早年创伤经历对高原军官创伤后应激障碍症状的影响:亲子疏离的中介作用  

Effect of childhood trauma experiences on post-traumatic stress disorder symptoms in military officers at high altitude:mediating role of parent-child alienation

作　　者：郝维红 代宗佩 谭洁滢 金晓敏 金晨璇 谢菲 戴琴[1] HAO Weihong;DAI Zongpei;TAN Jieying;JIN Xiaomin;JIN Chenxuan;XIE Fei;DAI Qin(Psychological Training Center,School of Medical Psychology,Army Medical University(Third Military Medical University),Chongqing 400038;Department of Military Nursing,Noncommissioned Officer School,Army Medical University(Third Military Medical University),Shijiazhuang,Hebei Province 050081;School of Public Policy and Administration,Chongqing University,Chongqing 400044,China;Department of Field Nursing,Faculty of Nursing,Army Medical University(Third Military Medical University),Chongqing 400038)

机构地区：[1]陆军军医大学(第三军医大学)医学心理系心理训练中心,重庆400038 [2]陆军军医大学(第三军医大学)士官学校军事护理系,石家庄050081 [3]重庆大学公共管理学院,重庆400044 [4]陆军军医大学(第三军医大学)护理系野战护理学教研室,重庆400038

出　　处：《陆军军医大学学报》2024年第14期1640-1646,共7页Journal of Army Medical University

基　　金：军事护理创新专项应用基础项目(2021HL003);陆军军医大学科技创新能力提升专项军事医学项目(2021XJS12)。

摘　　要：目的了解高原军官创伤后应激障碍(post-traumatic stress disorder,PTSD)症状的现状,探讨早年创伤经历对高原军官PTSD症状的影响以及亲子疏离的作用。方法本研究采用横断面研究设计方案。于2021年10月采用整群抽样法,使用童年期创伤问卷(childhood trauma question,CTQ)、亲子疏离感问卷(inventory of alienation toward parents,IAP)、PTSD自评量表(the post-traumatic stress disorder checklist-civilian version,PCL-C)对238名男性高原军官进行问卷调查,分析亲子疏离在早年创伤经历与PTSD症状间的中介效应。结果①高原军官PTSD症状阳性检出率为8.5%。②有早年创伤经历组的军官PTSD症状阳性检出率为15.6%,显著高于无早年创伤经历组(5.1%,χ^(2)=7.27,P<0.01)。③PTSD症状、早年创伤经历和亲子疏离之间呈显著正相关(r=0.35~0.76,P<0.01)。④早年躯体虐待经历(β=1.05,P<0.001)和亲子疏离(β=0.39,P<0.01)都正向预测高原军官PTSD症状的严重程度。⑤亲子疏离在早年躯体虐待经历与PTSD症状之间起部分中介作用(β=1.16,95%CI:0.54~1.75)。结论有早年创伤经历的高原军官PTSD症状阳性检出率更高、症状更重。早年躯体虐待经历不仅对PTSD症状有直接影响,还会通过亲子疏离间接影响其严重程度。Objective To explore the current status of post-traumatic stress disorder(PTSD)symptoms among military officers at high altitude,determine the effects of childhood trauma experiences on the symptoms,and investigate the role of parent-child alienation in the process.Methods A cross-section study was conducted on 238 male military officers at high altitude subjected with cluster sampling.All of them were surveyed with childhood trauma question(CTQ),inventor of alienation toward parents(IAP),and Post-traumatic Stress Disorder Checklist(PCL-C)in October 2021.Then the mediating effect of parent-child alienation on childhood trauma and PTSD symptoms was investigated.Results①The prevalence of PTSD-positive symptoms was 8.5%among the military officers at high altitude.②The prevalence of PTSD-positive symptoms was 15.6%for the military officers with childhood trauma,which was significantly higher than that of those without childhood trauma(5.1%,Chi-square=7.27,P<0.01).③PTSD symptoms,childhood trauma experiences and parent-child alienation were significantly positively correlated with each other(r=0.35~0.76,P<0.01).④Both childhood physical abuse(β=1.05,P<0.001)and parent-child alienation(β=0.39,P<0.01)could positively predict the severity of PTSD symptoms for them.⑤Parent-child alienation played a partial mediating role in the association between physical abuse and PTSD symptoms(β=1.16,95%CI:0.54~1.75).Conclusion Military officers at high altitude with childhood trauma have a higher prevalence of PTSD-positive symptoms and more severe symptoms.Childhood physical abuse can not only directly affect PTSD symptoms,but also indirectly affect its severity through parent-child alienation.

关 键 词：创伤后应激障碍 早年创伤 亲子疏离 军官 高原 

分 类 号：R339.54[医药卫生—人体生理学] R395.2[医药卫生—基础医学] R821.2[哲学宗教—心理学]