创伤暴露对青少年暴力行为和自杀意念的影响:创伤后应激障碍和抑郁的中介作用

采用创伤暴露问卷、基于DSM-5的创伤后应激障碍症状核查表、流调中心用抑郁量表和青少年行为问题调查表,在雅安地震3.5年后对地震极重灾区的703名中学生进行调查,考察创伤暴露对暴力行为和自杀意念的影响,并检验创伤后应激障碍和抑郁在其中的中介作用。结果发现：创伤暴露可以直接正向预测暴力行为和自杀意念,PTSD在创伤暴露对暴力行为和自杀意念的影响间起中介作用,抑郁仅在创伤暴露对自杀意念的影响间起中介作用,而在创伤暴露对暴力行为影响间的中介效应不显著。     

创伤后应激障碍对震后青少年自杀意念的影响：安全感的调节作用

为探讨创伤后应激障碍（PTSD）及其各个症状簇对震后青少年自杀意念的影响，并检验安全感在其中的调节作用，研究采用创伤暴露程度问卷、流调中心抑郁量表儿童版、DSM-5的PTSD症状核查表、安全感量表和儿童行为问题核查表对汶川地震8.5年后的1136名中学生进行调查。结果发现：PTSD、负性认知和情绪改变症状、警觉性增高症状分别正向预测自杀意念，侵入性症状和回避性症状对自杀意念的预测作用不显著；安全感在侵入性症状、负性认知和情绪改变症状、警觉性增高症状、PTSD与自杀意念之间起负向调节作用，在回避性症状与自杀意念之间不起调节作用。这表明PTSD各症状簇对震后青少年自杀意念的预测作用不同，且安全感在其中发挥的调节作用也不同。     

中小学生的灾难暴露程度对创伤后应激障碍的影响：中介和调节效应

汶川地震后1年时,采用灾难暴露程度问卷、主观害怕程度问卷、社会支持问卷和创伤后应激障碍症状量表,对地震极重灾区的3058名中小学生进行调查,考察灾难暴露程度、主观害怕程度、社会支持与创伤后应激障碍的关系。结果发现：（1）震后1年时中小学生创伤后应激障碍的发生率为9.6%,其中有目睹他人死亡经历的学生的创伤后应激障碍发生率为16.2%;（2）灾难暴露程度能正向预测创伤后应激障碍,而主观害怕程度在灾难暴露程度对创伤后应激障碍的影响中起部分中介作用;（3）社会支持在灾难暴露程度与创伤后应激障碍的关系中起调节作用,但不能调节主观害怕程度与创伤后应激障碍之间的关系。其中,无论支持的性质如何,父母和教师的支持都能缓解灾难暴露程度对创伤后应激障碍的影响,而同学和其他人的支持则不具有调节效应。     

青少年的创伤暴露程度与创伤后应激障碍的关系——核心信念挑战、主观害怕程度和侵入性反刍的作用

采用创伤暴露程度问卷、核心信念量表、主观害怕程度问卷、反刍问卷和创伤后应激障碍问卷,以雅安地震6个月后的310名中学生为被试,考察其创伤暴露程度、核心信念挑战、主观害怕程度、侵入性反刍与创伤后应激障碍之间的关系。结果发现,雅安地震6个月后青少年的创伤后应激障碍的发生率及整体水平较低,其中男生水平低于女生,高一年级学生水平相对高于初一、初二和高二年学生。结构方程模型的结果显示,创伤暴露程度可以通过核心信念挑战对创伤后应激障碍起正向预测作用,也可以通过核心信念挑战经侵入性反刍的多重中介来正向预测创伤后应激障碍;创伤暴露程度还可以通过主观害怕程度经侵入性反刍的多重中介来正向预测创伤后应激障碍。但是创伤暴露程度不能直接通过侵入性反刍预测创伤后应激障碍,也不能通过主观害怕程度直接预测创伤后应激障碍。     

