地震后青少年创伤后应激障碍的潜在结构分析

为考察地震后青少年创伤后应激障碍（PTSD）的潜在症状结构,本研究采用儿童创伤后应激障碍症状量表和儿童抑郁量表,对汶川地震一年后的746名中学生进行调查。利用验证性因素分析对竞争模型进行比较,结果发现包括侵入性、回避性、麻木性、精神痛苦性唤起和焦虑性唤起等5个症状的PTSD精神痛苦性唤起模型显著优于DSM-IV的PTSD模型、4维情感麻木模型和4维精神痛苦模型。效度分析的结果发现,PTSD精神痛苦性唤起模型具有良好的外部区分效度。所有结果均表明PTSD精神痛苦性唤起模型在汶川地震后青少年群体中具有良好的适用性,可以作为判定震后青少年PTSD症状的有效标准。     

失独父母创伤后应激障碍症状的潜在类别及其相关因素

摘 要 研究旨在探讨失独父母创伤后应激障碍（PTSD）症状的潜在类别及相关因素,分析不同类别失独父母心理韧性的差异。采用创伤后应激障碍量表（PCL-5）、心理韧性量表对385名失独父母进行测查。结果发现：（1）失独父母PTSD症状存在三种潜在类别：PTSD高症状组（30%）、PTSD中度症状组（38%）、PTSD低症状组（32%）。（2）相比PTSD低症状组而言,PTSD高或中度症状组有显著的年龄和失独年限效应,PTSD高症状组中年龄≤60岁、失独年限<10年的人群所占比例较高;PTSD中度症状组的年龄≤60岁的人群所占比例更高。（3）PTSD高症状组心理韧性得分显著低于其他两组。应及时关注和干预小于60岁、失独年限<10年和低心理韧性的失独群体。     

失独父母创伤后应激障碍症状的潜在类别及其相关因素

摘 要 研究旨在探讨失独父母创伤后应激障碍（PTSD）症状的潜在类别及相关因素,分析不同类别失独父母心理韧性的差异。采用创伤后应激障碍量表（PCL-5）、心理韧性量表对385名失独父母进行测查。结果发现：（1）失独父母PTSD症状存在三种潜在类别：PTSD高症状组（30%）、PTSD中度症状组（38%）、PTSD低症状组（32%）。（2）相比PTSD低症状组而言,PTSD高或中度症状组有显著的年龄和失独年限效应,PTSD高症状组中年龄≤60岁、失独年限<10年的人群所占比例较高;PTSD中度症状组的年龄≤60岁的人群所占比例更高。（3）PTSD高症状组心理韧性得分显著低于其他两组。应及时关注和干预小于60岁、失独年限<10年和低心理韧性的失独群体。     

小学生创伤后应激障碍对睡眠问题的影响:积极认知的调节作用

本研究采用创伤暴露程度问卷、儿童创伤后应激障碍症状量表、应对方式问卷和儿童行为问题核查表对汶川地震30个月后844名小学生进行调查,探讨汶川地震后小学生的创伤后应激障碍(PTSD)、积极认知与睡眠问题之间的关系。结果表明,PTSD对睡眠问题具有正向预测作用,积极认知对睡眠问题的预测作用不显著。调节效应的检验结果发现,积极认知调节着PTSD及其回避性症状对睡眠问题的影响,具体表现为PTSD及其回避性症状对睡眠问题的预测作用随着积极认知水平的增加而降低,但是积极认知分别在PTSD的闯入性症状和警觉性增高症状与睡眠问题的关系之间不起调节作用。     

蓄意创伤受害者的创伤后应激障碍症状及影响因素分析

目的:研究蓄意创伤受害者的PTSD症状及影响因素。方法:采用事件冲击问卷、创伤经历揭露问卷、受害人认可问卷和攻击描述问卷等测查工具对163名蓄意创伤受害者进行调查。结果:(1)蓄意创伤受害者的PTSD三大症状之间相关显著,且方差分析结果差异显著,闯入性症状>回避症状>高警觉症状;(2)创伤严重程度与PTSD三大症状的相关显著;(3)创伤揭露中情绪反应对PTSD三大症状都有显著的预测作用;(4)社会认可度中的一般性排斥对PTSD三大症状都有显著的预测作用。结论:蓄意创伤受害者有着较强的PTSD症状,且以闯入性症状最为严重,回避和高警觉症状次之;创伤的严重程度、揭露时的情绪反应和社会认可度中的一般性排斥等都对蓄意创伤受害者的PTSD症状有影响作用。     

