汶川地震灾后26例急性应激反应心理危机干预综合分析

A Comprehensive Analysis on 26 Clinical Cases of Crisis Intervention to Post-disaster Acute Stress Reactivity

汶川大地震后,作者对绵阳安置点内来自北川县的26例灾民采用聆听观察、访谈、当事人自诉等方法收集资料,发现17例都有痛失亲人的遭遇;正常心理反应4例,神经衰弱反应2例,恐惧反应8例,抑郁反应9例,精神病反应3例。对评断为精神病反应的3例进行了及时的转介。同时发现:社会支持系统与个体内在因素相互作用,影响问题的形成和发展。采用支持性陪伴、积极宣泄、(交互式)放松、理性情绪疗法和认知行为疗法等短期治疗策略有效。作者认为灾后急性心理危机干预后续干预的长期性必须引起社会的普遍关注。建立统筹协调的可持续发展的灾后心理干预工作系统和运行机制势在必行。

By general diagnotic devices as observating, hstening, interviewing, and shortterm psychological intervention tech- nics as Supportive Company, Positive Catharsis, Reciprocal Relaxation, Rational - Emotion Therapy, Cognitive - Behavioral Therapy and Transference, we worked with 26 subject, Beichuan County victims from 5. 12 Wenchuan Great Earth - Quake at Victim Shelter at Mianyang Nanhe Center of Sports ＆ Games, among whom 9 aged from 6 to 17 years old, 9 aged from 22 to 46, and 8 from 56 to 74. Among the 26 victim subjects, 18 experienced the great grief of the death of their dearests, relatives or friends. After our diagnostic evaluation by the reference of DSM - Ⅳ - TR, we found 4 cases of Normal Reactivity, 2 cases of neurosthenia reactivity, 8 of panic reactivity, 9 of Depressive Reactivity and 3 cases of Psychosis Reactivity. By our great efforts all the cases were effectively treated and the victim subjects＇ mental conditions were mostly getting better. At the same time we found the social supportive system （both its objetive and subjective aspects ） often go together influencing the reactivities of disaster survivors. And we found the mobility of victims made great impact on continuous intervention for their further mental restoration. We strongly hope a working and coordinating system for post- disaster mental assisstance practice must be established by the effort of both our government and non - governmental psychological profession organizations soon after the Post - Disaster Acute Intervention Period.