Psychiatry. 2023 Spring;86(1):42-52. doi: 10.1080/00332747.2022.2120309. Epub 2022 Oct 3.
: No previous studies examined how survivors made meaning (i.e. interpreted the personal significance) of a disaster experience after seven years. This qualitative study follows up on a previously published analysis of 182 directly-exposed survivors of the Oklahoma City bombing, assessed after six months had elapsed for bombing-related psychopathology and meaning-making processes. The current study examines how 113 survivors (62% follow-up rate) made meaning of their bombing experience after seven years. : Survivors answered questions about the effects of the bombing on their beliefs and perspectives. Their responses were hand recorded by interviewers and transcribed. Content was coded into themes, allowing codes of multiple themes. Excellent interrater reliability was obtained (Cohen's kappa≥.8). : The survivors were 50% (57/113) male, 93% (105/113) Caucasian, 34% (38/113) college educated, and 71% (80/113) married with a mean (SD) age of 42.5 (10.6) (range = 19-69) years at the time of the bombing. Eight themes emerged and indicated that survivors matured in personal goals and character, interpersonal relationships, and philosophical thought (e.g., reconsideration of human nature and religion). More than one third of the comments included negative remarks about personal harm, especially psychological effects. : Nearly two thirds of the material was positive in tone and consistent between six months and seven years. Negative content was entirely new relative to six-month baseline interview responses, suggesting many survivors incorporate greater reflection on negative outcomes in meaning-making processes over time. After several years, clinicians could encourage survivors to integrate positive and negative consequences as meaning. Longer-term studies are needed.
以前的研究没有探讨幸存者在灾难发生七年后如何理解(即解释个人意义)灾难经历。本定性研究是对俄克拉荷马城爆炸事件中 182 名直接幸存者的先前发表分析的后续研究,这些幸存者在六个月后接受了与爆炸相关的精神病理学和意义构建过程的评估。目前的研究探讨了 113 名幸存者(62%的随访率)在七年后如何理解他们的爆炸经历。
幸存者回答了关于爆炸对他们信仰和观点影响的问题。他们的回答由访谈者手写记录并转录。内容被编码为主题,允许有多个主题的代码。获得了极好的评分者间可靠性(Cohen's kappa≥.8)。
幸存者中 50%(57/113)为男性,93%(105/113)为白种人,34%(38/113)受过大学教育,71%(80/113)已婚,平均年龄(SD)为 42.5(10.6)(范围为 19-69)岁。在爆炸发生时。出现了八个主题,表明幸存者在个人目标和性格、人际关系和哲学思想方面成熟了(例如,重新考虑人性和宗教)。超过三分之一的评论包含了对个人伤害的负面评价,尤其是心理影响。
将近三分之二的材料语气是积极的,与六个月和七年的时间是一致的。负面内容与六个月基线访谈的回复完全不同,这表明许多幸存者在随着时间的推移,在意义构建过程中对负面结果进行了更多的反思。几年后,临床医生可以鼓励幸存者将积极和消极的后果整合为意义。需要进行更长期的研究。