创伤与创伤后的应激障碍

Trauma and post-traumatic stress disorder

背景:创伤事件影响着个体情感、认知和身体等很多方面,很多的创伤个体会进一步的发展为创伤后应激障碍,从而造成个体在社会和职业机能上的损伤。目的:简明介绍创伤和创伤后应激障碍的概念,分类,诊断标准,测量和症状,并分析创伤和创伤后应激障碍的关系。资料来源:利用计算机检索1990-01/2005-12与创伤和创伤后应激障碍的症状、心理反应、影响因素相关的文献,中文文献来源于中国全文期刊数据库,检索的关键词包括“创伤,创伤后应激障碍”。英文文献来源于ProQuest数据库,检索的关键词包括“trauma,PTSD,Post-traumaticStressDisorder”。资料选择:对资料进行初审,纳入详细阐述了创伤和创伤后应激障碍的症状、心理效应及其影响因素的文献。筛除与之无明显联系的文章。排除①器质性损伤和运动损伤的部分。②个案研究的文献。③重复性的研究。资料提炼:共收集到58篇文献,选择与本文密切相关的15篇进行综述。资料综合:创伤后应激障碍是目前第4个最常见的精神疾病,分为急性、慢性、延迟发生创伤后应激障碍3种亚型。美国精神病学协会提出6个症状标准用来进行诊断。创伤后应激障碍的核心特征就是表现出与超出平常经验的、确切的创伤性事件相联系的明确的症状特征。创伤后应激障碍的实证研究主要包括应激源、影响因素及创伤和创伤后应激障碍导致的心理反应。结论:研究创伤后的各种心理反应及创伤后应激障碍的症状对于临床创伤患者具有非常重要的意义。对创伤和创伤后应激障碍的研究进行回顾有利于临床医务人员的工作和创伤患者的康复。

BACKGROUND： The trauma has effects on many aspects of emotion, cognition and body of human. Many individuals who experienced trauma will develop into post-traumatic stress disorder （PTSD）, and damage the social and occupational function of human. OBJECTIVE： To compendiously introduce the concept, classification, diagnosis standard, measurement and symptom of trauma and PTSD, and analyze the relationship between them. DATA SOURCES： An overall on-line retrieval from CNKI and ProQuest database was conducted to identify the articles about symptoms, psychological responses and influencing factors of trauma and PTSD published between January 1990 and December 2005 by using the key words of ＂trauma, PTSD, Post-traumatic Stress Disorder＂. STUDY SELECTION： After preliminary screening, the articles associated with the symptoms, psychological responses and factors of trauma and PTSD were selected. And the articles with insignificant correlation were excluded. Exclusive criteria：①organic trauma and akinesia ②literatures of case study③repeated study. DATA EXTRACTION： Totally 58 articles were collected, and 15 related ones were reviewed. DATA SYNTHESIS： PTSD is the fourth common psychiatric disease at present, and consisted of three isoforms of acute, chronic and delayed PTSD. There were 6 symptom criterions raised by American Psychiatric Association for diagnosis PTSD. The core characters of PTSD were specific symptoms -related with transcendental and precise traumatic events. And the empirical study of PTSD included stressor, influencing factors and psychological responses induced by trauma and PTSD. CONCLUSION： It is very important to study various psychological responses after trauma and symptoms of PTSD for clinical traumatic patients, Furthermore, the clinicians and the patients can benefit from the reviews of trauma and PTSD researches.