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2008年汶川地震幸存儿童创伤后应激障碍随时间的变化及预测变量

Changes Over Time in Post-traumatic Stress Disorder Among Children Who Survived the 2008 Wenchuan Earthquake and Predictive Variables.

作者信息

Chen Ying, Lam Chow, Deng Hong, Ko Kam Ying

机构信息

Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.

Department of Psychology, Illinois Institute of Technology, Chicago, IL, United States.

出版信息

Front Psychiatry. 2021 Sep 22;12:691765. doi: 10.3389/fpsyt.2021.691765. eCollection 2021.

Abstract

This study examines changes over time in post-traumatic stress disorder (PTSD) among children who survived the 2008 Wenchuan earthquake and the relevant predictive variables. A total of 203 children and adolescents were investigated 24 months after the earthquake, and 151 children and adolescents completed the 1-year follow-up study. Participants completed the Children's Revised Impact of Event Scale (CRIES-13), the Center for Epidemiologic Studies Depression Scale (CES-D) and the Connor-Davidson Resilience Scale (CD-RISC). Hierarchical linear regression analysis was used to evaluate the predictors of changes in PTSD severity. Eighty percent of the children still had some PTSD symptoms 2 years after the Wenchuan earthquake, and 66.25% of the children had symptoms that lasted 3 years. In the model predicting PTSD symptom severity, the loss of family members and child burial explained a significant 21.9% of the variance, and depression explained a significant 16.7% of the variance. In the model predicting changes in PTSD severity, the change scores for resilience and depression explained a significant 18.7% of the variance, and cognitive behavioral therapy (CBT) explained a significant 33.6% of the variance. PTSD symptoms in children and adolescents can persist for many years after trauma. In addition to using psychological interventions to improve PTSD symptoms, improvements in depression and resilience should also be considered.

摘要

本研究调查了在2008年汶川地震中幸存的儿童创伤后应激障碍(PTSD)随时间的变化情况以及相关预测变量。地震发生24个月后,共对203名儿童和青少年进行了调查,151名儿童和青少年完成了为期1年的随访研究。参与者完成了儿童事件影响量表修订版(CRIES - 13)、流行病学研究中心抑郁量表(CES - D)和康纳 - 戴维森心理韧性量表(CD - RISC)。采用分层线性回归分析来评估PTSD严重程度变化的预测因素。汶川地震2年后,80%的儿童仍有一些PTSD症状,66.25%的儿童症状持续了3年。在预测PTSD症状严重程度的模型中,家庭成员的丧失和儿童被掩埋情况解释了21.9%的显著方差,抑郁解释了16.7%的显著方差。在预测PTSD严重程度变化的模型中,心理韧性和抑郁的变化分数解释了18.7%的显著方差,认知行为疗法(CBT)解释了33.6%的显著方差。儿童和青少年的PTSD症状在创伤后可能会持续多年。除了采用心理干预来改善PTSD症状外,还应考虑改善抑郁和心理韧性。

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