Nationwide longitudinal study of psychological responses to September 11
Nationwide longitudinal study of psychological responses to September 11
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DOI：
10.1001/jama.288.10.1235
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发表时间：
2002-09-11
影响因子：
120.7
通讯作者：
Gil-Rivas, V
中科院分区：
文献类型：
--
作者：
Silver, RC;Holman, EA;Gil-Rivas, V
背景2001年9月11日，对美国的攻击提供了一个独特的机会，纵向研究的过程中，以创伤性事件在nationalscale.Objective检查的程度，人口因素，精神和身体健康史，一生中暴露于压力事件，9月11日相关的经验，和应对策略后不久的攻击预测随着时间的推移的心理后果。设计，设置，和参与者一个国家的概率样本3496成年人接受了基于Web的调查; 2729人（78%的参与率）在恐怖袭击发生后9至23天内完成（75%在9至14天内完成）。从第1波样本（n =2729）中随机抽取1069名居住在纽约州纽约以外的小组成员，并接受第二次调查; 933名（87%的参与率）在袭击发生后约2个月完成调查。第三次调查（n=787）完成后约6个月的attacks.Main Outcome Measures 9月11日相关症状的急性应激，创伤后应激，和全球distress.Results以外的纽约市17%的美国人口报告的症状9月11日相关的创伤后应激2个月后的攻击，5.8%这样做，在6个月。高水平的创伤后应激症状与女性性别有关（比值比[OR]，1.64; 95%置信区间[Cl]，1.17-2.31），婚姻分离（OR，2.55; 95%CI，1.06-6.14），9·11前医生诊断的抑郁或焦虑障碍（OR，1.84; 95% CI，1.33-2.56）或身体疾病（OR，0.93; 95%CI，0.88-0.99），暴露于发作的严重程度（OR，1.31; 95% CI，1.11-1.55），以及早期脱离应对努力（例如，放弃：OR，1.68; 95% CI，1.27-2.20;否认：OR，1.33; 95% CI，1.07-1.64;自我分心：OR，1.31; 95% CI，1.07-1.59）。除了人口统计学和911事件前的健康变量外，全球灾难还与袭击造成的损失严重程度有关（β =.07; P=.008）和早期应对策略（例如，否认增加：β = 0.08; P= 0.005;放弃：β = 0.05; P= 0.04;积极应对减少：β =-0.08; P=.002）。结论重大国家创伤的心理影响不仅限于那些直接经历创伤的人，而且反应程度也不能简单地通过创伤暴露或损失的客观测量来预测。相反，在事件发生后不久使用特定的应对策略与随着时间的推移出现的症状有关。特别是，脱离应对努力可能预示着创伤后长达6个月的心理困难。
Context The September 11, 2001, attacks against the United States provide a unique opportunity to examine longitudinally the process of adjustment to a traumatic event on a national scale.Objective To examine the degree to which demographic factors, mental and physical health history, lifetime exposure to stressful events, September 11-related experiences, and coping strategies used shortly after the attacks predict psychological outcomes over time.Design, Setting, and Participants A national probability sample of 3496 adults received a Web-based survey; 2729 individuals (78% participation rate) completed it between 9 and 23 days (75% within 9 to 14 days) after the terrorist attacks. A random sample of 1069 panelists residing outside New York, NY, were drawn from the wave 1 sample (n =2729) and received a second survey; 933 (87% participation rate) completed it approximately 2 months following the attacks. A third survey (n=787) was completed approximately 6 months after the attacks.Main Outcome Measures September 11-related symptoms of acute stress, posttraumatic stress, and global distress.Results Seventeen percent of the US population outside of New York City reported symptoms of September 11-related posttraumatic stress 2 months after the attacks; 5.8% did so at 6 months. High levels of posttraumatic stress symptoms were associated with female sex (odds ratio [OR], 1.64; 95% confidence interval [Cl], 1.17-2.31), marital separation (OR, 2.55; 95% Cl, 1.06-6.14), pre-September 11 physician-diagnosed depression or anxiety disorder (OR, 1.84; 95% Cl, 1.33-2.56) or physical illness (OR, 0.93; 95% Cl, 0.88-0.99), severity of exposure to the attacks (OR, 1.31; 95% Cl, 1.11-1.55), and early disengagement from coping efforts (eg, giving up: OR, 1.68; 95% Cl, 1.27-2.20; denial: OR, 1.33; 95% Cl, 1.07-1.64; and self-distraction: OR, 1.31; 95% Cl, 1.07-1.59). In addition to demographic and pre-September 11 health variables, global distress was associated with severity of loss due to the attacks (beta=.07; P=.008) and early coping strategies (eg, increased with denial: beta=.08; P=.005; and giving up: beta=.05; P=.04; and decreased with active coping: beta=-.08; P=.002).Conclusions The psychological effects of a major national trauma are not limited to those who experience it directly, and the degree of response is not predicted simply by objective measures of exposure to or loss from the trauma. Instead, use of specific coping strategies shortly after an event is associated with symptoms over time. In particular, disengaging from coping efforts can signal the likelihood of psychological difficulties up to 6 months after a trauma.