神经胶质母细胞瘤术后患者创伤后成长与心理弹性的相关性分析

目的探讨神经胶质母细胞瘤术后患者创伤后成长与心理弹性的相关性。方法采用创伤后成长评定量表、心理弹性问卷对242例神经外科胶质母细胞瘤术后病人进行调查。结果胶质母细胞瘤术后患者创伤后成长得分(64.62±18.40)分,心理弹性得分(62.86±15.60)分,创伤后成长总分及各维度与心理弹性总分及各维度均呈正相关,相关系数为0.411~0.681。结论胶质母细胞瘤术后患者创伤后成长处于中等水平,心理弹性水平较低,创伤后成长与心理弹性呈正相关。     

自我管理程序干预对首发脑卒中患者自我效能创伤后成长及心理韧性的影响

目的探讨自我管理程序干预对首发脑卒中患者康复自我效能、创伤后成长、心理韧性的影响。方法选取2019-09—2020-02郑州大学第二附属医院收治的90例首发脑卒中患者,采用随机数字表法分为干预组45例和对照组45例。对照组采用常规的护理模式和健康教育,干预组在此基础上进行自我管理程序干预,比较2组患者干预3个月后康复自我效能、创伤后成长及心理韧性得分。结果干预后干预组患者康复自我效能(总分77.02±8.656 vs 71.33±10.187)、创伤后成长(总分55.11±5.457 vs 51.00±5.800)及心理韧性(总分50.29±5.550 vs 46.13±5.421)各维度得分及总分较对照组显著提高,差异有统计学意义(P<0.05)。结论在首发脑卒中患者中实施自我管理程序干预,可明显提高患者的康复自我效能水平,增强患者的心理韧性,促进创伤后成长,加快康复进程。     

脑卒中患者主要照顾者创伤后成长水平与社会支持的相关性研究

目的：了解脑卒中患者主要照顾者的创伤后成长水平与社会支持现状，探讨其创伤后成长水平与社会支持的相关性。方法：选择福建医科大学附属第二医院神经内科收治的处于急性期或病情稳定期以及多次发作的脑卒中患者的主要照顾者作为调查对象，采用创伤后成长评定量表和领悟社会支持量表进行问卷调查。结果：脑卒中患者主要照顾者创伤后成长评定量表及领悟社会支持量表的平均评分分别为(70.15±5.31)分和(53.32±6.18)分，均不受性别的影响。脑卒中患者主要照顾者的创伤后成长评定量表评分与领悟社会支持量表评分、家庭内源性支持和家庭外源性支持呈正相关(r=0.446，r=0.292，r=0.572；P均0.05)。结论：脑卒中患者主要照顾者创伤后成长属于高等水平，社会支持属于中等水平，其创伤后成长水平与社会支持程度呈正相关。     

脑卒中康复期患者心理弹性与创伤后应激障碍相关性研究

目的旨在分析脑卒中康复期患者心理弹性与创伤后应激障碍(PTSD)相关性。方法选取我院神经内科于2016年1月~2017年4月期间收治124例康复期脑卒中患者作为观察对象。分别使用一般情况自制调查问卷、心理弹性量表和创伤后应激障碍问卷调查患者一般情况、家庭情感支持和创伤后应激障碍。结果康复期脑卒中患者心理弹性量总分(61.19±8.62)分,创伤后应激障碍总分(40.54±10.81)分。患者心理弹性与创伤后应激障碍呈现显著负相关性(P0.01)。结论脑卒中康复期患者具有较高的PTSD的发生率,且心理弹性较差。患者的心理弹性程度与PTSD严重程度有负相关,临床中应重视对此类患者及早的予以心理干预。     

