创伤后成长与创伤后应激障碍症状相关性的meta分析

A meta-analysis of relationship between posttraumatic growth and posttraumatic stress disorder symptoms

目的：采用meta分析的方法,评价基于Pearson相关系数的创伤后成长（PTG）与创伤后应激障碍（PTSD）症状的相关性。方法：计算机检索Pub Med、EMBASE、Cochrane Library、知网、万方等中英文数据库,收集1996年1月-2014年8月关于PTG与PTSD症状相关性的文献。由2名研究者独立对文献进行筛选、资料提取和质量评价后,用Stata12.0软件进行meta分析。结果：最终纳入52篇文献。结果示PTG与PTSD症状得分呈正相关（ES=0.21,95%CI：0.17～0.26）。亚组分析示,成人（ES=0.22,95%CI：0.17～0.27）相关程度高于儿童（ES=0.18,95%CI：0.05～0.31）;创伤类型相关程度由高到低依次为军事冲突、照顾者、助人职业、混合事件、自然灾害、意外事故和疾病;按创伤时间分组,相关程度随时间呈倒＂U＂型曲线关系,18～24个月相关程度最高（ES=0.29,95%CI：0.08～0.49）。其中,6篇维度间的meta分析结果示除PTSD症状的回避维度与PTG各维度得分、PTSD症状的高警觉维度与PTG的欣赏生活维度得分、PTSD症状各维度与PTG的他人关系维度得分间的相关检验无统计学意义外,其余均有统计学意义。结论：创伤后成长与创伤后应激障碍症状存在关联,年龄、创伤类型和创伤时间对创伤后成长与创伤后应激障碍症状关系有影响。

Objective：The meta-analysis was applied to evaluate the relationship between posttraumatic growth（PTG） and posttraumatic stress disorder（PTSD） symptoms through the Pearson correlation coefficient.Methods：PubMed,EM BASE,Cochrane Library,CNKI and Wan Fang database were systematically searched for studies on the correlation between PTG and PTSD symptoms from January 1996 to August 2014.The quality of studies was critically evaluated and the data were extracted by two reviewers independently.Meta-analysis was conducted by using the Stata 12.0.Results：Totally 52 studies were finally identified.Pooling analysis noted that PTG scores were positively correlated with scores of PTSD symptoms（ES =0.21,95%CI：0.17-0.26）.Subgroup analyses showed a stronger correlation between scores of PTG and PTSD symptoms among adults（ES =0.22,95%CI：0.17-0.27）than children（ES =0.18,95%CI：0.05-0.31）.Trauma types from strong to weak,in turn,to military conflicts,caregivers,helping professions,mixed trauma,natural disasters,accidents and diseases.Grouped according to time since trauma,there was a curvilinear relationship over time such that the correlation between scores of PTG and PTSD symptoms was stronger at intermediate when reached in 18-24 months than at near or far post-trauma time（ES =0.29,95%CI：0.08-0.49）.Among included studies,six studies provided the correlation between each factors of the PTGI with each subscales of the IES-R,no significant correlation was found between the avoidance subscale of the IES-R with all PTGI factors,the hyperarousal subscale of the IES-R with appreciation of life factor of the PTGI,all three subscales of the IES-R with relating to others factor of the PTGI,and the rest were all statistically significant.Conclusion：This meta-analysis provides the evidence that PTG may be positively correlated with PTSD symptoms,and this correlation may be modified by age,trauma types and time since trauma,respectively.