地震灾区中学生创伤后成长与创伤后应激障碍的关系研究

PSYCH OpenIR > 健康与遗传心理学研究室

	地震灾区中学生创伤后成长与创伤后应激障碍的关系研究
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	赵品良
	2013-05
摘要	研究目标：（1）研究创伤后成长问卷（PTGI）在中国地震灾区青少年幸存者中的信效度；（2）探索创伤后成长和创伤后应激障碍的关系。研究方法：以汶川大地震集中灾区绵阳市北川县两所中学的1640名初一、初二的中学生为研究对象，以创伤后成长问卷（PTGI）与加州大学创伤后应激障碍评估指数（UCLA PTSD Index）为主要评估工具，采用探索性因素分析、验证性因素分析、相关分析和多元回归分析为主要统计方法。研究结果：（1）PTGI的因素结构效度：将总体样本随机分为两个部分进行探索性因素分析和验证性因素分析。在删除了不适用于中国文化的灵性改变维度的2个条目和具有双因素载荷的6个条目后，探索性因素分析保留了原PTGI问卷的13个条目，发现PTGI在中国青少年群体中表现出了三因素结构（个人力量，生活取向和人际关系），各条目在3个因子上的载荷在0.45-0.81之间，因子之间的相关系数为0.51-0.57；验证性因素分析在第二个独立样本中交叉验证了了该结构的稳定性。（2）PTGI的效标效度：13项PTGI总分与心理韧性和社会支持呈现中等到高等程度的正相关（相关系数分别为0.629和0.404），与抑郁症状呈现中等程度的负相关（相关系数为-0.330），显示PTGI-13在测量地震幸存者的积极恢复情况方面是有效的。（3）PTGI的信度：PTGI-13的内部一致性系数为0.86，个人力量、生活取向和人际关系分维度的内部一致性系数依次为0.788,0.769和0.721。（4）通过验证性因素分析比较创伤后应激障碍的四个竞争性结构模型，发现Elhai等人（2011）提出的五因素结构模型（分别为闯入维度，回避维度，麻木维度，情绪痛苦唤醒维度和焦虑唤醒维度）拟合最优。以PTG的三因素结构模型和PTSD的五因素结构模型为基础，回归分析发现，PTSD的闯入分维度对PTG的生活取向因子有正向预测作用；PTSD的回避分维度对PTG总分、个人力量因子和人际关系因子有正向预测作用；PTSD的麻木分维度对PTG的总分及各因子有负向预测作用；PTSD的痛苦唤醒和焦虑唤醒分维度对人际关系因子有正向预测作用。研究结论：（1）修订后的PTGI-13的信效度达到测量学要求，可以用于中国青少年群体的创伤后成长的评估。PTGI-13由个人力量、生活取向和人际关系三个维度构成。（2）以PTSD的五因素结构模型为基础，PTSD的不同子维度与创伤后成长的关系不同，主要表现在回避分维度能促进创伤后成长，而情绪麻木分维度则不利于创伤后成长的发生。
其他摘要	Objectives: (1) To investigate the psychometric properties of the Chinese version of PTGI (Post-Traumatic Growth Inventory) among Chinese Adolescents survivors after the Wenchuan earthquake in 2008. (2) To explore the relationship between Post-Traumatic Growth (PTG) and Post-traumatic Stress Disorder (PTSD) symptoms. Methods: A total of 1640 adolescents in grade seven and eight from Beichuan County, Mianyang, Southwest China, one of the most destroyed districts in the Wenchuan Earthquake participated the study and finished the PTGI, UCLA PTSD Index and some other related scales. Results: (1) The factor structure validity of PTGI. The total sample of 1640 students was randomly split to two samples. Two items belonging to the original factor SC(Spiritual Change) and other six items loading at least three factors in the first run of exploratory factor analysis (EFA) were deleted. In the first sample, exploratory factor analysis (EFA) got a three-factor structure, namely Personal Strength (PS), Life Orientation (LO) and Relationship to Others (RO). The loading of the left thirteen items on the three factors ranged from 0.45 to 0.81. The correlations between the three factors ranged from 0.51 and 0.57. Confirmatory factor analysis (CFA) in the second independent sample cross-validated the three-factor structure from EFA. (2) The external validity of PTGI. The 13-item PTGI was positively related to Resilience and Social Support in a medium to high degree (r=0.629 & r=0.404), and was negatively related to Depressive symptoms, indicating good external validity of PTGI-13. (3) The Reliability of PTGI. The Cronbach’s αof the total scale was 0.86 and that of the three sub-scale was 0.788, 0.769 and 0.721, respectively. (4) The five-factor model of PTSD developed by Elhai et al. (2011) showed the best model fit by CFA to compare four competing models including DSM-IV three factor model, four-factor numbing model and four-factor dysphoria model. The chosen five-factor model of PTSD contained five dimensions, namely intrusion, avoidance, numbing, dysphoric arousal and anxious arousal. The regression analysis indicated that intrusion predicted LO positively, avoidance predicted PTG, PS, and RO positively, numbing predicted PTG and its all three factors negatively, the dysphoric arousal and anxious arousal predicted RO positively. Conclusions: (1) The modified 13-item Chinese version of PTGI showed satisfactory psychometric properties and could be used to measure the posttraumatic growth among Chinese youth. Different from the original five-factor structure of PTGI, the modified PTGI-13 showed a three factor structure (Personal Strength, Life Orientation and Relationship to Others). (2) Based the three factor model of PTGI-13 and the five factor model of PTSD, regressive analysis showed that different dimensions of PTSD related to PTG differently. Specifically, the criterion of numbing was negatively related to PTG, while the criterion of avoidance facilitated the development of PTG. Given the recent modification of diagnostic criteria of PTSD in DSM-V draft, these were quite reasonable results.
学科领域	医学心理学
关键词	创伤后成长创伤后应激障碍汶川地震中国青少年
学位类型	硕士
语种	中文
学位专业	心理学
学位授予单位	中国科学院研究生院
学位授予地点	北京
文献类型	学位论文
条目标识符	http://ir.psych.ac.cn/handle/311026/19782
专题	健康与遗传心理学研究室
作者单位	中国科学院心理研究所
推荐引用方式 GB/T 7714	赵品良. 地震灾区中学生创伤后成长与创伤后应激障碍的关系研究[D]. 北京. 中国科学院研究生院,2013.

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