Infrequent near death experiences in severe brain injury survivors - A quantitative and qualitative study
Infrequent near death experiences in severe brain injury survivors - A quantitative and qualitative study
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DOI：
10.4103/0972-2327.107715
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发表时间：
2013-01-01
影响因子：
1.7
通讯作者：
Chaudhury, Suprakash
中科院分区：
文献类型：
--
作者：
Hou, Yongmei;Huang, Qin;Chaudhury, Suprakash
背景：濒死体验(NDE)正受到科学界越来越多的关注，因为它不仅让人得以一窥濒死环境中大脑-大脑相互作用的复杂性，而且还因为它们对幸存者的各个心理方面都有重大而持久的影响。文献中有关NDE的总发生率的报道差异很大，从10%的适度数字到35%左右，甚至高达72%的令人难以置信的数字，那些濒临死亡的人。世界各地的理论家和研究人员在解释这一现象时普遍持有的观点上的差异，在某种程度上类似于这种偶然性的差异。尽管如此，客观证据最能支持生理学理论。一系列的生理过程被用来解释NDES。这些症状包括脑缺氧、高碳酸血症等化学改变、内啡肽、氯胺酮和5-羟色胺的存在，或颞叶或边缘系统的异常活动。尽管NDES的生理学理论一直围绕着脑内的紊乱进行，但到目前为止还没有研究开始评估特定脑损伤患者的濒死体验。他们中的大多数都评估了心脏骤停患者的NDE。创伤后昏迷是一种这样的状态，文献严重缺乏任何与NDES相关的信息。患者回忆起他们创伤后昏迷的任何记忆都是NDE研究人员的宝贵资产，需要特别关注。材料和方法：本研究旨在从长期昏迷的重型颅脑损伤幸存者那里收集这一有价值的信息。本研究在广州市999脑科医院颅脑损伤科进行，中国。纳入这项研究的患者是那些从严重头部损伤后的创伤后昏迷中恢复过来的人。共有86例患者入选。以临终体验量表(NDES)评分在7分及以上作为筛选临终体验的标准。在确定这些个体之后，使用解释现象学分析(IPA)的普拉卡什修正来访谈和记录数据以进行定性分析。结果：我们发现，与早期的报告相反，颅脑损伤后患者的不良反应明显较低。在招募的86名患者中，只有3人有明确和自信的NDE经历。我们进行了定性研究，以进一步探索这些经验。这3名患者的IPA揭示了四个主要主题：1.独特的光影；2.强烈的惊讶、喜悦和恐惧；3.无助感；4.超自然而理性的经验。结论：与其他濒死病例相比，NDE在颅脑损伤病例中并不常见。但经历它的人会对他们的信仰系统和情绪产生巨大的影响。这一经验应该通过更大样本的研究来进一步探索。
Background: Near death experiences (NDE) are receiving increasing attention by the scientific community because not only do they provide a glimpse of the complexity of the mind-brain interactions in 'near-death' circumstances but also because they have significant and long lasting effects on various psychological aspects of the survivors. The over-all incidence-reports of NDEs in literature have varied widely from a modest Figure of 10% to around 35%, even up to an incredible Figure of 72% in persons who have faced close brush with death. Somewhat similar to this range of difference in incidences are the differences prevalent in the opinions that theorists and researchers harbor around the world for explaining this phenomena. None the less, objective evidences have supported physiological theories the most. A wide range of physiological processes have been targeted for explaining NDEs. These include cerebral anoxia, chemical alterations like hypercapnia, presence of endorphins, ketamine, and serotonin, or abnormal activity of the temporal lobe or the limbic system. In spite of the fact that the physiological theories of NDEs have revolved around the derangements in brain, no study till date has taken up the task of evaluating the experiences of near-death in patients where specific injury has been to brain. Most of them have evaluated NDEs in cardiac-arrest patients. Post-traumatic coma is one such state regarding which the literature seriously lacks any information related to NDEs. Patients recollecting any memory of their post-traumatic coma are valuable assets for NDE researchers and needs special attention. Materials and Methods: Our present study was aimed at collecting this valuable information from survivors of severe head injury after a prolonged coma. The study was conducted in the head injury department of Guangdong 999 Brain hospital, Guangzhou, China. Patients included in the study were the ones Recovered from the posttraumatic coma following a severe head injury. A total of 86 patients were chosen. Near death experience scale (NDES) score of 7 or more was used as the criteria of screening NDE experiences. After identifying such individuals, the Prakash-modification of the Interpretative Phenomenological Analysis (IPA) was used to interview and record the data for qualitative analysis. Results: We found that contrary to earlier incidence reports, NDEs in post head injury patients were markedly low. Only 3 out of 86 of the patients recruited had a clear and confident experience of NDE. We conducted a qualitative study to explore further into these experiences. IPA of these 3 patients revealed four master themes: 1. Unique light visions 2. Intense feelings of astonishment, pleasure, and fear 3. The sense of helplessness 4. Supernatural but rationality of experience. Conclusion: NDE is uncommon in head-injury cases as compared to other near-death conditions. But the persons experiencing it have immense impacts on their belief systems and emotions. This experience should be further explored by studies of larger samples.