汶川地震后青少年创伤后应激障碍症状及其相关因素研究

The present paper studies focus on the symptoms of the post-traumatic stress disorder in adolescents post-disaster. 482 students from 6 secondary schools and 17 primary schools in the extremely severe disaster areas in Mianzhu, Sichuan province and 785 students from 3 primary schools and 9 secondary schools in the severe disaster areas in Baoji, Shaanxi respectively were surveyed on the symptoms of the post-traumatic stress disorder and the extent of disaster exposure after the Wenchuan earthquake. Self-compiled background information questionnaire and CRIES were used for the investigation. In this study, we contrast the extent of disaster exposure in the two areas in order to explore the related factors about the post-traumatic stress disorder in adolescent post-disaster. The main results of this paper can be summarized as follows： 1. There are significant positive corrections between the post-traumatic stress disorder and the extent of disaster exposure(get trapped in the earthquake、relatives and friends have been injured in the earthquake、look at relatives and friends dying in the earthquake).The more exposed in the disaster, the more serious symptom of the post-traumatic stress disorder. The trauma exposure indicators (get trapped in the earthquake, relatives and friends have been injured in the earthquake、look at relatives and friends dying in the earthquake)were all significant predictors for PTSD severity. 2. There are significant sex difference in the extent（F=8.750, p <0.05） and the incidence rate of PTSD（χ =20.735, df=5,p =0.001）, the extent and the incidence rate of girls in Mianzhu is significantly higher than that of boys. 3. The age is also an influence factor of PTSD. The extent （F=7.246, p <0.001）and the incidence rate （χ =20.735, df=5,p =0.001）of PTSD get higher as adolescent in Mianzhu get older. 4. As the extremely severe disaster areas, the extent of disaster exposure of Mianzhu areas significantly higher than that of the severe disaster areas Baoji. However, there are not difference in the extent of PTSD between two areas（t=0.181，df=1265,p=0.857）, there are only significant difference in the incidence rate of PTSD between two areas（χ =8.766，df=1,p=0.003）, the incidence rate of PTSD in Mianzhu areas significantly higher than that of Baoji areas.

中学生强迫症状及其心理、环境危险因素和整合模型研究

Obsessive-Compulsive Symptoms, which are one of common factors effected on mental health of secondary school students, have been rarely studied at home and abroad. In accordance with the problems existed in these literature up till now, the thesis had mainly studied the measured tool, contents and structure, developmental features, psychosocial risk factors and integrated model of obsessive-compulsive symptoms from them by means of investigation with quetionnaires. The entire research was divided into three phases. 3185 students(age 14.68±1.75 years) were firstly measured with the 20-item Leyton Obsessional Inventory-Child Version(LOI-CV) at four secondary schools including six grades in Beijing city, which was applied to revise LOI-CV, and to study the structure and contents, developmental features and screen of obsessive-compulsive symptoms. Then, 216 subjects with obsessive-compulsive symptoms, paired with controls in the light of school, grade and gender, were investigated with 10 self-rating scales on obsessive-compulsive symptoms, anxiety, depression, personality, coping and attributional style, negative life events, parent's rearing style, family environment and life adaptation in school, and with an inventory on social demography. The results were used to explore psychosocial risk factors and integrated model of obsessive-compulsive symptoms. The third survey was only carried out, about two months after the second, among 264 subjects with obsessive-compulsive symptoms through MMOCI and Negative Life Event Scale for Adolescents, in order to probe into the integrated model. The research had mainly found: (1) LOI-CV can be used as a screen tool for obsessive-compulsive symptoms in urban adolescents in China; (2) Total screening-out ratio of obsessive-compulsive symptoms was 13.6% (male:15.0%, female:12.2%). The most common manifestations of obsessive-compulsive symptoms were hating dirt and contamination, doing things in exact manner, angry if someone messes desk, bad conscience but no one else, worry about cleanliness, repeated thoughts or words; the least were favorite or special number, spending extra time on homework, special number or words to avoid, talking or moving to avoid bad luck, fussy about hands. The checking and repetition, cleanliness and tidiness, general obsessions were more common forms than numbers-luck; (3) No differences were existed in serious degree of obsessive-compulsive symptoms, but the screening-out ratio in male was higher than it in female; (4) No differences were detected in the serious degree of obsessive-compulsive symptoms except the scores of cleanliness and tidiness among grades, but the screening-out ratio of the grades justly entering secondary school or going to graduate were higher than other ones; (5) The main psychosocial risk factors for obsessive-compulsive symptoms included anxiety, mother's over-protecting and over-interfering, fantasy, flexibility, self-actualization, peers relationship, sense of responsibility, negative life events, mother's occupation, help-seeking, and (6) The integrated model on psychosocial risk factors suggested that the possible developed and sustained mechanism of obsessive-compulsive symptoms was that personality, coping and attributional styles constructed the developmental diathesis foundation of obsessive-compulsive symptoms; negative life events were promoting factors of them. There was a dynamic interaction between personality and environmental factors. Negative emotion played a core role in the developmental process of them. The continued existence of obsessive-compulsive symptoms was related to pre-existed obsessive-compulsive symptoms and negative life events experienced by an individual. Therefore, this research not only let us get a deeper understanding of obsessive-compulsive symptoms and more entirely find out psychosocial risk factors, firstly applied diathesis-stress theory to comprehend the psychological mechanism of obsessive-compulsive symptoms and, moreover, elaborate and expand it, but also has more important practice significance of treatment, prevent and education for obsessive-compulsive symptoms in secondary school students.