舟曲泥石流灾后儿童创伤后应激障碍与应对方式的关系

目的 探讨创伤后应激障碍(posttraumatic stress disorder,PTSD)与应对方式的关系,为早期预测创伤后应激障碍和心理干预提供科学依据.方法 采用整群抽样的方法用简易应对方式问卷(Simplified copingstyle questionnaire,SCSQ)和创伤后应激障碍17项筛查问卷(PTSD Checklist-Civilian version,PCL-C)对舟曲县的596名学生进行问卷调查,获得有效问卷592份.结果 PTSD症状阳性组共45人,占总人数的7.60%,其中男生15人,占男生人数的5.34%,女生30人,占女生人数的9.65%.男女生在PCL-C和SCSQ上的得分均存在统计学差异(P<0.05);PTSD筛查阳性组、阴性组在积极应对和消极应对上得分有统计学差异(P<0.05);控制性别、年级因素,PTSD总分与积极应对方式(β =-0.473,标准化β =-0.524,P<0.001)和消极应对方式(β =0.556,标准化β =0.427,P<0.001)有关联.结论 应对方式可作为PTSD发生率的预测因素,积极应对是PTSD的保护性因素,尽早引导学生采取积极的应对方式,对预防PTSD有重要作用.     

创伤后应激障碍的睡眠障碍

尽管睡眠障碍在精神疾病中非常常见，但他常常被当作精神疾病的二级症状，认为对其主要精神疾病的治疗才是缓解睡眠苦恼的最可行办法。事实上，比如创伤后应激障碍(PTSD)的噩梦并不随总症状评分的下降而减少，有时可持续很长时间，而采用针对睡眠紊乱的治疗方案后，超过50％患者的创伤后应激症状可得到有效缓解。现论述PTSD对睡眠的影响，并讨论睡眠紊乱的治疗问题。     

癌症与创伤后应激障碍

严重威胁生命的恶性疾病如癌症所导致的创伤后应激障碍（ＰＴＳＤ）越来越引起临床医生的重视,国外不少精神科医生致力于与癌症相关ＰＴＳＤ的临床研究,积累了一些经验,本文就此做一综述。     

创伤后应激障碍的心理治疗

心理治疗被认为是创伤后应激障碍(PTSD)的首选治疗方案.根据目前的理论解释和文献研究,认知行为治疗技术如暴露治疗、焦虑管理训练、认知治疗等对PTSD比较有效.眼动脱敏和再加工 治疗方法可能对PTSD有效,但需要进一步的研究支持.本综述从理论解释、具体方法、效果研究和治疗原则等方面介绍PTSD的心理治疗技术.     

创伤后应激障碍

本文介绍创伤后应激障碍及其有关的几个问题。     

创伤后应激障碍的神经生物学机制

美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)关于创伤后应激障碍(PTSD)的定义中所述及的症状是因为中枢神经系统对应激信息的记忆过程出现了障碍，使条件化的恐惧反应难于抑制或过分抑制所致。目前关于其产生机制包括以下方面：     

创伤后应激障碍

本综述了创伤后应激障碍的病因学、临床特征及治疗方面的新进展。     

癌症与创伤后应激障碍

严重威胁生命的恶性疾病如癌症所导致的创伤后应激障碍（PTSD）越来越引起临床医生的重视,国外不少精神科医生致力于与癌症相关PTSD的临床研究,积累了一些经验,本就此做一综述。     

The role of sleep disturbance in the relationship between post-traumatic stress disorder and suicidal ideation

We tested if the risk of suicidal ideation in individuals with PTSD symptoms was dependent on comorbid sleep disturbance. Our cross-sectional sample included 2465 participants with complete data from the 21 year follow-up of the Mater University Study of Pregnancy (MUSP), a birth cohort study of young Australians. Using structural equation modelling with indirect pathways we found that 12 month PTSD symptoms did not directly predict suicidal ideation at 21 when adjusting for major depression symptoms, polyvictimization and gender. However, PTSD symptoms had an indirect effect on suicidal ideation via past-month sleep disturbance. Our results suggest that increased suicidal ideation in those with PTSD may result from the fact that PTSD sufferers often exhibit other comorbid psychiatric conditions which are themselves known to predict suicidal behaviours. Sleep disturbance may be targeted in those who experience PTSD to help prevent suicidal ideation.     