社会支持对震后青少年创伤后应激障碍和创伤后成长的影响:自我效能感的中介作用

本研究采用创伤暴露问卷、社会支持问卷、自我效能感量表、创伤后应激障碍症状核查表和创伤后成长问卷,在汶川地震8.5年后对地震极重灾区的1185名中学生进行调查,考察社会支持对创伤后应激障碍（PTSD）和创伤后成长（PTG）的影响,并检验自我效能感在其中的中介作用。结果发现：在控制创伤暴露程度、性别和年龄等变量后,社会支持不仅可以直接负向预测PTSD、正向预测PTG,也可以通过自我效能感的中介作用负向预测PTSD、正向预测PTG。这表明,自我效能感在社会支持与PTSD、社会支持与PTG的关系中都具有部分中介效应。     

创伤暴露程度对中学生创伤后应激障碍的影响：复原力的调节作用

采用创伤暴露程度调查表、复原力量表和创伤后应激障碍症状量表调查了汶川地震1年后的773名中学生,考察了其复原力在创伤暴露程度与创伤后应激障碍关系中的调节作用。结果发现,地震1年后,中学生的创伤后应激障碍水平较低,其中男生的水平低于女生,初一学生的水平相对低于初二、高一和高三学生;创伤暴露程度对创伤后应激障碍及其各维度都有显著的正向预测作用;复原力在创伤暴露程度对创伤后应激障碍及其回避性症状与警觉性增高症状的影响上发生负向调节作用,在创伤暴露程度对闯入性症状的影响上不起调节作用。     

创伤暴露程度对青少年物质滥用的影响：创伤后应激障碍与依恋的中介作用

为了考察汶川地震后青少年的创伤暴露程度、创伤后应激障碍（PTSD）、父母依恋和同伴依恋与物质滥用之间的关系,采用创伤暴露程度问卷、儿童创伤后应激障碍症状量表、父母与同伴依恋问卷和物质滥用问卷对汶川县和茂县的1435名中学生进行调查,选取有物质滥用的青少年354名作为本研究的对象。结果发现：创伤暴露程度可以直接正向预测作用物质滥用。不过,在创伤暴露与物质滥用直接关系之间加入PTSD、父母和同伴依恋之后,创伤暴露程度对物质滥用的直接预测作用不再显著,并且创伤暴露程度不能通过同伴依恋预测物质滥用,也不能通过PTSD经同伴依恋对物质滥用发挥多重中介作用;但创伤暴露程度能通过PTSD正向预测物质滥用,可以通过父母依恋负向预测物质滥用,并且创伤暴露程度还可以通过PTSD经过父母依恋对物质滥用发挥正向的多重中介作用。     

青少年创伤后应激障碍和创伤后成长对亲社会行为的影响:生命意义的中介作用

采用创伤暴露程度问卷、创伤后应激障碍症状核查表、创伤后成长问卷、生命意义感量表和亲社会行为问卷,在汶川地震8.5年后对地震极重灾区的1182名中学生进行调查,考察创伤后应激障碍（PTSD）和创伤后成长（PTG）对亲社会行为的影响,并检验存在意义感和寻求意义感在其中的中介作用。结果发现：PTSD可以直接负向预测亲社会行为,也可以通过降低存在意义感进而负向预测亲社会行为,还可以通过提高寻求意义感进而正向预测亲社会行为;PTG可以直接正向预测亲社会行为,也可以分别通过提高存在意义感和寻求意义感进而正向预测亲社会行为。     

创伤暴露程度、主观害怕程度对儿童创伤后应激障碍影响的追踪研究:社会支持的调节作用

为了考察创伤暴露程度、主观害怕程度、社会支持与创伤后应激障碍（PTSD）之间的纵向关系,本研究采用创伤暴露程度问卷、主观害怕程度问卷、社会支持问卷与儿童创伤后应激障碍症状量表对雅安地震半年后的303名小学生进行测查,并于震后一年半时进行再次测查。逐步回归分析的结果发现,创伤暴露程度对地震半年后的PTSD具有显著的正向预测作用,对震后一年半的PTSD没有显著的预测作用;无论是震后半年还是一年半,主观害怕都可以加剧PTSD、社会支持都可以缓解PTSD;社会支持在创伤暴露程度与PTSD之间不起显著的调节作用,但却可以显著地调节主观害怕程度对震后一年半的PTSD的影响,表现为主观害怕程度对震后一年半的PTSD的正向预测作用随着社会支持水平的增加而降低。     

