Post-traumatic stress reactions among Rwandan children and adolescents in the early aftermath of genocide
Post-traumatic stress reactions among Rwandan children and adolescents in the early aftermath of genocide
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DOI：
10.1093/ije/dyn375
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发表时间：
2009-08-01
影响因子：
7.7
通讯作者：
Stehling-Ariza, Tasha
中科院分区：
文献类型：
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作者：
Neugebauer, Richard;Fisher, Prudence W.;Stehling-Ariza, Tasha
方法对819岁的卢旺达人进行全国创伤调查（NTS），使用创伤后应激障碍（PTSD）症状清单和可能的战争时期经历清单来测量创伤暴露。符合PTSD诊断标准的个体被归类为可能的PTSD病例。国家国税厅采访了居住在社区的青少年和其他被安置在无人陪伴儿童中心的青少年；前者（1547年）是本报告的主题。研究中途的工具变化将受访者分为两个样本。结果在受访者中，有90多人目睹了杀戮并受到生命威胁；失去直系亲属35人；30人目击强奸或性器官切割；15人躲在尸体下面。在样本1中，95名受访者报告了一个或多个再体验症状，95名报告了三个或更多的回避/钝化症状，63名报告了两个或更多的唤醒症状；在样本2中，这些数字分别为96、95和56。在样本1和样本2中，创伤后应激障碍的总体发生率分别为62和54，并与暴露表现出剂量反应关系。在受辐射最严重的人群中，这一比例为100。女性患PTSD的可能性高于男性。年龄的结果不一致。在工业化社会中，大多数创伤性暴力的幸存者只是短暂地经历过症状。在卢旺达的调查中，可能患有创伤后应激障碍的症状水平和比例异常高，这表明，在灾难性的人为暴力的极限下，年轻人的心理恢复能力几乎消失了。
Methods The National Trauma Survey (NTS) of Rwandans aged 819 measured traumatic exposures using an inventory of possible war time experiences and post-traumatic stress reactions with a checklist of symptoms of Post-traumatic stress disorder (PTSD). Individuals meeting assessed PTSD diagnostic criteria are classified as cases of probable PTSD. The NTS interviewed youth residing in the community and others institutionalized in unaccompanied childrens centres; the former (n 1547) are the subject of the present report. Instrument change midway into the study divides respondents into two samples.Results Among respondents, over 90 witnessed killings and had their lives threatened; 35 lost immediate family members; 30 witnessed rape or sexual mutilation; 15 hid under corpses. In Sample 1, 95 of respondents reported one or more re-experiencing symptom, 95 reported three or more avoidance/blunting symptoms and 63 reported two or more arousal symptoms; in Sample 2, these figures were 96, 95 and 56, respectively. The overall rate of probable PTSD was 62 and 54 in Samples 1 and 2, respectively, and exhibited a doseresponse relationship with exposure. Among the most heavily exposed individuals the rate was 100. Rates of probable PTSD were higher among females than among males. Results for age were inconsistent.Conclusion In industrialized societies, most survivors of traumatizing violence experience symptoms only transiently. In the Rwanda survey, symptom levels and rates of probable PTSD were exceptionally elevated, suggesting that at the limits of catastrophic man-made violence, psychological resilience among youth is all but extinguished.