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创伤后应激障碍中鲁莽/自毁行为在中国地震亲历者中的症状学研究
Alternative TitleSymptomatlogical Study on Reckless/ Self-destructive Behaviors in Posttraumatic Stress Disorder among Chinese Victims of an Destructive Earthquake
方若蛟
Subtype硕士
Thesis Advisor王力
2018-06
Degree Grantor中国科学院大学
Place of Conferral中国科学院心理研究所
Degree Name理学硕士
Degree Discipline健康心理学
Keyword《精神疾病诊断与统计手册》第五版 创伤后应激障碍 鲁莽/自毁行为 身区体健康 地震
Abstract

鲁莽/自毁行为症状(E2症状)是《精神疾病诊断与统计手册》第五版C Diagnostic And Statistical Manual of Mental Disorders Fifth Edition, DSM-5)创伤后应激障碍(Posttraumatic stress disorder, PTSD)诊断标准的新增症状。本研究主要研究了该症状在中国地震亲历者中的症状学特征,研究E2症状在处于不同年龄阶段的亲历者中的症状表现,以及其在PTSD诊断中的作用。本研究调查了745亲历名汉川地震的青少年(平均年龄13.6,女性53.3%)和1194名亲历汉川地震的成人(平均年龄48.0,女性67.8% )。分别调查了青少年、成人两样本的PTSD筛查阳性率、PTSD各症状阳性率;并对E2症状所在的唤起和反应性的改变症状维度(E标准)全部症状进行了项目反应理论分析:检验了两样本中E2阳性组与阴性组在PTSD严重程度、各症状维度严重程度上的差异;以及E2在两样本中的诊断效能;合并两样本后检验了年龄阶段和E2症状表现对PTSD筛查阳性及总体症状严重程度的影响;并选取两样本中额外完成了躯体健康调查问卷的1193人(平均年龄48.0,女性67.8% ),检验了E2阳性组、阴性组在躯体健康程度上的差异。结果发现:青少年样本中PTSD筛查阳性率为5.9%,成人样本中为13.8%;两样本中E}症状都不是流行率最高的症状;IRT结果显示青少年样本中E2症状在E标准各个症状中表现出最高的难度和第二高的区分度,成人样本中E2症状则表现出最高的难度和第二低的区分度;在青少年和成人中,E2症状阳性组相较于阴性组PTSD总体严重程度和各个症状簇严重程度都更高;青少年和成人中E2症状诊断效能都较好;性别为女性、处于成人阶段和E2症状表现阳性都是PTSD筛查阳性和PTSD总体症状更为严重的显著预测因素;E2症状阳性组比阴性组表现出更差的躯体健康情况,在睡眠、头痛、肠胃和呼吸系统各方面都表现出更多的问题。本研究的发现表明E2症状具有良好的症状学特征,并且存在年龄阶段的特异性。本研究为新修订的DSM-5 PTSD诊断标准在中国人群中的适用性提供了实证支持。

Other Abstract

In the current research we investigated the symptomatological characters of reckless/self-destruction behavior criterion (E2) in post-traumatic stress disorder (PTSD) based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) among Chinese earthquake victims. We studied differences of E2 symptoms in earthquake victims at different age stages as well as different roles of this symptom in the diagnosis of PTSD for earthquake victims at different age stages. We investigated 745 (mean age 13.6; 53.3% female) adolescent Wenchuan earthquake victims and 1194 (mean age 48.0; 67.8% female) adult Wenchuan earthquake victims. We studied prevalence of I'TSD, prevalence of PTSD symptoms, and did IRT analysis for symptoms reflecting the hyperarousal symptoms (E criteria) which contains E2 in both samples. We also tested differences of PTSD severity, criterions severity between groups differing on their endorsement status of E2,and E2's diagnosis efficiency in both samples. After combined two samples, we studied the influence of stages of development and EZ on prevalence of PTSD and severity of PTSD. We use the data of 1193 (mean age 48.0; 67.8% female) people who completed the Physical Health Questionnaire in two samples, tested differences of the physical health between groups differing on their endorsement status of E2 in both samples. The prevalence of possible PTSD in adolescents was 5.9%, the prevalence of possible PTSD in adults was 13.8%. E2 symptom was not the highest prevalence symptom in both samples. In IRT results, E2 showed the highest level of difficulty, and second highest discrimination, relative to the other E criteria's items in the adolescent sample. In the adult sample E2 showed the highest level of difficulty but second lowest discrimination. In both samples, groups endorsed E2 had higher overall PTSD

severity and higher severity of each symptom clusters than groups did not endorse E2. E2 showed high diagnosis efficiency in both samples. Female, be adult and endorsed,E2 were the significant predictors for possible PTSD and overall severity of PTSD. Compare to the group did not endorse E2, endorsed E2 group showed worse physical health and showed more problems in sleep, headaches, gastrointestinal and respiratory systems. The findings of current study indicated that symptom of E2 have good symptomatic features, and age-specificity. Current study provided empirical support for the applicability of the DSM}5 PTSD newly revised criteria in the Chinese population.

Pages38
Language中文
Document Type学位论文
Identifierhttp://ir.psych.ac.cn/handle/311026/28844
Collection健康与遗传心理学研究室
Recommended Citation
GB/T 7714
方若蛟. 创伤后应激障碍中鲁莽/自毁行为在中国地震亲历者中的症状学研究[D]. 中国科学院心理研究所. 中国科学院大学,2018.
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