老年脑卒中患者的心理弹性影响二元应对和负性情绪的路径分析

目的 探讨老年脑卒中患者心理弹性对配偶双方的二元应对和负性情绪的影响及其影响路径。方法 采用便利抽样法,选取2020-10—2021-08华北理工大学附属医院收治的392例脑卒中患者及其配偶为研究对象,使用二元应对量表、心理弹性量表、焦虑自评量表和抑郁自评量表进行调查。结果老年脑卒中患者及其配偶二元应对得分分别为（105.190±17.741）分、（91.180±14.727）分,负性情绪（焦虑、抑郁）发生率为63.01%,焦虑、抑郁和心理弹性得分分别为（50.020±7.608）分、（46.120±9.702）分、（46.740±12.864）分。配偶双方二元应对、患者心理弹性与负性情绪之间均存在相关性（P<0.001）。心理弹性在患者二元应对和负性情绪（焦虑、抑郁）之间具有显著的中介效应,中介效应占比分别为16.93%、19.60%。结论 老年脑卒中患者容易出现负性情绪,夫妻双方二元应对能力需进一步加强,心理弹性在配偶双方二元应对与负性情绪之间具有一定的调节作用,医护人员可通过提高患者和配偶双方二元应对水平,增强心理弹性以改善患者的负性情绪。     

基于积极心理学视角的乳腺癌术后患者创伤后成长纵向调查

目的从积极心理学角度出发,调查乳腺癌患者术后乳房缺失的应对方式和创伤后成长心理变化的趋势,并探讨其相互关系,为循证护理提供依据。方法采用医学应对问卷和创伤后成长量表,对180例乳腺癌患者于手术后、术后1个月、3个月和6个月4个时间点进行追踪调查。结果第1次的调查资料收集完整共180份,第2次回收178份,第3次回收175份,第4次回收167份。本组患者应对方式总分在术后、术后1个月、3个月、6个月时总分在4个时段得分差异无统计学意义(P0.05)。创伤后成长评分在术后、术后1个月、3个月、6个月4个时段得分无统计学差异。Pearson相关性分析:面对得分与创伤后成长总分、各分量得分正相关(r=0.241～0.410);回避得分与创伤后成长总分及各分量表得分呈正相关(r=0.166～0.259);屈服得分与创伤后成长总分及各分量表得分呈负相关(r=-0.324～-0.486)。结论乳腺癌患者术后回避与屈服的分值较高,应适度地给予干预,引导患者采用积极应对;乳腺癌术后创伤后成长不明显,积极面对患者的创伤后成长有正性促进作用。     

首发精神分裂症和抑郁症患者症状严重程度与儿童期创伤、心理弹性及社会支持的相关性分析

目的 探讨首发精神分裂症和抑郁症患者症状严重程度与儿童期创伤、心理弹性及社会支持的关系。方法 采用方便抽样法，选取2019年12月至2022年1月在河北医科大学第一医院精神卫生中心住院和门诊就诊的91例首发精神分裂症患者、121例抑郁症患者为精神分裂症组和抑郁症组。同期选取在我院进行体检的110名健康人为对照组。采用阳性与阴性症状量表（PANSS）、汉密尔顿抑郁量表（HAMD）、儿童期创伤问卷（CTQ）、心理弹性量表（CD-RlSC）及社会支持量表（SSRS）进行测评。采用Spearson相关分析精神分裂症患者、抑郁症患者症状严重程度与童年期创伤、心理弹性、社会支持的相关性。结果 精神分裂症组患者的PANSS评分为（90.70±12.36）分，CTQ总分为39(32,46)分，CD-RISC总分为31(24,37)分，SSRS评分为30(24,34)分。抑郁症组患者的HAMD评分为（19.60±3.92）分，CTQ总分为37(33,45)分，CD-RISC总分为36(28,42)分，SSRS评分为31(27,35)分。对照组的CTQ总分为35(31,40)分，CD-RISC总分为44(...     

