热射病事件后官兵急性应激反应与创伤后应激障碍症状调查

Acute stress response and symptoms of post-traumatic stress disorder in CAPF soldiers after a heat stroke incident

目的探讨训练导致重型热射病事件后官兵急性应激反应(acute stress response,ASR)发生的特征及继发创伤后应激障碍(post-traumatic stress disorder,PTSD)发生情况。方法收集2020年7月(事件发生后1 d)和2020年8月(事件发生后1个月)对重型热射病事件涉及单位官兵整体采样。采用单样本前后对照方法,应用急性应激反应量表(acute stress response scale,ASRS)对直接经历事件的官兵(直接经历者)进行评分。比较在同一训练环境中直接经历事件的官兵(事件组)与未经历事件的官兵(对照组)在事件后1个月ASRS及PTSD检查表平民版(PTSD checklist-civilian version,PCL-C)的评分差异。结果直接经历者ASRS量表总反应指数在事件发生后1个月比事件发生后1 d明显下降,差异有统计学意义(t=3.191,P=0.003)。在控制军龄变量后,事件组ASRS中行为维度评分均值高于对照组,呈边缘性显著差异;继续对ASRS中行为维度分析,两组在注重外形因子[F(1,60)=5.801,P=0.019,η^(2)=0.088]、饮食因子[F(1,60)=3.859,P=0.05,η^(2)=0.060]差异具有统计学意义;两组PCL-C量表评分差异无统计学意义。结论虽然热射病事件未导致事件经历者ASR及PTSD发生,但事件经历者ASR的行为维度有一定改变,建议以认知行为疗法干预为主。

Objective To investigate the characteristics of acute stress responses and symptoms of post-traumatic stress disorder(PTSD)in soldiers of the Chinese People’s Armed Police Force(CAPF)after a severe heat stroke incident.Methods The acute stress response scale(ASRS)and the PTSD checklist-civilian version(PCL-C)were used to score CAPF soldiers of the units involved in the incident one day and thirty days after the incident.A single sample control study was used to investigate the changes of acute stress responses of these CAPF soldiers from the 1 st day to the 30 th day after the incident.A controlled study was used to find out about the difference in acute stress responses and symptoms of PTSD between soldiers who had experienced the incident(as the incident group)and those who had not(as the control group)at the 30 th day after the incident.Results The mean score of ASRS of soldiers who had experienced the incident was significantly lower at the 30 th day after the incident than at the 1 st day after the incident(t=3.191,P=0.003).After controlling for the factor of length of military service,the mean score of the behavioral dimension of ASRS of the incident group was marginally significantly higher than that of the control group[F(1,60)=3.482,P=0.067,η^(2)=0.055].According to more in-depth analysis of the behavior dimension of ASRS,there was significant difference between the two groups in the factor of attention to appearance[F(1,60)=5.801,P=0.019,η^(2)=0.088]and diet[F(1,60)=3.859,P=0.05,η^(2)=0.060].There was no significant difference in PCL-C scale scores between the two groups.Conclusions Although the results of this study indicate that this heat stroke incident did not cause acute stress disorder or PTSD in those involved in the incident,the changes in the behavioral dimension of acute stress responses deserve attention.The cognitive behavioral therapy is recommended intervention.