Interventions for post-traumatic stress disorder in children and adolescents

Clinical features, epidemiology and aetiology of post-traumatic stress disorder (PTSD) are outlined. Treatment outcome studies involving children with PTSD who have survived traumatic accidents, natural disasters and child sexual abuse are reviewed. An evidence-based assessment and treatment protocol is outlined for children and adolescents with PTSD. Key components of effective treatment are psycho-education about trauma reactions, sustained exposure to trauma-related cues and memories until habituation occurs, coping skills training for children to help them manage anxiety and parent training to equip parents with the skills to help them facilitate their children's recovery.     

The relationship between patterns of family interaction and psychiatric disorder in children

This study examined the relationship between patterns of family interaction, in particular parental overprotection, and emotional and behavioural problems in children. The role children play in influencing the pattern of parental care was also investigated because increased parental protection could be a response to, rather than a cause of, emotional disorders in children. A population was examined on two occasions, 18 months apart, using Rutter's parent and teacher questionnaires. The data suggested that overprotection was particularly disruptive to children's emotional state when it was associated with irritability and distress in the parents. The converse relationship, in which emotional and behavioural problems in children had a significant influence on the degree of parental protection and pattern of interaction within the family, was also demonstrated by the use of cross-lagged correlations.     

颅脑损伤患者术后创伤后成长与创伤后应激障碍的相关性

目的 观察颅脑损伤患者术后创伤后成长水平及创伤后应激障碍(PTSD)情况,分析创伤后成长水平与PTSD的关系.方法 选取2017-02—2019-02郑州市第九人民医院手术治疗的63例颅脑损伤患者,所有患者术后1个月接受创伤后成长评定量表(PTGI)评估,依据评估结果分为高水平组与低水平组,调查2组一般资料并评估患者术...     

Rem sleep behavior disorder: potential relationship to post-traumatic stress disorder.

Rapid eye movement sleep behavior disorder (RBD) is a parasomnia in which there is enactment, often violent, of dream mentation. Although this syndrome is sometimes associated with neurologic disorders, psychiatric comorbidity is not typical. The authors present a unique series of veterans with RBD. A high incidence of comorbidity with post-traumatic stress disorder is noted. The literature on RBD is reviewed, and the coexistence of RBD and post-traumatic stress disorder is reasoned. The authors suggest that it is possible that similar neuropathologic processes are responsible for both conditions, at times in the same patient.     

执行功能的异常与创伤后应激障碍之间的关联

正创伤后应激障碍(Post-traumatic Stress Disorder,PTSD)是对异乎寻常的威胁性或灾难性应激事件或情境延迟的和/或延长的反应(世界卫生组织,1992)。1980年DSM-Ⅲ首次确立创伤后应激障碍诊断标准后,对PTSD患者认知特点的研究主要集中于记忆方面。Kanagaratnam等[1]提出,个体将对环境的感知整合为一个整体的能力,是其成功地认     

Physical and sexual abuse in childhood: relationship with post-traumatic stress disorder

This study describes the reactions of children and adolescents to physical and/or sexual abuse, suggesting two distinct symptom pictures. Findings indicate that a majority (55%) of this clinical population develop symptoms characteristic of post-traumatic stress disorder, whereas abused children and adolescents who do not develop associated post-traumatic stress disorder symptoms exhibit more anxiety, depression, externalizing behaviors, and more problems overall. Significant differences were also found between children and adolescents reacting to single event abuse who display more behavior disorders and victims of ongoing abuse who appear significantly more disturbed, with symptoms ranging from depression to psychosis.