病毒性脑炎患者创伤后成长状况及影响因素分析

目的总结病毒性脑炎患者创伤后成长现状,并筛查其影响因素。方法以2017年7月至2019年7月在四川大学华西医院诊断与治疗的病毒性脑炎患者为调查对象,采用横断面调查方法,包括一般资料调查表、创伤后成长评定量表(PTGI)、家庭关怀度指数问卷(APGAR)以及心理弹性量表(CD-RISC),分析PTGI评分与年龄、APGAR和CD-RISC评分的相关性,筛查创伤后成长相关影响因素。结果共发放调查问卷110份,回收有效问卷105份,回收有效率95.45%。PTGI总评分平均为57.76±15.23,各维度评分依次为人际关系维度(16.92±3.49)、人生感悟维度(12.44±3.20)、个人力量维度(11.91±3.50)、精神改变维度(8.82±3.48)和新的可能性维度(7.67±3.49)。偏相关分析显示,PTGI总评分与APGAR评分(r=0.331,P=0.001)和CD-RISC评分(r=0.286,P=0.003)呈正相关关系。Logistic回归分析显示,存在并发症(OR=0.029,95%CI:0.003～0.320;P=0.004)负向影响PTGI评分,APGAR评分较高(OR=1.260,95%CI:1.051～1.511;P=0.013)和CD-RISC评分较高(OR=1.093,95%CI:1.035～1.153;P=0.001)正向影响PTGI评分。结论病毒性脑炎患者创伤后成长水平欠佳。针对出现并发症的患者应强化心理干预,同时充分认识到家庭关怀度和人格坚韧程度对创伤后成长的协同促进作用,采取针对性措施,促使此类患者建立更好的创伤后心理调控机制,加快创伤后成长。     

负性情绪、心理弹性与乳腺癌根治术创伤后成长的关系

目的 研究负性情绪、心理弹性与乳腺癌根治术创伤后成长的关系.方法 选择本院2015年11月-2018年11月收治的180例乳腺癌根治术患者作为研究对象,采取创伤后成长评定量表(PTGI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、中文版患者恐惧疾病进展简化量表(FoP-Q-SF)、心理弹性量表(CD-RISC)对...     

首发儿童青少年精神分裂症患者父母的心理状态

目的:探究首发儿童青少年精神分裂症患者父母的心理状态。方法:招募首发儿童青少年精神分裂症患者的父母98名(研究组)与健康对照者98名(对照组)。对患儿父母采用Link病耻感系列量表评估病耻感;采用Herth希望量表(HHI)、心理弹性量表(CD-RISC)和社会支持评定量表(SSRS)评估其希望水平、心理弹性和社会支持。将病耻感各维度得分与中点分比较,并比较两组间的HHI、CD-RISC和SSRS评分。结果:患儿父母的贬低-歧视感知量表(PDD)总分、病耻感应对量表(CO)总分及各因子评分、病耻感情感体验量表(SRF)总分和误解因子评分显著高于中点分(P均0.05)。研究组HHI、CD-RISC及SSRS总分及各因子分均显著低于对照组(P均0.001)。结论:首发儿童青少年精神分裂症患者父母的病耻感较高,希望水平、心理弹性水平及社会支持水平都较低。     

新型冠状病毒肺炎病人康复早期心理应激状态调查及影响因素分析

目的 探讨新型冠状病毒肺炎（COVID-19）病人康复早期心理应激状态及其影响因素。方法 以2020年3月1日至2020年3月14日由专科医院治愈出院并转入我院隔离观察病房的COVID-19康复者126例为研究对象，通过网络问卷调查采集心理学信息，问卷包含创伤后应激障碍自评量表（PTSD-SS）、抑郁自评量表和焦虑自评量表。采用多元线性回归分析检验影响因素。结果 126例PTSD-SS评分平均（45.5±18.9）分，39例（31.0%）存在应激障碍；创伤性再体验评分平均（15.4±6.8）分，52例（41.3%）有反复重现体验症状；回避症状评分平均（11.9±5.7）分，35例（27.8%）存在回避症状；警觉性增高评分平均（11.3±5.0）分，51例（40.5%）警觉性增高。28例（22.2%）有焦虑情绪，48例（38.1%）有抑郁情绪。多因素线性回归分析发现，退休、心理支持与PTSD-SS评分及其三个症状评分呈显著负相关（P<0.05），女性、焦虑情绪与PTSD-SS评分及其三个症状评分呈显著正相关（P<0.05），抑郁情绪与警觉性增高评分呈显著正相关（P<0.05）。结论 近1/3的COVID-19病人康复早期存在应激障碍，女性、未退休、缺乏心理支持、存在焦虑抑郁情绪这四大类人群应激障碍症状尤为严重，建议所有康复病人定期接受心理评估     

