创伤康复期患者应激障碍与心理弹性的相关研究  

Correlation of prevalence of post traumatic stress disorder with mental health and resilience in rehabilitation patients with traumatic injury

作　　者：陈翰[1,2] 张佳佳[1] 李敏[1] 许莹[1] 缪毅[1] 汪琴[2] 刘宏亮[2] 

机构地区：[1]第三军医大学护理系心理学教研室,重庆400038 [2]第三军医大学西南医院康复科,重庆400038

出　　处：《第三军医大学学报》2010年第18期2006-2009,共4页Journal of Third Military Medical University

基　　金：国家高技术研究发展计划(863计划;2008AA022602);第三军医大学预研基金项目(2009XYY13)~~

摘　　要：目的调查创伤康复期患者创伤后应激障碍(post traumatic stress disorder,PTSD)发生率、心理健康水平与心理弹性的关系。方法采用创伤后应激障碍症状清单-平民版(PTSD checklist-civilian version,PCL-C)、成人心理弹性量表(resilience scale for adults,RSA)、症状自评量表(symptom checklist90,SCL-90)、艾森克人格问卷(eysenck personalityquestionnaire,EPQ)、应对方式问卷对重庆市3所三甲医院康复科2008年12月至2010年3月158名的创伤康复期患者进行问卷调查。以PTSD总分38分划界,将患者分为PTSD阳性组和阴性组。结果创伤康复期患者PTSD总分≥38分比例为34.18%,PTSD阳性组和阴性组在心理弹性(t=-4.744,P=0.000)、人格的神经质(t=3.549,P=0.001)及应对方式的合理化(t=2.502,P=0.013)方面差异有显著性。②创伤康复期患者SCL-90量表中躯体化、抑郁、焦虑、恐惧、偏执和精神性因子分均显著高于全国常模(P<0.05),SCL-90阳性组在心理弹性的自我认知和未来计划上得分显著低于阴性组(P<0.05),在EPQ的神经质因子得分显著高于阴性组(P<0.01),在应对方式上的自责、幻想、退避、合理化因子得分显著高于阴性组(P<0.05)。③PTSD总分与RSA总分显著负相关,与SCL-90总分、神经质和合理化应对方式3个因素显著正相关(r值分别为:-0.343、0.390、0.362和0.170),SCL-90总分和RSA总分共能解释PTSD总分的28.8%。结论创伤康复期患者创伤后应激障碍发生率较高,低心理弹性、低心理健康水平是PTSD的重要预测因素。Objective To investigate the relationship of post traumatic stress disorder（PTSD）with mental health and resilience in patients during rehabilitation after trauma.Methods One hundred and seventy-nine rehabilitation patients after traumatic injury admitted in 3 high-grade hospitals from December 2008 to March 2010 were tested with PTSD checklist-civilian version（PCL-C）,Resilience Scale for Adult（RSA）,Self-report Symptom Checklist 90（SCL-90）,Eysenck Personality Questionnaire（EPQ）,and Copying Style Questionnaire.There were totally 158 valid questionnaires obtained,including 117 males and 41 females,130 married and 28 unmarried with an age ranging from 14 to 65（39.15±11.58）.Results The average PTSD score of this cohort was 34.72±11.89.Among them,there were 54 patients（34.18%）with a score not lower than 38 who were identified as PTSD positive group,and the left 104 were PTSD negative group.Significant difference was found in mental resilience（t=-4.744,P=0.000）,psychoticism（t=3.549,P=0.001）,coping styles rationalization（t=2.502,P=0.013）between PTSD positive and negative groups（P〈0.05）.Compared with the norms,evaluative indexes scores of SCL-90 including somatization,depression,anxiety,fear,crankiness and psychosis were higher（P〈0.05）.The scores on self-cognition and planning in RSA in SCL-90 positive group were lower,nervousness in personality and self-blame,delusion,withdraw and rationalization in copying style were higher than those in negative group（P〈0.05,0.01）.Correlation analysis showed total scores of PTSD were negatively related with total RSA scores,and positively related with SCL-90 score,nervousness and coping style rationalization,separately.Regression results showed that those 4 factors explained 28.8% of total score of PTSD.Conclusion The prevalence rate of PTSD is high in the rehabilitation patients following traumatic injury.Low resilience and mental heath are the main predictors for PTSD.

关 键 词：应激障碍 创伤后 康复 心理学 临床 心理弹性 

分 类 号：R395.2[哲学宗教—心理学] R641[医药卫生—医学心理学]