Pynoos R S, Goenjian A, Tashjian M, Karakashian M, Manjikian R, Manoukian G, Steinberg A M, Fairbanks L A
Department of Psychiatry and Biobehavioral Sciences, University of California School of Medicine, Los Angeles.
Br J Psychiatry. 1993 Aug;163:239-47. doi: 10.1192/bjp.163.2.239.
One and a half years after the devastating earthquake in Armenia in 1988, 231 children from three cities at increasing distances from the epicentre were randomly screened in their schools to determine the frequency and severity of post-traumatic stress reactions, using the Children's Post-traumatic Stress Disorder Reaction Index (CPTSD-RI). A systematic clinical assessment of PTSD based on DSM-III-R criteria was also conducted on approximately half of this sample. A high CPTSD-RI score was strongly correlated with a clinical diagnosis of PTSD. A strong positive correlation was found between proximity to the epicentre and overall severity of post-traumatic stress reaction, as well as severity of core component symptoms of PTSD. High rates of chronic, severe post-traumatic stress reactions were found among children in the two most damaged cities, Spitak and Gumri. Analyses controlling for exposure revealed that girls reported more persistent fears than boys. These findings indicate that after catastrophic natural disaster, post-traumatic reactions in children may reach epidemic proportions, remain high for a prolonged period, and jeopardise the well-being of the child population of a large region. Systematic screening of children for PTSD can provide critical information for a rational public mental health programme after such a disaster.
1988年亚美尼亚发生毁灭性地震一年半后，从距离震中越来越远的三个城市的学校中随机挑选了231名儿童，使用儿童创伤后应激障碍反应指数（CPTSD-RI）来确定创伤后应激反应的频率和严重程度。还对该样本中约一半的儿童进行了基于《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）标准的创伤后应激障碍系统临床评估。CPTSD-RI高分与创伤后应激障碍的临床诊断密切相关。震中距离与创伤后应激反应的总体严重程度以及创伤后应激障碍核心症状的严重程度之间存在强烈的正相关。在受灾最严重的两个城市斯皮塔克和古姆里的儿童中，发现慢性、严重创伤后应激反应的发生率很高。控制暴露因素的分析显示，女孩比男孩报告了更多持续的恐惧。这些发现表明，在灾难性自然灾害之后，儿童的创伤后反应可能达到流行程度，长时间居高不下，并危及广大地区儿童群体的福祉。对儿童进行创伤后应激障碍的系统筛查可为灾后合理的公共心理健康计划提供关键信息。