癫痫患者疾病感知与心理弹性水平的相关性

目的观察癫痫(EP)患者心理弹性水平情况,分析疾病感知(IP)与心理弹性水平的关系,以指导早期干预、提高EP患者心理弹性水平。方法选取郑州市第九人民医院2019-02—2020-05收治的77例EP患者为研究对象,采用心理弹性量表(CD-RISC)评估患者心理弹性水平并分组;设计基线资料调查问卷,采集并比较患者基线资料,重点比较患者IP情况[采用简易IP问卷(BIPQ)评估],分析EP患者IP与心理弹性水平的关系。结果 77例EP患者,29例心理弹性水平低下,占37.66%;心理弹性水平低下组社会支持、自我效能感、IP敏感度评分均低于心理弹性水平正常组,差异有统计学意义(P<0.05);组间其他资料比较差异无统计学意义(P>0.05)。经单因素分析后建立多元回归模型行多因素分析,结果显示社会支持低下、自我效能感一般、IP敏感度低下均为EP患者心理弹性水平低下的影响因素(OR>1,P<0.05),其中IP敏感度低下带来的影响最显著,可能作为独立危险因素。经双变量Pearson直线相关性检验显示,IP与心理弹性水平呈正相关(r>0,P<0.05)。结论 EP患者心理弹性水平不容乐观,可能与患者IP敏感度低下有关,临床应重视观察EP患者心理弹性水平现状,并早期给予IP敏感度低下的EP患者针对性干预,以提高心理弹性水平,可能对治疗疾病有积极意义。     

汶川地震1年后北川干部创伤后应激症状及其与焦虑抑郁的关系

目的探讨汶川地震1年后北川干部创伤后应激症状及其与焦虑抑郁状况的关系。方法采用焦虑自评量表、抑郁自评量表、PCL-C对北川县事业单位的2055名干部进行调查。结果①1341人(65.3%)再体验症状阳性,780人(38.0%)回避/麻木症状阳性,1076人(52.4%)警觉性增高症状阳性,695人(33.8%)三大症状均呈阳性。②北川干部SAS总粗分(37.22±9.20)高于中国常模(29.78±10.07),有差异显著性(P<0.001);③SDS总粗分(41.97±8.30)与标准分(52.47±10.37)均高于国内常模(33.46±8.55,41.88±10.57),有差异显著性(P<0.001);④PCL、SDS、SAS得分在受教育程度、亲人遇难、房屋倒塌、身体受伤方面均存在差异显著性;⑤PCL-C总分及各分量表得分与SDS标准分、SAS标准分均显著正相关(P<0.001)。结论汶川地震发生1年后,北川干部创伤后应激症状、焦虑症状、抑郁症状仍广泛存在,其中丧失明显者更为显著,而且创伤后应激症状常共病抑郁等其他心理问题。提示,在干预创伤后应激症状时,应同时改善合病的抑郁等状况。     

The relationship between morningness-eveningness and resilience in mood disorder patients

BackgroundThere is some evidence that resilience is related to mental illness. Patients with a mood disorder have a tendency to show eveningness, and they tend to be less resilient. However, no study has investigated the association between resilience and morningness-eveningness in patients with a mood disorder. The aim of this study was to explore whether morningness-eveningness is related to resilience in patients with a mood disorder.MethodsWe recruited 224 patients with major depressive disorder (MDD), 77 with bipolar disorder (BD), and 958 control participants. Morningness-eveningness and resilience were evaluated using the Composite Scale of Morningness (CS) and the Connor-Davidson Resilience Scale (CD-RISC), respectively.ResultsThe CD-RISC scores were significantly lower in patients with MDD, followed by those with BD, than those of the control group. The CD-RISC score was positively correlated with the CS score in patients with MDD and BD. Multiple linear regression analyses revealed that the CS score was significantly associated with the CD-RISC score after controlling for the possible influence of age, gender, length of education, economic status, onset age, and suicide attempt history in the MDD group. However, the association did not reach statistical significance in patients with BD.ConclusionsHigher resilience was positively correlated with morningness in patients with MDD or BD. In multiple regression analysis, a significant linear relationship was observed between resilience and morningness only in patients with MDD. The biological mechanism underlying the relationship between morningness-eveningness and resilience should be explored.     