大学生的冲动性特质与自杀意念的关系:一个有调节的中介模型

以应激-易感模型为依据考察冲动性特质与自杀意念的关系,并在此基础上提出一个有调节的中介模型,探讨负性生活事件影响的中介作用以及家庭环境的调节作用。采用巴瑞特冲动性量表、青少年生活事件量表、家庭环境量表、贝克自杀意念量表对902名大学生进行集体施测,旨在考察负性生活事件的影响对大学生冲动性特质与自杀意念的中介作用以及家庭环境的调节作用,结果表明:(1)冲动性特质和负性生活事件的影响能正向预测大学生的自杀意念;(2)负性生活事件的影响在冲动性特质和自杀意念之间起中介作用;(3)负性生活事件影响的中介作用和冲动性特质的直接作用受家庭环境的调节。这些结果对于综合解释环境与个体因素对自杀意念的作用与机制具有重要意义。     

Exposure to Violence in Young Inner-City Adolescents: Relationships With Suicidal Ideation, Depression, and PTSD Symptomatology

This study examined the relationship of exposure to violence to suicidal ideation, depression, and post-traumatic stress disorder (PTSD) symptomatology in 94 young adolescents from an inner-city school. Participants completed self-report measures of the Reynolds Adolescent Depression Scale, the Suicidal Ideation Questionnaire—Junior, Adolescent Psychopathology Scale—Posttraumatic Stress Disorder Subscale, and the Exposure to Violence Questionnaire. Using a hierarchical multiple regression design, exposure to violence demonstrated a unique relationship with PTSD symptomatology. Specifically, the relationship between violence exposure and PTSD symptomatology remained significant after controlling for depression and suicidal ideation severity. Controlling for PTSD symptomatology resulted in nonsignificant relationships between violence exposure and depression and suicidal ideation in adolescents. Additional analyses suggest that PTSD functions as a mediating variable between exposure to violence and depression and suicidal ideation. The implication of these results and suggestions for future research are discussed.     

The Relationship Between Posttraumatic Stress Symptoms and Suicide Ideation Among Child Survivors Following the Wenchuan Earthquake

The association between posttraumatic stress disorder (PTSD) symptoms and suicide ideation was examined in a sample of 2,298 child survivors of the Wenchuan earthquake. Results indicated that intrusion, avoidance, hyperarousal symptom clusters, and PTSD total score were significantly associated with suicide ideation. Except for intrusion, other measures of PTSD remained as statistically significant correlates of suicide ideation even after controlling for age, gender, direct exposure, indirect exposure, and depression. Furthermore, results showed that PTSD symptoms had an indirect influence on suicide ideation that was mediated by depression. The findings suggest that avoidance and hyperarousal symptom clusters of PTSD may be two important indicators of suicide ideation among child survivors of the Wenchuan earthquake. Implications of the results for intervention and prevention of suicide behavior are discussed.     

The relationship between posttraumatic stress symptomatology and suicidal behavior in school-based adolescents

This study investigated the relationship between posttraumatic stress disorder (PTSD) symptomatology and suicidal behavior, specifically suicidal ideation and suicide attempt history, while controlling for depression and gender in 106 adolescents in an urban high school. Participants completed self-report measures of the Adolescent Psychopathology Scales-Posttraumatic Stress Disorder Subscale (APS-PTS), the APS-Suicide Attempt History (APS-SAH), the Suicidal Ideation Questionnaire-Junior (SIQ-JR), and the Reynolds Adolescent Depression Scale (RADS). Analyses were conducted using a hierarchical multiple regression design to account for the relationship between PTSD symptomatology and depression. Regression results showed that after controlling for depression and gender, PTSD symptomatology was significantly related to suicidal ideation and showed a trend toward suicide attempt history. In addition, adolescents with high levels of PTSD symptomatology were more likely than peers with "average" levels of PTSD symptomatology to be currently thinking about suicide and to have made a past suicide attempt. These findings show that PTSD symptomatology has a unique relationship to adolescent suicidal behavior that cannot be explained by depression or gender. The importance of these results and their implications for future research are discussed.     

