震后远期青少年创伤后应激障碍与社会支持的关系研究

Association of Social Support with Long-term Level of Post-traumatic Stress Disorder in Adolescents after Wenchuan Earthquake

目的探讨震后远期青少年创伤后应激障碍(PTSD)的流行程度及其与社会支持的关系。方法于2014年1月,采用分层随机抽样的方法在汶川地震极重灾区抽取青少年(年龄14~35岁)暴露者135例。采用结构式问卷对其进行调查,内容包括人口社会学信息、创伤后应激障碍测量量表平民版(PCL-C)、领悟社会支持量表(PSSS),其中PCL-C包括B组、C组、D组3个分量表,PSSS包括家庭支持、朋友支持、其他支持3个分量表。采用多元线性回归分析、典型相关分析探讨社会支持与PTSD的关系。结果青少年PCL-C总量表的平均得分为(29.6±12.9)分,以44分为截断值的PTSD阳性率为15.6%(21/135)。B组、C组、D组症状的阳性率分别为69.6%(94/135)、49.6%(67/135)、57.8%(78/135),B组症状阳性率高于C组、D组,差异有统计学意义(P<0.05)。多元线性回归分析结果显示,PSSS总量表得分及其他支持分量表得分是PCL-C总量表得分的影响因素;其他支持得分是B组、C组、D组分量表得分的影响因素,家庭支持得分是B组分量表得分的影响因素(P<0.05)。典型相关分析中1组典型变量具有统计学意义,相关系数为0.446(P<0.001)。来自社会支持的第1组典型变量公式为:U1=-0.359×家庭支持+0.302×朋友支持-0.949×其他支持,来自PTSD的第1组典型变量公式为:V1=0.456×B组+0.293×C组+0.363×D组。结论震后远期青少年PTSD仍然需要得到关注,来自于家庭外社会支持较少的个体在PTSD B组、D组上表现明显,强化震后远期青少年领悟社会支持有助于缓解PTSD症状。

Objective To investigate the prevalence of long-term level of post-traumatic stress disorder（ PTSD） in adolescents after Wenchuan earthquake and to explore its association with social support.Methods By using stratified random sampling,we selected 135 survivors aged between 14 and 35 from the areas severely affected by the Wenchuan earthquake in January 2014.They were surveyed by a structured questionnaire covering sociodemographic data,PTSD Checklist-Civilian Version（ PCL-C） consisting of B,C and D subscales,Perceived Social Support Scale（ PSSS） consisting of family,friends and significant other subscales.Multiple linear regression and canonical correlation analyses were performed to explore the association between social support and PTSD.Results The average total scores of PCL-C in the adolescents were（ 29.6± 12.9） points.The overall prevalence rate of PTSD among the respondents was 15.6%（ 21/135） if 44 points was taken as the cutoff value.The proportion of respondents giving positive responses to the questions listed in subscales B,C and D was 69.6%（ 94/135）,49.6%（ 67/135）,57.8%（ 78/135）,respectively;respondents were more likely to respond positively to the questions listed in subscale B than those listed in other two scales（ P 0.05）.Multiple linear regression analysis found that,the total scores of PSSS and scores of significant other subscale were associated factors for the total scores of PCL-C（ P 0.05）;scores of significant other subscale was related to the scores of B,C and D subscales（ P 0.05）;scores of family subscale was an associated factor for scores of B subscale（ P 0.05）.Only one set of canonical correlation variable about perceived social support and PTSD reached significant level,the correlation coefficient was 0.446（ P 0.001）.The equation for performing a canonical correlation about perceived social support is：U1 =-0.359 × scores of family subscale ＋ 0.302 × scores of friends subscale-0.949 × scores of significant other subscale.And that for performing a canonical correlation about PTSD is：V1 = 0.456× scores of subscale B ＋ 0.293 × scores of subscale C ＋ 0.363 × scores of subscale D.Conclusion The prevalence of long-term level of PSTD in adolescent survivors of Wenchuan earthquake needs to be paid attention.Those who receive less support from others except their families,are more likely to give positive responses to the items listed in subscales B and D.Strengthening perceived social support can contribute to alleviating the symptoms of PSTD in them.