青少年恐怖袭击幸存者创伤后应激症状与叙事结构之间的关系。
The relationship between posttraumatic stress symptoms and narrative structure among adolescent terrorist-attack survivors.
作者信息
Filkuková Petra, Jensen Tine K, Hafstad Gertrud Sofie, Minde Hanne Torvund, Dyb Grete
机构信息
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway;
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.
出版信息
Eur J Psychotraumatol. 2016 Mar 16;7:29551. doi: 10.3402/ejpt.v7.29551. eCollection 2016.
BACKGROUND
The structure of trauma narratives is considered to be related to posttraumatic stress symptomatology and thus the capacity to make a coherent narrative after stressful events is crucial for mental health.
OBJECTIVE
The aim of this study is to understand more of the relationship between narrative structure and posttraumatic stress symptoms (PTSS). More specifically, we investigated whether internal and external focus, organization, fragmentation, and length differed between two groups of adolescent survivors of a mass shooting, one group with low levels of PTSS and one group with high levels of PTSS.
METHOD
The sample comprised 30 adolescents who survived the shooting at Utøya Island in Norway in 2011. They were interviewed 4-5 months after the shooting and provided a free narrative of the event. PTSS were assessed using the UCLA Posttraumatic Stress Disorder Reaction Index (PTSD-RI).
RESULTS
We found that survivors with high levels of PTSS described more external events and fewer internal events in their narratives compared with survivors with low levels of symptoms. The analysis also showed that especially narratives containing more descriptions of dialogue and fewer organized thoughts were related to higher levels of PTSS. The groups did not differ in levels of narrative fragmentation or in length of the narratives.
CONCLUSION
Specific attributes of narrative structure proved to be related to the level of PTSS. On the basis of our results, we can recommend that practitioners focus especially on two elements of the trauma narratives, namely, the amount of external events, particularly dialogues, within the narrative and the number of organized thoughts. Participants with high levels of PTSS provided trauma narratives with low amount of organized (explanatory) thoughts accompanied by detailed descriptions of dialogues and actions, which is indicative for "here and now" quality of recall and a lack of trauma processing.
背景
创伤叙事的结构被认为与创伤后应激症状学有关，因此在压力事件后构建连贯叙事的能力对心理健康至关重要。
目的
本研究的目的是更深入地了解叙事结构与创伤后应激症状（PTSS）之间的关系。更具体地说，我们调查了两组大规模枪击事件青少年幸存者之间在内部和外部焦点、组织、碎片化程度和长度方面是否存在差异，一组PTSS水平低，另一组PTSS水平高。
方法
样本包括30名在2011年挪威于特岛枪击事件中幸存的青少年。枪击事件发生4至5个月后对他们进行了访谈，并要求他们对该事件进行自由叙事。使用加州大学洛杉矶分校创伤后应激障碍反应指数（PTSD-RI）评估PTSS。
结果
我们发现，与症状水平低的幸存者相比，PTSS水平高的幸存者在叙事中描述的外部事件更多，内部事件更少。分析还表明，特别是那些包含更多对话描述和更少组织化思维的叙事与更高水平的PTSS相关。两组在叙事碎片化程度或叙事长度方面没有差异。
结论
叙事结构的特定属性被证明与PTSS水平有关。根据我们的研究结果，我们建议从业者特别关注创伤叙事的两个要素，即叙事中外部事件的数量，特别是对话，以及组织化思维的数量。PTSS水平高的参与者提供的创伤叙事中组织化（解释性）思维较少，同时伴有对话和行动的详细描述，这表明回忆具有“此时此地”的特点，且缺乏创伤处理。
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