青少年重复创伤暴露与创伤后应激障碍的关系:安全感与认知重评的中介作用

采用创伤暴露程度问卷、生活事件量表、安全感量表、情绪调节策略问卷和修订后的DSM-5的PTSD核查表对汶川地震8.5年后的1156名中学生进行调查,考察其重复创伤暴露、安全感和认知重评与PTSD之间的关系。结果发现,在控制初次地震暴露后,重复创伤暴露可以直接正向预测PTSD,也可以通过确定控制感和人际安全感分别间接地正向预测PTSD,还可以通过人际安全感经认知重评的多重中介作用来正向预测PTSD。不过,重复创伤暴露不能直接经过认知重评对PTSD发挥显著的预测作用,也不能通过确定控制感经认知重评来对PTSD发挥显著的多重间接预测作用。     

Moral transgression during the Vietnam War: a path analysis of the psychological impact of veterans’ involvement in wartime atrocities

Background and Objectives: Involvement in wartime combat often conveys a number of deleterious outcomes, including posttraumatic stress disorder (PTSD), depression, hostility, aggression, and suicidal ideation. Less studied is the effect of engagement in wartime atrocities, including witnessing and perpetrating abusive violence.

Design and Methods: This study employed path analysis to examine the direct effects of involvement in wartime atrocities on hostility, aggression, depression, and suicidal ideation independent of combat exposure, as well as the indirect effects via guilt and PTSD symptom severity among 603 help-seeking male Vietnam War veterans.

Results: Involvement in wartime atrocities was predictive of increased guilt, PTSD severity, hostility, aggression, depressive symptoms, and suicidal ideation after controlling for overall combat exposure. Combat-related guilt played a minor role in mediating the effect of atrocity involvement on depression and suicidal ideation. PTSD severity had a larger mediational effect. However, it still accounted for less than half of the total effect of involvement in wartime atrocities on hostility, aggression, and suicidal ideation.

Conclusions: These findings highlight the heightened risk conveyed by involvement in wartime atrocities and suggest that the psychological sequelae experienced following atrocity involvement may extend well beyond guilt and PTSD.     

父母忽视对青少年自杀意念的影响:自尊和希望的中介作用

为考察父母忽视对青少年自杀意念的影响及其作用机制，采用父母忽视量表、自尊量表、希望量表和自杀意念量表，对全国七个省份八所中学共845名初二学生进行调查。结果表明：（1）父母忽视、自尊、希望和自杀意念两两之间存在显著的相关，且父母忽视对自杀意念具有显著的正向预测作用；（2）自尊和希望在父母忽视与自杀意念的关系中起部分中介作用。具体而言，父母忽视通过三条路径影响自杀意念：一是自尊的单独中介作用；二是希望的单独中介作用；三是自尊-希望的链式中介作用。本研究揭示了父母忽视与青少年自杀意念的关系及其作用机制，对预防以及减少青少年自杀行为具有一定的现实意义。     

Sexual assault history and suicidal behavior in a national sample of women

This study examined demographic and psychosocial correlates of suicidal ideation and suicide attempts in women with histories of sexual assault in childhood and/or adulthood identified from a national sample of women. Multivariate analyses showed that women with histories of sexual assault in both childhood and adulthood reported significantly greater odds of lifetime suicide attempts, controlling for demographic factors and other psychosocial characteristics. As predicted, younger age (marginal), stressful life events (marginal), depression, PTSD, and alcohol dependence symptoms were also significantly associated with suicidal ideation. Furthermore, number of lifetime traumatic events and depression were each associated with lifetime odds of suicide attempts. Implications for studying the role of sexual trauma and other psychosocial factors in relation to women's suicidal behavior are discussed.