本文選題：創(chuàng)傷后應(yīng)激障礙 + 干預(yù)模式　； 參考：《云南師范大學(xué)》2015年碩士論文

【摘要】：2014年8月3日16時30分在云南省昭通市魯?shù)榭h發(fā)生了6.5級的地震。由于此次地震震級高,震源淺,當(dāng)?shù)厝丝诿芏瘸砻?地形地質(zhì)情況復(fù)雜、次生災(zāi)害叢生以及經(jīng)濟(jì)發(fā)展?fàn)顩r等因素,此次地震給魯?shù)榭h帶來了慘重的人員傷亡和巨大的經(jīng)濟(jì)損失,并且對災(zāi)區(qū)人民的心靈造成了嚴(yán)重的心理創(chuàng)傷。面對災(zāi)難的突然發(fā)生,會引起人類一系列的應(yīng)激反應(yīng),包括生理和心理上的不適,心理上會有恐慌、焦慮、恐懼、脆弱、罪惡感、孤獨(dú)、意志消沉(包括有自殺的企圖)、憤怒和挫折感等多種反應(yīng),若是這些反應(yīng)沒有得到及時處理,則會發(fā)展成創(chuàng)傷后應(yīng)激障礙(PTSD)。創(chuàng)傷后應(yīng)激障礙的影響可能持續(xù)數(shù)月,經(jīng)歷長久的時間也難以化解,有的甚至影響終身。創(chuàng)傷后應(yīng)激障礙的主要癥狀為回避性癥狀、闖入性癥狀、認(rèn)知和心境的負(fù)性改變以及警覺性增高癥狀等。在患有PTSD的群體中,學(xué)生群體是較為特殊與龐大的一類群體,他們由于處于身心發(fā)展的關(guān)鍵期,發(fā)育尚不成熟,也沒有成年人相對完善的應(yīng)對機(jī)制,PTSD對他們的影響尤為突出,一旦在這一時期受影響,會對終身的心理健康造成難以逆轉(zhuǎn)的改變。本研究采用問卷調(diào)查法對魯?shù)榭h極重災(zāi)區(qū)的災(zāi)區(qū)中學(xué)生的PTSD現(xiàn)狀進(jìn)行調(diào)查,從中篩查出PTSD嚴(yán)重的學(xué)生,并結(jié)合繪畫投射測驗(yàn)、班主任推薦和邀請性訪談的結(jié)果,確定干預(yù)對象,并使用本研究構(gòu)建的地震后PTSD學(xué)生沙盤游戲治療和繪畫治療的干預(yù)模式對其進(jìn)行心理干預(yù)。問卷使用云南省社會心理學(xué)會根據(jù)DSM-5最新標(biāo)準(zhǔn)修訂的《DSM-5學(xué)生PTSD調(diào)查問卷》,數(shù)據(jù)收集后使用spssl8.0進(jìn)行數(shù)據(jù)分析,數(shù)據(jù)結(jié)果分析采用獨(dú)立樣本T檢驗(yàn)、配對樣本T檢驗(yàn)等分析方法。最終確定70名干預(yù)對象,進(jìn)行地震后PTSD學(xué)生沙盤游戲治療和繪畫治療干預(yù)模式的干預(yù)。問卷前測結(jié)果顯示:地震災(zāi)后PTSD學(xué)生的主要癥狀較為嚴(yán)重的是闖入性癥狀,其次是回避癥狀、喚醒和反應(yīng)改變和社會功能受損,認(rèn)知與心境負(fù)性改變。且在總分上存在性別和年級差異,表現(xiàn)為女生得分高于男生,初一年級學(xué)生得分高于初二年級學(xué)生得分。通過理論分析、干預(yù)模式建立、干預(yù)實(shí)施和結(jié)果分析,本研究得出以下結(jié)論:結(jié)論一:震后學(xué)生PTSD量表檢出率存在男女差異,女生的PTSD量表得分要高于男生,并且在闖入性癥狀、回避性癥狀、認(rèn)知與負(fù)性改變癥狀上,女生要比男生得分更高。結(jié)論二:震后學(xué)生PTSD檢出率存在年級差異,初一年級學(xué)生的PTSD量表得分要高于初二學(xué)生,且在總分和闖入性癥狀、回避癥狀、認(rèn)知與心境負(fù)性改變?nèi)齻�維度上存在有顯著差異。結(jié)論三:經(jīng)過沙盤游戲和繪畫治療干預(yù)模式的干預(yù),地震災(zāi)區(qū)PTSD干預(yù)組的學(xué)生量表分?jǐn)?shù)顯著降低,說明干預(yù)模式有效。結(jié)論四:經(jīng)過本研究干預(yù)模式的干預(yù),震后災(zāi)區(qū)學(xué)生的PTSD癥狀有明顯治愈效果,特別是在闖入性癥狀、認(rèn)知與心境負(fù)性改變以及喚醒和反應(yīng)改變?nèi)齻�維度上。
[Abstract]:An earthquake of magnitude 6.5 occurred at 16:30 on August 3, 2014 in Ludian County, Zhaotong City, Yunnan Province. Due to such factors as high magnitude, shallow focus, dense local population, complex topography and geological conditions, numerous secondary disasters and economic development, the earthquake has brought heavy casualties and huge economic losses to Ludian County. And has caused serious psychological trauma to the people in the disaster area. In the face of a sudden disaster, it can cause a series of stress reactions, including physical and psychological discomfort, psychological panic, anxiety, fear, vulnerability, guilt, loneliness, Depression (including suicidal attempts, anger, frustration, etc.) can develop into PTSD if these reactions are not dealt with in time. The effects of post-traumatic stress disorder may last for months, and long periods of time can be difficult to overcome, and some may even affect life. The main symptoms of post-traumatic stress disorder are avoidance symptoms, intrusive symptoms, negative changes in cognition and mood, and increased alertness. In the group with PTSD, the student group is a special and large