Carr V J, Lewin T J, Webster R A, Kenardy J A, Hazell P L, Carter G L
Discipline of Psychiatry, Faculty of Medicine and Health Sciences, University of Newcastle, NSW, Australia.
Psychol Med. 1997 Jan;27(1):167-78. doi: 10.1017/s0033291796004278.
A sample of 1089 Australian adults was selected for the longitudinal component of the Quake Impact Study, a 2-year, four-phase investigation of the psychosocial effects of the 1989 Newcastle earthquake. Of these, 845 (78%) completed a survey 6 months post-disaster as well as one or more of the three follow-up surveys.
The phase 1 survey was used to construct dimensional indices of self-reported exposure to threat the disruption and also to classify subjects by their membership of five 'at risk' groups (the injured; the displaced; owners of damaged small businesses; helpers in threat and non-threat situations). Psychological morbidity was assessed at each phase using the 12-item General Health Questionnaire (GHQ-12) and the Impact of Event Scale (IES).
Psychological morbidity declined over time but tended to stabilize at about 12 months post-disaster for general morbidity (GHQ-12) and at about 18 months for trauma-related (IES) morbidity. Initial exposure to threat and/or disruption were significant predictors of psychological morbidity throughout the study and had superior predictive power to membership of the targeted 'at risk' groups. The degree of ongoing disruption and other life events since the earthquake were also significant predictors of morbidity. The injured reported the highest levels of distress, but there was a relative absence of morbidity among the helpers.
Future disaster research should carefully assess the threat and disruption experiences of the survivors at the time of the event and monitor ongoing disruptions in the aftermath in order to target interventions more effectively.
从1089名澳大利亚成年人中选取样本用于“地震影响研究”的纵向部分,这是一项为期两年、分四个阶段的对1989年纽卡斯尔地震心理社会影响的调查。其中,845人(78%)在灾后6个月完成了一项调查以及三项随访调查中的一项或多项。
第一阶段调查用于构建自我报告的受威胁程度和干扰程度的维度指标,并根据五个“风险”组(受伤者;流离失所者;受损小企业主;处于威胁和非威胁情境中的帮助者)的成员身份对受试者进行分类。在每个阶段使用12项一般健康问卷(GHQ - 12)和事件影响量表(IES)评估心理疾病。
心理疾病发病率随时间下降,但一般发病率(GHQ - 12)在灾后约12个月趋于稳定,创伤相关发病率(IES)在约18个月趋于稳定。在整个研究过程中,最初暴露于威胁和/或干扰是心理疾病发病率的重要预测因素,并且比目标“风险”组的成员身份具有更强的预测能力。地震后的持续干扰程度和其他生活事件也是发病率的重要预测因素。受伤者报告的痛苦程度最高,但帮助者中相对较少有发病情况。
未来的灾害研究应仔细评估幸存者在事件发生时的威胁和干扰经历,并监测灾后的持续干扰情况,以便更有效地确定干预目标。