Poole G V, Lewis J L, Devidas M, Hauser C J, Martin R W, Thomae K R
Department of Surgery, University of Mississippi Medical Center, Jackson 39216, USA.
J Trauma. 1997 Apr;42(4):711-5. doi: 10.1097/00005373-199704000-00022.
Trauma has a high rate of recurrence, suggesting that some people are more injury-prone than others. This study was performed to evaluate some of the psychological and social factors that might influence the likelihood of traumatic injury.
A case-control study was conducted to evaluate the relationship between selected psychosocial factors and traumatic injury. At a Level I trauma center, victims of intentional trauma (excluding attempted suicide), victims of nonintentional trauma, and patients undergoing elective surgery were interviewed by a person blinded to the purposes of the study. They were given an intelligence test and underwent a structured interview, yielding psychiatric diagnostic categories established in the third edition of the Diagnostic and Statistical Manual of Mental Disorders, Revised (DSM-III-R).
Trauma patients were younger than elective surgery patients (p < 0.01) and were more likely to be men (p < 0.01). Victims of intentional injury had a higher probability of alcohol use (p < 0.01) and admitted illicit drug use (p < 0.001) than either nonintentional injury victims or elective surgery patients. Victims of intentional injury were more likely to be unemployed than those in the other two groups (p < 0.02), whereas elective surgery patients were more likely to be retired (p < 0.05) or to be disabled (p < 0.0001). The average intelligence score was slightly above the median in the nonintentional trauma group and in the control group (55th percentile and 54th percentile, respectively), compared with a mean intelligence score equivalent to the 35th percentile in the victims of intentional trauma (p < 0.001). Thirty percent of elective surgery patients met diagnostic criteria for at least one category of psychopathology, compared with 50% of nonintentional trauma patients, and 63% of intentional trauma patients (p < 0.01, trauma vs. elective surgery). Logistic regression analysis identified six variables that were independently associated with an increased tendency to be a victim of trauma: younger age, lower intelligence, antisocial personality, mental retardation, depression, and low income.
Victims of trauma, both nonintentional, and especially intentional, have a high incidence of psychopathology. Victims of intentional trauma have significantly lower intelligence scores than either nonintentional injury or elective surgery patients. The high incidence of unemployment, alcohol abuse, and illicit drug use in victims of intentional injury might provide several opportunities for trauma prevention programs. Underlying psychological disorders will have to be addressed to reduce the likelihood of becoming a victim of trauma.
创伤的复发率很高，这表明有些人比其他人更容易受伤。本研究旨在评估一些可能影响创伤性损伤可能性的心理和社会因素。
进行了一项病例对照研究，以评估所选心理社会因素与创伤性损伤之间的关系。在一家一级创伤中心，由对研究目的不知情的人员对故意创伤受害者（不包括自杀未遂者）、非故意创伤受害者和接受择期手术的患者进行访谈。他们接受了智力测试并进行了结构化访谈，得出了《精神障碍诊断与统计手册》第三版修订本（DSM-III-R）中确立的精神科诊断类别。
创伤患者比择期手术患者年轻（p < 0.01），且男性比例更高（p < 0.01）。故意受伤的受害者饮酒概率更高（p < 0.01），承认使用非法药物的比例也高于非故意受伤受害者或择期手术患者（p < 0.001）。故意受伤的受害者比其他两组更可能失业（p < 0.02），而择期手术患者更可能退休（p < 0.05）或残疾（p < 0.0001）。非故意创伤组和对照组的平均智力得分略高于中位数（分别为第55百分位数和第54百分位数），而故意创伤受害者的平均智力得分相当于第35百分位数（p < 0.001）。30%的择期手术患者符合至少一种精神病理学类别的诊断标准，相比之下，非故意创伤患者为50%，故意创伤患者为63%（p < 0.01，创伤组与择期手术组）。逻辑回归分析确定了六个与创伤受害者倾向增加独立相关的变量：年龄较小、智力较低、反社会人格、智力迟钝、抑郁和低收入。
创伤受害者，无论是非故意的，尤其是故意的，精神病理学发病率都很高。故意创伤受害者的智力得分明显低于非故意受伤或择期手术患者。故意受伤受害者中高失业率、酗酒和使用非法药物的情况可能为创伤预防项目提供几个机会。必须解决潜在的心理障碍，以降低成为创伤受害者的可能性。