灾后中小学生创伤后应激障碍和抑郁症状的共存模式

为揭示灾后中小学生创伤后应激障碍(PTSD)和抑郁在症状层面的共存模式, 本研究分别在汶川地震和雅安地震1年后, 对灾区的中小学生进行问卷调查, 并基于高斯图形模型和贝叶斯爬山算法构建了二者的共存症状网络。结果发现, 在DSM-IV的框架下, PTSD和抑郁的重叠症状以及情绪麻木症状在二者的共存网络中起到了桥接作用; 子网络探测结果与DSM-IV划分的症状边界不同, PTSD中的闯入性症状和回避性症状是其区别于抑郁的特异性症状, 且多为闯入性症状激发回避性症状; 在二者的共存模式中, 多为抑郁症状激发PTSD症状。上述结果在汶川和雅安两个样本中均得到了交叉验证, 具有一定的可推广性。     

价值观对蓄意创伤受害者创伤后应激障碍症状的影响

探讨价值观对蓄意创伤受害者创伤后应激障碍（Posttraumatic Stress Disorder ,简称PTSD）症状的影响方式。方法：采用事件冲击量表、受害人认可评价量表、施瓦兹价值观量表作为测查工具,测查了163 名蓄意创伤受害者。结果：（1）蓄意创伤受害者的PTSD三大症状表现有显著差异,闯入症状水平最高,回避症状水平次之,高警觉症状水平最低。（2）蓄意创伤受害者所持的价值观和对外界接纳的评价能较好地预测PTSD三大症状。（3）内敛价值类型通过诸如社会接纳等反映外在标准的因素影响PTSD的闯入症状。结论：蓄意创伤受害者PTSD症状表现有其自身的特点,对外界接纳的评价和自身所持的价值观对其PTSD症状有直接或间接的影响     

高唤醒对创伤后应激障碍形成发展的影响及其神经机制

高唤醒是创伤后应激障碍(PTSD)的主要症状之一, 对创伤后应激障碍的形成与发展起核心作用。急性应激期产生的高唤醒可以预测其后PTSD的回避与麻木、再体验等症状的形成, 在创伤后早期, 降低唤醒程度可以减轻PTSD相关的症状表现。下丘脑-垂体-肾上腺轴异常变化会导致去甲肾上腺素(NE)、促肾上腺皮质激素释放因子(CRF)过度释放, 同时皮质醇(酮)水平下降, 这二者是高唤醒产生与维持的主要原因。另外, 5-羟色胺(5-HT)系统的高度激活也影响了高唤醒的形成。食欲素神经肽与NE、CRF与5-HT系统有密切的神经联系, 可能参与高唤醒的调节, 是近年来研究的一个热点。     

术后乳腺癌患者体象对创伤后应激障碍和创伤后成长的影响：反刍的中介作用

为探讨乳腺癌患者反刍这一认知情绪调节方式在体象和创伤后应激障碍（PTSD）、创伤后成长（PTG）之间的中介作用,采用体象量表（BIS）、认知情绪调节问卷中文版（CERQ-C）、创伤后应激障碍量表（PSS）和创伤后成长问卷（PTGI）对150名乳腺癌术后患者进行研究。结果发现：（1）乳腺癌患者的体象可以正向预测PTSD和PTG;（2）乳腺癌患者的反刍在体象和PTSD的闯入性症状、回避性症状中起中介作用,在体象与PTG中的中介作用不显著。结果表明,体象既可以正向预测乳腺癌患者的PTSD和PTG,也可以通过反刍的中介作用影响PTSD。     

