创伤暴露对青少年暴力行为和自杀意念的影响:创伤后应激障碍和抑郁的中介作用

doi:10.16187/j.cnki.issn1001-4918.2021.01.13

摘要/Abstract

摘要： 采用创伤暴露问卷、基于DSM-5的创伤后应激障碍症状核查表、流调中心用抑郁量表和青少年行为问题调查表，在雅安地震3.5年后对地震极重灾区的703名中学生进行调查，考察创伤暴露对暴力行为和自杀意念的影响，并检验创伤后应激障碍和抑郁在其中的中介作用。结果发现：创伤暴露可以直接正向预测暴力行为和自杀意念，PTSD在创伤暴露对暴力行为和自杀意念的影响间起中介作用，抑郁仅在创伤暴露对自杀意念的影响间起中介作用，而在创伤暴露对暴力行为影响间的中介效应不显著。

关键词: 创伤暴露, PTSD, 抑郁, 暴力行为, 自杀意念

Abstract: To explore the mediating effect of posttraumatic stress disorder (PTSD) and depression in the relationship between traumatic exposure and violent behavior, suicidal ideation among adolescents after the Ya'an earthquake. All adolescents completed the Trauma exposure questionnaire, PTSD checklist for DSM-5, the Center for Epidemiologic Studies Depression Scale for Children and the Child Behavior Problems Questionnaire. The results indicated that traumatic exposure directly and positively predicted violent behaviors and suicidal ideation. Moreover, traumatic exposure positively predicted violent behavior and suicidal ideation via PTSD, and traumatic exposure positively predicted suicidal ideation but not violent behavior via depression. This study suggests that traumatic exposure is one of the risk factors for suicidal ideation and violent behavior among adolescents after the earthquake. PTSD and depression played an important role to mediate the effect of traumatic exposure on suicidal ideation and violent behavior.

Key words: traumatic exposure, PTSD, depression symptoms, violent behavior, suicidal ideation

中图分类号:

B844

余青云, 王文超, 伍新春, 田雨馨. 创伤暴露对青少年暴力行为和自杀意念的影响:创伤后应激障碍和抑郁的中介作用[J]. 心理发展与教育, 2021, 37(1): 101-108.

YU Qingyun, WANG Wenchao, WU Xinchun, Tian Yuxin. Posttraumatic Stress Disorder and Depression Mediates the Relationship between Traumatic Exposure and Violent Behavior/Suicidal Ideation in Adolescents After an Earthquake[J]. Psychological Development and Education, 2021, 37(1): 101-108.

