儿童期不良生活事件与创伤后应激障碍的相关性研究

Study on the correlation between childhood adverse life events and posttraumatic stress disorder

目的:了解农村儿童创伤后应激障碍流行特征及影响因素,分析儿童期不良生活事件与创伤后应激障碍相关性,探讨儿童期不良生活事件对心理健康的影响。方法:采用横断面调查研究方法,整群抽取河南省濮阳市南乐县某高中12个班级和10所乡镇中学学校进行问卷调查,调查内容包括一般情况、社会支持、儿童青少年创伤后应激障碍情况以及儿童青少年躯体虐待情况,采用χ2检验和多因素非条件logistic回归分析进行危险因素分析。结果:本次共调查学生2 500人,回收2 315份调查表,有效问卷2 283份,有效应答率89.52%。调查对象平均年龄为(14.22±1.71)岁,男生1 027人,女生1 256人。PTSD的检出率为8.94%,其危险因素分别为入睡困难、睡眠很少充足、睡眠有时充足、以打架及吵架来解决冲突、人际关系因子异常、学习压力因子异常、丧失因子异常、躯体虐待;保护因子为上网<2 h、社会支持水平为中等。结论:儿童期不良生活事件、躯体虐待、睡眠差、社会支持低等均与儿童创伤后应激障碍的发生具有相关性,家庭、学校及社会应重视儿童青少年的心理卫生问题,促进其身心及社会功能的健康发展。

Objective： To understand the epidemiological characteristics and influencing factors of posttraumatic stress disorder （PTSD） in rural children, analyze the correlation between childhood adverse life events and PTSD, explore the impact of childhood adverse life events on psychological health. Methods： A cross -sectional study was carried out among school students from 12 classes in a senior high school and 10 township senior high schools in Nanle county of Puyang city in Heiaan province. All the students were surveyed by a questionnaire, the contents included general situations, social support, PTSD and physical abuse situations, X2 test and multivariate non - condi- tional logistic regression analysis were used to analyze the risk factors. Results： A total of 2 500 students participated in the survey, 2 315 questionnaires were retrieved and 2 238 questionnaires were valid, the effective response rate was 89. 52%. The average age of participants was （ 14. 22 ±1.71 ） years, 1 027 boys and 1 256 girls were included. The detection rate of PTSD was 8. 94%, the risk factors included difficulty falling asleep, lack of sleep, lack of sleep sometimes, dealing with conflict through fight and quarrel, abnormal interpersonal factor, abnormal academic pressure factor, abnormal loss factor, physical abuse; the protective factors included online time 〈 2 hours and medium social support. Conclusion： Childhood adverse life events, physical abuse, poor quality of sleep and low social support are associated with childhood PTSD. Family, school and the society should pay more attention to psychological health of children and adolescents and promote physical and psychological health development and social function.