创伤后应激障碍患者情绪记忆优势研究述评

创伤后应激障碍(PTSD)是由高情绪刺激引起延迟出现和长期持续的精神障碍。闯入、闪回、病理性重复体验、持续性警觉性增高和回避等症状严重损害其认知功能。PTSD患者记忆形成了情绪网络。情绪记忆具有强烈、持久的特点, 在记忆中具有优势地位。回顾PTSD患者情绪记忆优势的行为及脑成像研究发现, PTSD患者情绪记忆优势研究结果并不完全一致, 受到诸多因素的影响, 这些影响因素需进一步探讨。     

Bereavement following the death of a child: Implications for family therapy

The death of a child, is perhaps one of the most excruciating events that a family could experience. Although much literature exists on the short-term effects of child death, little is written on the long-term family repercussions.This article briefly reviews the literature on bereavement, and then focuses on the effects of child death in the family. Issues of specific interest to the family therapist are highlighted.     

Testing a Military Family Stress Model

The current study examines a military family stress model, evaluating associations between deployment‐related stressors (i.e., deployment length/number, posttraumatic stress disorder [PTSD] symptoms) and parent, child, parenting, and dyadic adjustment among families in which a parent had previously deployed to Iraq or Afghanistan in the recent conflicts. Married families (N = 293) with at least one child between the ages of 4 and 12 were recruited from a Midwestern state. Service members were from the Reserve Component (National Guard or Reserves); fathers (N = 253) and/or mothers had deployed (N = 45) to the recent conflicts in the Middle East. Multiple‐method (observations of parenting and couple interactions; questionnaires) and multiple informant measures were gathered online and in the homes of participants, from parents, children, and teachers. Findings demonstrated associations between mothers’ and fathers’ PTSD symptoms and a latent variable of child adjustment comprising teacher, parent, and child report. Mothers’ but not fathers’ PTSD symptoms were also associated with dyadic adjustment and parenting practices; parenting practices were in turn associated with child adjustment. The results are discussed in terms of their implications for military family stress research and interventions to support and strengthen parents and families after deployment.     

Child mortality and parental grief: An evolutionary analysis

Across most of human history, infant and child mortality rates were very high, suggesting the death of a child was a challenge faced by many ancestral parents. Prolonged grief likely harmed grievers’ fitness, yet grief is ubiquitous and often protracted, thereby presenting a puzzle for evolutionary arguments. We integrate existing theories of grief with patterns of parental bereavement to examine how human psychology has been shaped to respond to the death of a child. We contend that variation in life history strategy may explain the relative difficulty with which individuals recover from losing a child. We propose that the same physiological mechanisms underlying detachment and grief during dissolved romantic relationships may also underlie the intensity of parental attachment and bereavement. This theoretical review thus integrates evolutionary theory with extant grief research to provide a functional analysis of the immense suffering associated with the loss of a child.     

THE AFTERMATH OF THE VIOLENT DEATH OF A CHILD: AN INTEGRATION OF THE ASSESSMENTS OF PARENTS' MENTAL DISTRESS AND PTSD DURING THE FIRST 5 YEARS OF BEREAVEMENT

Mental distress and posttraumatic stress disorder (PTSD) were assessed simultaneously among 173 parents bereaved by the accident, suicide, or homicide death of an adolescent or young adult child. Official death records were used to identify potential participants. Study data were collected prospectively 4, 12, 24, and 60 months post-death. T tests compared study parents and normative samples on mental distress and PTSD, whereas repeated measures analysis of variance compared mothers and fathers on the same two outcomes over time. The results showed that 5 years after the deaths, 61% of the study mothers and 62% of the fathers met diagnostic criteria for mental distress, and 27.7% of the mothers and 12.5% of the fathers met diagnostic criteria for PTSD. The hypothesized interactions between gender and trends over time were partially supported, and the hypothesized main effects for both time and gender were supported. Finally, parents' self-reports were that 3 to 4 years were required to reach loss accommodation. Parents' long-term health and well-being and their bereavement service needs are discussed in light of the findings.     