参考文献

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA:American Psychiatric Association.
Anderson, C. A., & Bushman, B. J. (2002). Human aggression. Annual Review of Psychology, 53(19), 27-51.
Armour, C., Müllerová, J., & Elhai, J. D. (2016). A systematic literature review of PTSD's latent structure in the diagnostic and statistical manual of mental disorders:DSM-IV to DSM-5. Clinical Psychology Review, 44(4), 60-74.
Bar-Haim, Y., Holoshitz, Y., Eldar, S., Frenkel, T. I., Muller, D., Charney, D. S., … Wald, I. (2010). Life-threatening danger and suppression of attention bias to threat. American Journal of Psychiatry, 167(6), 694-698.
Beck, A. T., Steer, R. A., & Ranieri, W. F. (1988). Scale for suicide ideation:Psychometric properties of a self-report version. Journal of Clinical Psychology, 44(4), 499-505.
Benarous, X., Guedj, M. J., Braitman, A., Gallois, E., & Lana, P. (2014). The link between aggressive behavior and depression in adolescence. A cross-sectional study conducted in the psychiatric emergency unit at the Sainte-Anne hospital. Lencéphale, 40(6), 439-446.
Brener, N. D., Collins, J. L., Kann, L., Warren, C. W., & Williams, B. I. (1995). Reliability of the youth risk behavior survey questionnaire. American Journal of Epidemiology, 141, 575-580.
Brown, G. K., Beck, A. T., Steer, R. A., & Grisham, J. R. (2000). Risk factors for suicide in psychiatric outpatients:A 20-year prospective study. Journal of Consulting and Clinical Psychology, 68(3), 371-377.
Bryan, C., & Anestis, M. (2011). Reexperiencing symptoms and the interpersonal-psychological theory of suicidal behavior among deployed service members evaluated for traumatic brain injury. Journal of Clinical Psychology, 67(9), 856-865.
Cavanagh, J. T., Carson, A. J., Sharpe, M., & Lawrie, S. M. (2003). Psychological autopsy studies of suicide:A systematic review. Psychological Medicine, 33(3), 395-405.
Davis, M. T., Witte, T. K., & Weathers, F. W. (2014). Posttraumatic stress disorder and suicidal ideation:The role of specific symptoms within the framework of the interpersonal psychological theory of suicide. Psychological Trauma:Theory, Research, Practice, and Policy, 6(6), 610-618.
Dodge, K. A., Pettit, G. S., Bates, J. E., & Valente, E. (1995). Social information-processing patterns partially mediate the effect of early physical abuse on later conduct problems. Journal of Abnormal Psychology, 104(4), 632-643.
Dyer, K. F. W., Dorahy, M. J., Hamilton, G., Corry, M., Shannon, M., MacSherry, A, …McElhill, B. (2009). Anger, aggression, and self-harm in PTSD and complex PTSD. Journal of Clinical Psychology, 65(10), 1099-1114.
Fazel, S., Wolf, A., Chang, Z., Larsson, H., Goodwin, G. M., & Lichtenstein, P. (2015). Depression and violence:A Swedish population study. Lancet Psychiatry, 2(3), 224-232.
Fendrich, M., Weissman, M. M., & Warner, V. (1990). Screening for depressive disorder in children and adolescents:Validating the Center for Epidemiologic Studies Depression Scale for Children. American Journal of Epidemiology, 131, 538-551.
Freud, S. (1955). Beyond the pleasure principle. In The standard edition of the complete psychological works of Sigmund Freud, edited by James Strachey. Oxford, England.
Holtzworth-Munroe, A. (1992). Social skill deficits in maritally violent men:Interpreting the data using a social information processing model. Clinical Psychology Review, 12(6), 605-617.
Johnson, J., Gooding, P. A., Wood, A. M., & Tarrier, N. (2010). Resilience as positive coping appraisals:Testing the schematic appraisals model of suicide. Behaviour Research & Therapy, 48(3), 179-86.
Kang, N., You, J., Huang, J., Ren, Y., Lin, M. P., & Xu, S. (2019). Understanding the pathways from depression to suicidal risk from the perspective of the interpersonal-psychological theory of suicide. Suicide and Life-Threatening Behavior, 49(3), 684-694.
Krakowski, M., & Czobor, P. (2004). Gender differences in violent behaviors:Relationship to clinical symptoms and psychosocial factors. American Journal of Psychiatry, 161(3), 459-465.
Kukihara, H., Yamawaki, N., Uchiyama, K., Arai, S., & Horikawa, E. (2014). Trauma, depression, and resilience of earthquake/tsunami/nuclear disaster survivors of Hirono, Fukushima, Japan. Psychiatry and Clinical Neurosciences, 68(7), 524-533.
Kõlves, K., Kõlves, K. E., & De, L. D. (2013). Natural disasters and suicidal behaviours:A systematic literature review. Journal of Affective Disorders, 146(1), 1-14.
Lehtinen, V., & Joukamaa, M. (2010). Epidemiology of depression:Prevalence, risk factors and treatment situation. Acta Psychiatrica Scandinavica, 89(377), 7-10.
Liao, T. L., Chen, Y. S., Chen, C. Y., & Chien, L. Y. (2014). Self-reported internalizing and externalizing behaviours among junior high school students at 2 and 4 years after the 921 earthquake in Taiwan. Stress and Health, 30(4), 265-271.
Liu, D., Fu, L., Jing, Z., & Chen, C. (2016). Post-traumatic stress disorder and it's predictors among Tibetan adolescents 3 years after the high-altitude earthquake in China. Archives of Psychiatric Nursing, 30(5), 593-599.
