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灾难后的愤怒维度与心理健康:一场重大森林大火后的分布与影响。

Anger Dimensions and Mental Health Following a Disaster: Distribution and Implications After a Major Bushfire.

机构信息

Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.

Population Health Sciences, Bristol Medical School, University of Bristol, Bristol United Kingdom.

出版信息

J Trauma Stress. 2021 Feb;34(1):46-55. doi: 10.1002/jts.22616. Epub 2020 Nov 2.

Abstract

Anger is an important dimension of affect and a prominent feature of posttraumatic mental health, but it is commonly overlooked in postdisaster settings. We aimed to examine the distribution and implications of significant anger problems in the aftermath of a natural disaster, via analyses of Beyond Bushfires survey data from 736 residents of rural communities 5 years after the 2009 Black Saturday bushfires in Victoria, Australia. Assessments included the five-item Dimensions of Anger Reaction (DAR-5) scale along with measures of PTSD, depression, and significant mental illness, and indicators of life satisfaction, suicidality, hostile aggressive behavior, and violence exposure. The results indicated that approximately 10% of respondents from areas highly affected by the bushfires scored above the provisional cutoff criteria for significant anger problems on the DAR-5, which was a more than 3-fold increase, OR = 3.26, relative to respondents from areas of low-to-moderate bushfire impact. The rates were higher among women, younger participants, and those who were unemployed, and co-occurred commonly, although not exclusively, with other postdisaster mental health problems. Anger problems were also associated with lower life satisfaction, β = -.31, an 8-fold increase in suicidal ideation, OR = 8.68, and a nearly 13-fold increase in hostile aggressive behavior, OR = 12.98. There were associations with anger problems and violence exposure, which were reduced when controlling for covariates, including probable PTSD. The findings provide evidence indicating that anger is a significant issue for postdisaster mental health and should be considered routinely alongside other posttraumatic mental health issues.

摘要

愤怒是情感的一个重要维度,也是创伤后心理健康的一个突出特征,但在灾后环境中通常被忽视。我们旨在通过对澳大利亚维多利亚州 2009 年“黑色星期六”丛林大火 5 年后农村社区 736 名居民的“超越丛林大火”调查数据进行分析,研究自然灾害后严重愤怒问题的分布和影响。评估包括五分量表愤怒反应量表(DAR-5),以及创伤后应激障碍、抑郁和严重精神疾病的测量指标,以及生活满意度、自杀意念、敌对攻击行为和暴力暴露的指标。结果表明,约有 10%的受访者来自受丛林大火影响严重的地区,其在 DAR-5 上的愤怒问题显著得分超过了暂定的临界值标准,这一比例比受低至中度丛林大火影响地区的受访者高出 3 倍多,OR=3.26。在女性、年轻参与者和失业者中,这一比例更高,而且尽管并非排他性地,与其他灾后心理健康问题共同发生。愤怒问题还与较低的生活满意度相关,β=-.31,自杀意念增加 8 倍,OR=8.68,敌对攻击行为增加近 13 倍,OR=12.98。愤怒问题与暴力暴露有关,当控制协变量(包括可能的创伤后应激障碍)时,这些关联会减少。研究结果表明,愤怒是灾后心理健康的一个重大问题,应该与其他创伤后心理健康问题一起常规考虑。

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