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台湾 2015 年“福尔摩沙 Fun Coast 水乐园爆炸”事件后青年烧伤幸存者创伤后应激障碍、抑郁与创伤后成长的 3 年随访

PTSD, depression and posttraumatic growth in young adult burn survivors: Three-year follow-up of the 2015 Formosa fun coast water park explosion in Taiwan.

机构信息

Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan; Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. No.5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan.

Research Department of Clinical, Educational, and Health Psychology, University College, London, United Kindom. Gower Street, London, WC1E 6BT, UK.

出版信息

J Affect Disord. 2020 Sep 1;274:239-246. doi: 10.1016/j.jad.2020.05.025. Epub 2020 May 26.

Abstract

OBJECTIVE

The 2015 Formosa Fun Coast Water Park explosion was a devastating disaster in Taiwan, leaving 15 dead and 484 burn injured. The present study estimated the prevalence of probable PTSD, major depression (MDD), and significant posttraumatic growth (PTG) in burn survivors three years after the explosion. Potential predictors of PTSD and depressive symptoms and PTG (demographic, burn-related, and psychosocial variables) were examined.

METHODS

Participants were 125 young adult burn survivors. The mean age at the incident was 22.4 years (SD = 4.1) and 62.4% were female. The average total body surface area burned was 51.6% (SD = 19.2%).

RESULTS

Three years after the explosion, 16.8% and 8.8% of the burn survivors met DSM-5 criteria of probable PTSD and MDD. Gender differences were observed in the prevalence of MDD but not PTSD. PTG was still highly prevalent, with 47.2%, 78.4%, and 84.0% of participants reporting significant PTG at the total scale, subscale, and item levels, respectively. Using hierarchical regression, psychosocial variables explained large amounts of variance in PTSD and depressive symptoms and PTG post-burn (△R = 0.411, 0.377, and 0.523) beyond that explained by demographic and burn-related variables. More avoidance and less approach coping predicted greater PTSD and/or depression symptoms post-burn. More approach coping and greater social support strongly predicted higher PTG post-burn.

CONCLUSION

Rates of probable PTSD and MDD were relatively high in burn survivors, however, PTG was also highly prevalent. Coping styles and social support may play distinct roles in psychosocial adjustment after burn injury.

摘要

目的

2015 年台湾花莲丰滨乡“八仙水上乐园”粉尘爆炸是一场毁灭性的灾难,造成 15 人死亡,484 人烧伤。本研究旨在爆炸发生 3 年后,评估烧伤幸存者创伤后应激障碍(PTSD)、重度抑郁障碍(MDD)和显著创伤后成长(PTG)的发生率。同时探讨 PTSD 和抑郁症状以及 PTG 的潜在预测因素(人口统计学、烧伤相关和心理社会变量)。

方法

研究对象为 125 名年轻成年烧伤幸存者。事件发生时的平均年龄为 22.4 岁(标准差 [SD]=4.1),62.4%为女性。平均烧伤总面积为 51.6%(SD=19.2%)。

结果

爆炸发生 3 年后,16.8%和 8.8%的烧伤幸存者符合 DSM-5 创伤后应激障碍和 MDD 的可能诊断标准。在 MDD 的患病率方面存在性别差异,但 PTSD 则不然。PTG 仍然高度普遍,分别有 47.2%、78.4%和 84.0%的参与者在总量表、子量表和项目水平上报告了显著的 PTG。使用分层回归,心理社会变量解释了 PTSD 和抑郁症状以及烧伤后 PTG 变化的大部分(△R=0.411、0.377 和 0.523),超出了人口统计学和烧伤相关变量的解释。更多的回避和更少的接近应对预测烧伤后 PTSD 和/或抑郁症状更严重。更多的接近应对和更大的社会支持强烈预测烧伤后更高的 PTG。

结论

烧伤幸存者中 PTSD 和 MDD 的发病率相对较高,但 PTG 也高度普遍。应对方式和社会支持可能在烧伤后心理社会适应中发挥不同的作用。

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