Lutgendorf S K, Antoni M H, Ironson G, Fletcher M A, Penedo F, Baum A, Schneiderman N, Klimas N
Department of Psychology, University of Miami, Coral Gables, FL 33124, USA.
Psychosom Med. 1995 Jul-Aug;57(4):310-23. doi: 10.1097/00006842-199507000-00002.
This study examined the effects of Hurricane Andrew on physical symptoms and functional impairments in a sample of chronic fatigue syndrome (CFS) patients residing in South Florida. In the months after Hurricane Andrew (September 15-December 31, 1992), 49 CFS patients were assessed for psychosocial and physical functioning with questionnaires, interviews, and physical examinations. This sample was made up of 25 CFS patients living in Dade county, a high impact area, and 24 patients in Broward and Palm Beach counties, areas less affected by the hurricane. Based on our model for stress-related effects on CFS, we tested the hypothesis that the patients who had the greatest exposure to this natural disaster would show the greatest exacerbation in CFS symptoms and related impairments in activities of daily living (illness burden). In support of this hypothesis, we found that the Dade county patients showed significant increases in physician-rated clinical relapses and exacerbations in frequency of several categories of self-reported CFS physical symptoms as compared to the Broward/Palm Beach county patients. Illness burden, as measured on the Sickness Impact Profile, also showed a significant increase in the Dade county patients. Although extent of disruption due to the storm was a significant factor in predicting relapse, the patient's posthurricane distress response was the single strongest predictor of the likelihood and severity of relapse and functional impairment. Additionally, optimism and social support were significantly associated with lower illness burden after the hurricane, above and beyond storm-related disruption and distress responses. These findings provide information on the impact of environmental stressors and psychosocial factors in the exacerbation of CFS symptoms.
本研究调查了安德鲁飓风对居住在南佛罗里达的慢性疲劳综合征（CFS）患者样本的身体症状和功能损害的影响。在安德鲁飓风过后的几个月（1992年9月15日至12月31日），通过问卷调查、访谈和体格检查对49名CFS患者的心理社会和身体功能进行了评估。该样本由25名居住在受影响严重的戴德县的CFS患者以及24名居住在受飓风影响较小的布劳沃德县和棕榈滩县的患者组成。基于我们关于压力对CFS相关影响的模型，我们检验了以下假设：受此次自然灾害影响最大的患者，其CFS症状的恶化程度以及日常生活活动（疾病负担）方面的相关损害会最为严重。为支持这一假设，我们发现，与布劳沃德/棕榈滩县的患者相比，戴德县的患者在医生评定的临床复发以及几类自我报告的CFS身体症状频率方面显著增加。通过疾病影响量表测量的疾病负担在戴德县的患者中也显著增加。尽管风暴造成的破坏程度是预测复发的一个重要因素，但患者飓风后的应激反应是复发可能性和严重程度以及功能损害的最强单一预测因素。此外，乐观情绪和社会支持与飓风过后较低的疾病负担显著相关，这超出了与风暴相关的破坏和应激反应的影响。这些发现提供了关于环境应激源和心理社会因素对CFS症状加重影响的信息。
