Posttraumatic stress and depressive reactions among Nicaraguan adolescents after hurricane mitch
Posttraumatic stress and depressive reactions among Nicaraguan adolescents after hurricane mitch
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DOI：
10.1176/appi.ajp.158.5.788
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发表时间：
2001-05-01
影响因子：
17.7
通讯作者：
Pynoos, RS
中科院分区：
文献类型：
--
作者：
Goenjian, AK;Molina, L;Pynoos, RS
目的：这项研究确定了飓风米奇后，巴布亚青少年创伤后应激和抑郁反应的严重程度，以及这些反应与飓风暴露的客观和主观特征、家庭成员死亡、被迫搬迁和报复思想的关系。飓风过后六个月，来自三个不同暴露城市的158名青少年通过飓风暴露问卷进行了评估，结果：两市青少年创伤后应激障碍和抑郁反应均较严重，且有显著性差异（P <0.05）。创伤后应激和抑郁反应的严重程度以及客观飓风相关经历的特征遵循一种“暴露剂量”模式，该模式与各城市的死亡率和破坏率一致。影响程度（城市），客观和主观特征，报复的想法占68%的创伤后应激反应的严重程度的方差。严重的创伤后应激反应，死亡的家庭成员，和性别占59%的方差的严重程度depression.Conclusions：5类飓风后，青少年在严重受影响的地区与极端的客观和主观的飓风相关的创伤功能的曝光经验严重和慢性创伤后应激和共病抑郁反应。受严重影响的巴布亚新几内亚青少年的康复对于一个遭受多年政治暴力和贫困蹂躏的国家的社会和经济复苏至关重要。这些研究结果强烈表明，需要将公共心理健康的方法，包括系统的筛查和创伤/悲伤为重点的干预措施，在一个全面的灾难恢复计划。
Objective: This study determined the severity of posttraumatic stress and depressive reactions among Nicaraguan adolescents after Hurricane Mitch and the relationship of these reactions to objective and subjective features of hurricane exposure, death of a family member, forced relocation, and thoughts of revenge.Method: Six months after the hurricane, 158 adolescents from three differentially exposed cities were evaluated by using a hurricane exposure questionnaire, the Child Posttraumatic Stress Disorder Reaction Index, and the Depression Self-Rating Scale.Results: Severe levels of posttraumatic stress and depressive reactions were found among adolescents in the two most heavily affected cities. Severity of posttraumatic stress and depressive reactions and features of objective hurricane-related experiences followed a "dose-of-exposure" pattern that was congruent with the rates of death and destruction across cities. Level of impact (city), objective and subjective features, and thoughts of revenge accounted for 68% of the variance in severity of posttraumatic stress reaction. Severity of posttraumatic stress re action, death of a family member, and sex accounted for 59% of the variance in severity of depression.Conclusions: After a category 5 hurricane, adolescents in heavily affected areas with extreme objective and subjective hurricane-related traumatic features of exposure experience severe and chronic posttraumatic stress and comorbid depressive reactions. The recovery of the severely affected Nicaraguan adolescents is vital to the social and economic recovery of a country ravaged by years of political violence and poverty. These findings strongly indicate the need to incorporate public mental health approaches, including systematic screening and trauma/ grief-focused interventions, within a comprehensive disaster recovery program.