A 3-year follow-up study of psychosocial functioning and general symptoms in settled refugees

OBJECTIVE: Few community studies have addressed the longitudinal course of post-traumatic stress disorder (PTSD) in traumatized refugees in early resettlement. This longitudinal study investigated changes from the first (T1) to the second interview (T2), 3 years later. The relationship between traumatic exposures and psychosocial factors/psychological symptom load were examined. METHOD: Local health professionals performed the interviews, using rating scales and a structured questionnaire. A total of 240 (52%) refugees attended. RESULTS: Unchanged Hopkins Symptom Checklist-25 and increase in Harvard Trauma Questionnaire and post-traumatic stress symptoms-16 between T1 and T2 were found, indicating the severity and chronicity of problems. Mean post-traumatic stress score was 15% above cut-off. Severe life-threatening trauma and present life in exile with unemployment and unresolved family reunion were risk factors. CONCLUSION: Early diagnostic interview should be followed by targeted approach. Pinpointing those in need of specialist services is essential. An interdisciplinary approach is necessary in this work.     

Migrations,trauma and mental health: A literature update on psychological assessment

IntroductionMigrants and refugees often face potentially traumatic events and post-migratory stressors. Upon arrival in the host country, they can be referred to mental health services to assess the impact of their previous experiences. These cross-cultural clinical encounters may raise questions, particularly regarding the assessment of mental health using models based on Western conceptions of psychopathology.Objectives and methodThe objective of the present non-systematic review of the literature is to discuss the psychological evaluation of post-traumatic reactions in migrants and refugees. More specifically, we present current research on psychopathology, resilience and post-traumatic development (PTG) among the migrant and refugee population. We also examine the cross-cultural validity of concepts such as Post-Traumatic Stress Disorder, resilience and PTG. Finally, we describe the most frequently used tools in cross-cultural psychological assessment and briefly reflect on the question of cultural sensitivity of mental health professionals. A bibliographic search was carried out using the databases: PILOTS, Pubmed, APA PsycNET, and Google Scholar using the following keywords: “migrants”, “refugees”, “posttraumatic stress disorder”, “mental health”, “Psychopathology”, “risk factors”, “protection factors”, “posttraumatic growth” and “resilience”. We have also reviewed the reference lists of articles encountered from database searches.ResultsResponses to a potentially traumatic situation are multiple. Regarding the migrant and refugee population, the reviewed articles studied different post-traumatic reactions such as resilience, post-traumatic development, and psychopathologies. The most studied psychopathological responses were depression, anxiety and Post-traumatic Stress Disorder. After reviewing these studies, we asked the following question: considering the complexity of the migration process, what are the factors associated with the development of these different post-traumatic responses? Indeed, several individual and social factors before, during and after migration influence the mental health of individuals in a migration situation. Among the most cited risk factors identified were: to be a victim of or witness to violence in the country of origin and, after migration, to face post-migration difficulties such as asylum denial, to be in a precarious situation with regard to housing and work, as well as the difficulties linked to adaptation to the new culture. We have also described protective factors for the mental health of this population, such as: social support, psychological support, and a good quality of life in the host country. The reviewed articles also describe an important influence of cultural aspects on mental health, such as the perception of an event as traumatic. Although the authors of the reviewed articles accept this influence of culture on post-traumatic responses, most of the tools used to assess the mental health of migrants and refugees were created in a Western context. Studies show a growing concern with these cultural aspects, and certain tools that allow a more culturally sensitive evaluation, such as the “Cultural Formulation Interview”, are being developed.Discussion and conclusionEven if the concern with the sensitivity of the tools used in cross-cultural assessment seems to be more present in the international literature, researchers seem to encounter difficulties in better understanding the effects of culture on the mental health of individuals. With increasingly diverse societies, new research should not be based on participants’ geographic or ethnic origins, but rather try to “unpack” culture with, for example, the exploration of the relationships between certain values or orientations and the different expressions of psychological distress. Finally, given the still lacking development in the field of cross-cultural research, certain practices, such as the participation of interpreters, the supervision of cultural mediators or the use of culturally sensitive tools, can help the clinician to maintain good practices with patients from different cultures in the diagnostic and psychotherapeutical processes.     

