台风灾后受损情况对创伤后应激障碍者的影响:述情障碍的调节作用

Impact of post-typhoon damage on posttraumatic stress disorder symptoms: Moderating effect of alexithymia

目的:探讨述情障碍在台风灾后受损情况与创伤后应激障碍(PTSD)症状之间的调节作用。方法:采用台风灾后受损情况调查表、创伤后应激障碍检测表(PCL-5)和多伦多述情障碍量表(TAS-20)对经历过台风的311名海南省受灾民众进行调查。结果:①PTSD在述情障碍组中的症状阳性率(10.2%)显著高于非述情障碍组(3.4%),述情障碍在PTSD症状阳性组中的阳性率(70.0%)显著高于非PTSD症状组(42.3%)(χ~2=5.839,P<0.05);②述情障碍组与非述情障碍组在创伤性体验的反复重现、持续性回避、认知和心境的消极改变以及持续的警觉性增高维度得分及PCL-5总分之间差异有统计学意义(t=-3.669,-4.772,-3.881,-5.643,-5.109;P<0.001);③台风灾后受损情况,创伤后应激障碍症状与述情障碍两两间呈显著正相关(r=0.305,0.131,0.333;P<0.05);④台风灾后受损情况和述情障碍分别对创伤后应激障碍症状有显著的正向预测作用(β=0.266,t=5.112,P<0.001;β=0.298,t=5.723,P<0.001),述情障碍在台风灾后受损情况对创伤后应激障碍症状的影响上起显著的正向调节作用(β=0.165,t=3.133,P<0.01)。结论:述情障碍在台风灾后受损情况对创伤后应激障碍的影响上起正向调节作用。

Objective:To explore the moderating effect of alexithymia on post-typhoon damage and posttraumatic stress disorder symptoms.Methods:A total of 311 typhoon-affected people in Hainan Province were assessed by post-typhoon Damage Questionnaire,PTSD Checklist for DSM-5 and The 20-item Toronto Alexithymia Scale.Results:①The positive rate of PTSD symptoms after typhoon was significantly higher in the alexithymia group(10.2%)than that in the non-alexithymia group(3.4%).The positive rate of alexithymia after typhoon was significantly higher in the PTSD symptoms group(70.0%)than that in the non-PTSD symptoms group(42.3%)(χ~2=5.839,P<0.05).②There were significant differences between the alexithymia group and the non-alexithymia group in the scores of re-exprience,persistent avoidance,negative alterations,hyperarousal and PCL-5(t=-3.669,-4.772,-3.881,-5.643,-5.109;P<0.001);③There was a significant positive correlation among post-typhoon damage,PTSD symptoms and alexithymia(r=0.305,0.131,0.333;P<0.01);④Post-typhoon damage and alexithymia had positively predictive effects on PTSD symptoms respectively(β=0.266,t=5.112,P<0.001;β=0.298,t=5.723,P<0.001).Alexithymia played a significant positive moderating role in the impact of post-typhoon damage on PTSD symptoms(β=0.165,t=3.133,P<0.01).Conclusion:Alexithymia playes a significant positive moderating role in the impact of post-typhoon damage on PTSD symptoms.