI], 1.37-6.13) and financial hardship in the aftermath of the trauma (adjusted RR, 2.47; 95% CI, 1.16-5.26). In addition, the community factor of providing assistance in the aftermath of the avalanche (adjusted RR, 1.95; 95% CI, 1.04-3.64) was inversely associated with CS-PTSDS. Screening for these factors may be useful in identifying those most vulnerable to developing chronic PTSD after this unique type of disaster.
很少有自然灾害研究评估创伤发生十年后与创伤后应激障碍（PTSD）相关的因素。本研究以诺思的灾难模型为框架，旨在确定灾难发生16年后雪崩幸存者（n = 399）中与具有临床意义的创伤后应激症状（CS-PTSDS）相关的因素。共收到286名（72%）幸存者填写的自我报告问卷。采用创伤后诊断量表评估CS-PTSDS。多变量分析中，CS-PTSDS的预测因素为缺乏社会支持的继发后遗症因素（调整后相对风险[RR]，2.90；95%置信区间[CI]，1.37 - 6.13）以及创伤后经济困难（调整后RR，2.47；95% CI，1.16 - 5.26）。此外，雪崩后提供援助的社区因素（调整后RR，1.95；95% CI，1.04 - 3.64）与CS-PTSDS呈负相关。筛查这些因素可能有助于识别在这种特殊类型灾难后最易发展为慢性PTSD的人群。