Résilience et croissance post-traumatique : enjeux théoriques et cliniques

ObjectiveThis article discusses the theoretical and clinical links between the concepts of resilience and post-traumatic growth (PTC). These two concepts are so closely related that they are often, but wrongly, confused. Yet, they both offer interesting perspectives when distinguished epistemologically. The main objective of this article is to define these two entities and to discuss their complementarity and differences at the theoretical and clinical levels.MethodA review of the international literature on these concepts was conducted to identify similarities and differences.ResultsIt appears that resilience is a well-known and useful concept in psychology, but its definitional variability has consequences at the theoretical, clinical, and psychometric levels. It sometimes refers to the construct of post-traumatic growth that is, nevertheless, complementary and different: post-traumatic growth is described as “positive psychological changes [...] following exposure to a major trauma” and resilience, in its strict definition, refers to a return to pre-traumatic status (i.e. prior to the adverse event). Resilience and growth are two distinct and complementary entities, as they share a number of common processes but have different expressions and purposes.DiscussionThe notions of resilience and post-traumatic growth do not reflect the same phenomena and trajectories in subjects who have experienced adverse events. Resilience refers to a return to a pre-event level of functioning, whereas post-traumatic growth refers to the benefits and positive changes following a trauma with no opposition to suffering, as it would be the root cause of post-traumatic growth.ConclusionFrom a theoretical and clinical point of view, it is important to integrate post-traumatic growth into clinical psychology and psychiatry, in order to better understand the life paths of subjects struggling with psychotraumatic consequences. It would lead to a larger vision of “resistance and overcoming trauma processes” that would not oppose suffering and recovery, but that would study both constructs.     

Pituitary insufficiency after traumatic brain injury

After traumatic brain injury (TBI), patients present with psychological disorders that may be explained by post-traumatic pituitary insufficiency (PI). The goal of this study was to determine the relationship between hypopituitarism, neuropsychological changes and findings on CT scans after TBI. Hospital charts of 55 TBI patients were screened for age, Glasgow Coma Scale (GSC) score, hypoxia or hypotension. The first two CT scans were analyzed for hemorrhagic lesions. Basal levels of the following hormones were recorded: cortisol, prolactin, estradiol, testosterone, insulin-like growth factor 1 and free thyroxine. Hormonal stimulation tests were performed either if the basal hormone screening revealed an abnormality or if the patient answered “yes” to at least one question in the non-evaluated neuropsychological questionnaire. Overall, 14 out of 55 patients (25.4%) presented with PI; one of them with two hormonal deficits. Growth hormone deficit, hypothyroidism and hypocortisolism were found in one, one and two patients, respectively. Neuropsychological complaints were present in 67% of the patients and were associated with intracerebral hemorrhagic lesions and not PI. Neuropsychological complaints after TBI are more frequent than PI. Brain tissue damage is most important than PI in the development of psychological changes after TBI.     

创伤性颅脑损伤伴胫骨骨折患者反刍性沉思与创伤后成长的相关性

目的观察创伤性颅脑损伤(TBI)伴胫骨骨折患者创伤后成长(PTG)水平,分析患者反刍性沉思与PTG的关系。方法选取郑州市第九人民医院2019-04—2020-07收治的81例TBI伴胫骨骨折患者为研究对象,采用创伤后成长量表(PTGI)评估患者PTG水平并分组;设计基线资料调查问卷,采集患者基线资料,比较反刍性沉思情况[采用事件相关反刍性沉思问卷(ERRI)评估],分析TBI伴胫骨骨折患者反刍性沉思与PTG的关系。结果81例TBI伴胫骨骨折患者中32例(39.51%)PTG水平低下;PTG水平低下组文化程度、社会支持度评分、反刍性沉思倾向评分均低于PTG水平正常组,差异有统计学意义(P<0.05);组间其他资料比较差异无统计学意义(P>0.05)。经二元回归分析后建立多元回归模型行多元回归分析,结果显示文化程度低、社会支持度低、反刍性沉思倾向低均是TBI伴胫骨骨折患者PTG水平低下的影响因素(OR>1,P<0.05),其中反刍性沉思倾向低带来的影响最为显著,可能作为独立危险因素;相关性分析显示,TBI伴胫骨骨折患者反刍性沉思与PTG水平呈正相关(r>0,P<0.05)。结论TBI伴胫骨骨折患者的PTG水平普遍低下,可能受反刍性沉思倾向影响,临床应重视TBI伴胫骨骨折患者PTG水平的监测观察,并早期予以反刍性沉思倾向低的患者针对性干预,可能对提高患者PTG水平有积极意义。