The Relationships Between Family Financial Stress,Mental Health Problems,Child Rearing Practice,and School Involvement Among Taiwanese Parents with School-Aged Children

This study examined the relationships between family financial stress, mental health problems, child rearing practice, and school involvement using a sample of 431 parents with children in grades 1–4 from one elementary school in a rural area of Taiwan. Financial stress was hypothesized to be associated with parental mental health problems, which in turn were expected to be linked to poorer child rearing practice and less parental involvement in school. Structural equation models were constructed and tested in a stepwise manner. Results showed that financial stress was significantly associated with higher mental health problems, poorer child rearing effort, and decreased parental school involvement while parents’ mental health problems were not significantly associated with their child rearing efforts or involvement in school. These findings suggest that the impact of family financial stress on Taiwanese parents’ child rearing practice is largely direct rather than mediated through their mental health problems.     

Family Cohesion and Health-Related Quality of Life of Children with Type 1 Diabetes: The Mediating Role of Parental Adjustment

Despite the increasing number of studies on the health-related quality of life (HRQOL) of children with type 1 diabetes (T1D), little is known about the influence of family and parental factors on this outcome. This study aimed to explore whether family cohesion and children’s HRQOL were connected through three indicators of parental psychological adjustment (parenting stress, depressive symptoms, and anxious symptoms) as well as whether these links varied according to the child’s age. Levels of family cohesion, parenting stress, and depression/anxiety symptoms of parents of children with T1D and parents of healthy children were compared. The sample included 88 child–parent dyads composed of children/adolescents (8–18 years old) with T1D and one of their parents and 121 dyads composed of healthy children/adolescents and one of their parents. The parents completed self-report measures of family cohesion, parenting stress, and emotional adjustment, and the children completed measures of HRQOL. Testing of the hypothesized moderated mediational model showed that higher HRQOL ratings in children were associated with higher levels of cohesion through lower levels of parental stress, regardless of the child’s age. Parents of children with T1D perceived less cohesion and felt more anxiety and stress about parenting tasks compared to parents of healthy children. Our findings suggest that parents of children with T1D are at an increased risk of psychological maladjustment. Moreover, this study highlights the interrelation between family/parental functioning and child adjustment and makes an innovative contribution by identifying a mechanism that may account for the link between family and child variables.     

Impact of On-Site Personal Experience of Violent Death on Posttraumatic Stress Disorder of Bereaved Japanese Family Members in Forensic Autopsy Cases

The present study investigated the influence of direct on-site experience of violent death on the symptoms involved in posttraumatic stress disorder (PTSD) of bereaved Japanese family members (n = 367) in forensic autopsy cases, using a questionnaire survey. Factor analyses of three core symptoms of PTSD confirmed the factor structure. In general linear modeling, the major effect of direct on-site experience of violent death on PTSD score was significant, while manner of death alone did not have such an effect. These findings suggest that direct on-site experience of violent death is essential in the clinical assessment of PTSD-related symptoms of bereaved family members.     

Adoptive versus Mixed Families: Child Adjustment,Parenting Stress and Family Environment

Recent research in adoption has considered the factors and processes that underlie the adjustment of children and families. However, little research has been conducted on certain types of adoptive families, specifically on families with both adoptive and biological children often designated as mixed families. This subject is addressed by the present study which also analyzes the association between the type of adoptive family and children’s outcomes—prosocial and problem behavior—parenting stress and the relational family environment. It also examines whether children’s gender, age at adoption and the number of children in the home moderate these effects. 102 parents of adoptive children (ACF) 33 parents of both adoptive and biological children (ABCF) and 102 parents of biological children (BCF) participated in the study. Target-children were aged from 6 to 12 years. The Portuguese versions of the SDQ-P, PSI-SF and FES (Interpersonal Relationship dimension) were used. Results showed that the type of adoptive family—ACF and ABCF—significantly explained the variance of children’s behavioral problems and parenting stress. The child’s gender was shown to moderate the relationship between ACF parents and their perception of child’s prosocial behavior. The results give relevant clues as to the importance of distinct outcomes in adoptive families—ACF and ABCF—compared to families with only biological children and should, therefore, be a resource for professionals involved in the adopters’ suitability assessment and adoption intervention.