中国临床心理学杂志

慢性阻塞性肺疾病患者创伤后应激障碍症状群及其心理易感因素

作者：张会会刘莹莹林萍珍孙继伟邵頔曹枫林

单位：1. 山东大学护理学院济南 250012 2. 山东中医药大学附属医院济南 250014

关键词：慢性阻塞性肺疾病创伤后应激障碍症状群知觉压力症状反刍精神障碍诊断和统计手册第五版

分类号：R395.2

出版年,卷(期):页码：2017,25(3):479-484

摘要：

目的：调查慢性阻塞性肺疾病（COPD）患者创伤后应激障碍（PTSD）症状群的发生情况，探讨PTSD症状群的心理易感因素。方法：采用一般资料调查表、知觉压力量表、反刍思维量表、情绪调节问卷、创伤后应激障碍测评量表第五版对94名COPD患者进行调查。结果：COPD患者中PTSD的阳性率为25.5%，分别有58人（61.7%）、36人（38.3%）、57人（60.6%）、60人（63.8%）存在再体验、回避、认知与情绪的负性改变、唤醒症状群。分层线性回归结果显示，知觉压力、症状反刍均是回避[β=0.34（P=0.001），β=0.46（P=0.009）]、认知与情绪的负性改变[β=0.38（P<0.001），β=0.54（P=0.001）]、唤醒[β=0.21（P=0.044），β=0.64（P=0.001）]症状群的危险因素。此外，知觉压力还是再体验[β=0.33（P=0.001）]症状群的危险因素。结论：知觉压力、症状反刍水平高的患者更容易发生PTSD症状群。

Objective: To investigate the distribution and psychological vulnerability factors of posttraumatic stress disorder(PTSD) symptom clusters in patients with chronic obstructive pulmonary disease(COPD). Methods: 94 COPD patients were assessed with the general information questionnaire, the Perceived Stress Scale, Ruminative Responses Scale, Emotion Regulation Questionnaire, PTSD Checklist for the DSM-5. Results: The positive rate of PTSD in COPD patients was 25.5%, 58(61.7%), 36(38.3%), 57(60.6%), and 60(63.8%) patients undergone re-experiencing, avoidance, negative alterations in cognitions and mood and arousal symptom clusters, respectively. Hierarchical linear regression analysis revealed that perceived stress and symptom rumination were positively associated with the scores of avoidance[β=0.34(P=0.001), β=0.46(P=0.009), respectively], negative alterations in cognitions and mood[β=0.38(P<0.001), β=0.54(P=0.001), respectively] and arousal[β=0.21(P=0.044), β=0.64(P=0.001), respectively] symptom clusters. Besides, perceived stress was also positively associated with the scores of re-experiencing[β=0.33(P=0.001)] symptom clusters. Conclusion: Patients with high levels of perceived stress or symptom rumination are more likely to experience PTSD symptom clusters.

基金项目：

山东省科技重大专项（2015ZDXX0801A01）

作者简介：

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