group, because they are in the critical period of physical and mental development, their development is not mature, and there is no relatively perfect coping mechanism for adults. Once affected during this period, it can cause irreversible changes in mental health for life. This research uses the questionnaire method to investigate the PTSD status of the middle school students in the disaster area of Ludian County, and screen out the students with serious PTSD, and combine the results of the painting projection test, the head teacher's recommendation and the invite interview, to determine the intervention object. The intervention models of sand game therapy and painting therapy for PTSD students after earthquake were used in this study. The questionnaire was based on the PTSD questionnaire of DSM-5 students revised by Yunnan Society of Social Psychology according to the latest standard of DSM-5. The data were analyzed by spssl8.0 after data collection. The data results were analyzed by independent sample T test and paired sample T test. Finally, 70 subjects were selected for intervention of sand table therapy and painting therapy for PTSD students after the earthquake. The results of pre-questionnaire test showed that the main symptoms of PTSD students after earthquake disaster were intrusive symptoms, followed by avoidance symptoms, arousal and reaction changes and impaired social function, cognitive and mood negative changes. There are gender and grade differences in the total score, which shows that the female students score higher than the boys, and the junior high grade students score higher than the second grade students. Through theoretical analysis, intervention model establishment, intervention implementation and result analysis, this study draws the following conclusions: first, there is a difference between men and women in the detection rate of PTSD scale for students after the earthquake, and the score of PTSD scale for girls is higher than that for boys. And girls scored higher than boys in intrusive symptoms, avoidance symptoms, cognitive and negative changes. Conclusion: there is grade difference in the detection rate of PTSD in the students after the earthquake. The scores of PTSD scale of the first grade students are higher than those of the second grade students, and there are significant differences in the total score, the intrusive symptom, the avoidance symptom, the cognition and the negative mood change. Conclusion: after the intervention of sand game and painting therapy, the scores of PTSD intervention group were significantly decreased, which indicated that the intervention model was effective. Conclusion: through the intervention model of this study, the PTSD symptoms of the students in the disaster areas after the earthquake can be cured obviously, especially in the three dimensions of intrusive symptoms, negative cognitive and mood changes, and arousal and response changes.
【學(xué)位授予單位】：云南師范大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：B845.67

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