Lyketsos, C. G., Steele, C., Galik, E., Rosenblatt, A., Steinberg, M., Warren, A., & Sheppard, J. M. (1999). Physical aggression in dementia patients and its relationship to depression. American Journal of Psychiatry, 156(1), 66-71.
Mazza, J. J., & Reynolds, W. M. (1999). Exposure to violence in young inner-city adolescents:Relationships with suicidal ideation, depression, and PTSD symptomatology. Journal of Abnormal Child Psychology, 27(3), 203-213.
Milan, S., Zona, K., Acker, J., & Turcioscotto, V. (2013). Prospective risk factors for adolescent PTSD:Sources of differential exposure and differential vulnerability. Journal of Abnormal Child Psychology, 41(2), 339-353.
Nock, M. K., Borges, G., Bromet, E. J., Alonso, J., Angermeyer, M., Beautrais, A., …De Graaf, R. (2008). Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. The British Journal of Psychiatry, 192(2), 98-105.
Palermo, C. (2004). Gender differences in violent behaviors:Relationship to clinical symptoms and psychosocial factors. American Journal of Psychiatry, 161(3), 459-465.
Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879-891.
Salcioglu, E., & Basoglu, M. (2008). Psychological effects of earthquakes in children:Prospects for brief behavioral treatment. World Journal of Pediatrics, 4(3), 165-172.
Schwenk, T. L., Davis, L., & Wimsatt, L. A. (2010). Depression, stigma, and suicidal ideation in medical students. JAMA, 304(11), 1181-1190.
Scott, B. G., Lapré, G. E., Marsee, M. A., & Weems, C. F. (2014). Aggressive behavior and its associations with posttraumatic stress and academic achievement following a natural disaster. Journal of Clinical Child & Adolescent Psychology, 43(1), 43-55.
Sorsdahl, K., Stein, D. J., Williams, D. R., & Nock, M. K. (2011). Associations between traumatic events and suicidal behaviour in South Africa. The Journal of Nervous and Mental Disease, 199(12), 928-933.
Stratta, P., Capanna, C., & Riccardi, I., Carmassi, C., Piccinni, A., Dell'Osso, L., & Rossi, A. (2012). Suicidal intention and negative spiritual coping one year after the earthquake of L'Aquila (Italy). Journal of Affective Disorders 136(3), 1227-1231.
Strom, T. Q., Leskela, J., James, L. M., Thuras, P. D., Voller, E., Weigel, R., …Holz, K.B. (2012). An exploratory examination of risk-taking behavior and PTSD symptom severity in a veteran sample. Military Medicine, 177(4), 390-396.
Swanson, J. W., McGinty, E. E., Fazel, S., & Mays, V. M. (2015). Mental illness and reduction of gun violence and suicide:Bringing epidemiologic research to policy. Annals of Epidemiology, 25(5), 366-376.
Taft, C. T., Creech, S. K., & Kachadourian, L. (2012). Assessment and treatment of posttraumatic anger and aggression:A review. Journal of Rehabilitation Research and Development, 49(5), 777-788.
Troister, T., Davis, M. P., Lowndes, A., & Holden, R. R. (2013). A five-month longitudinal study of psychache and suicide ideation:Replication in general and high-risk university students. Suicide and Life-Threatening Behavior, 43(6), 611-620.
Troister, T., & Holden, R. R. (2013). Factorial differentiation among depression, hopelessness, and psychache in statistically predicting suicidality. Measurement & Evaluation in Counseling & Development, 46(1), 50-63.
Tull, M. T., Jakupcak, M., Paulson, A., & Gratz, K. L. (2007). The role of emotional in expressivity and experiential avoidance in the relationship between posttraumatic stress disorder symptom severity and aggressive behavior among men exposed to interpersonal violence. Anxiety, Stress & Coping, 20(4), 337-351.
Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD. Retrieved, from http://www.ptsd.va.gov
Ying, L. H., Wu, X. C., & Lin, C. D. (2012). Longitudinal linkages between depressive and posttraumatic stress symptoms in adolescent survivors following the Wenchuan earthquake in China:A three-wave, cross-lagged study. School Psychology International, 33(4), 416-432.
Ying, L., Chen, C., Lin, C., Greenberger, E., Wu, X., & Jiang, L. (2015). The relationship between posttraumatic stress symptoms and suicide ideation among child survivors following the Wenchuan earthquake. Suicide and Life-Threatening Behavior, 45(2), 230-242.
Zhou, X., & Wu, X. (2017). Moderating role of negative venting in the relationship between PTSD and violent behaviors and suicidal ideation in Chinese children after an earthquake. Child Indicators Research, 10(1), 221-230.
Zhou, X., Wu, X., & Zhen, R. (2017). Assessing the latent structure of DSM-5 PTSD among Chinese adolescents after the Ya'an earthquake. Psychiatry Research, 254, 33-39.
程科, 周宵, 陈秋燕, 张晨光, 伍新春. (2013). 小学生创伤后应激障碍对攻击行为的影响:应对方式的调节作用. 心理发展与教育, 29(6), 649-656.
李亚敏, 雷先阳, 张丹, 刘莉, 唐四元. (2014). 中国大学生自杀意念影响因素的元分析. 中国临床心理学杂志, 22(4), 638-640.
林崇德, 伍新春, 张宇迪, 臧伟伟, 周宵, 戴艳. (2013). 汶川地震30个月后中小学生的身心状况研究. 心理发展与教育, 29(6), 631-640.
邱晓惠, 孙海莲, 乔正学, 杨秀贤, 杨艳杰. (2008). 大学生抑郁情绪与冲动性攻击性关系的研究. 中华行为医学与脑科学杂志, 17(10), 932-934.
王文超, 伍新春, 周宵. (2018). 青少年创伤后应激障碍和创伤后成长的状况与影响因素-汶川地震后的10年探索. 北京师范大学学报(社会科学版), (2), 51-63.
温忠麟, 侯杰泰, 马什赫伯特. (2004). 结构方程模型检验:拟合指数与卡方准则. 心理学报, 36(2), 186-194.
伍新春, 王文超, 周宵, 陈秋燕, 林崇德. (2018). 汶川地震8.5年后青少年身心状况研究. 心理发展与教育, 34(1), 80-89.
伍新春, 张宇迪, 林崇德, 臧伟伟. (2013). 中小学生的灾难暴露程度对创伤后应激障碍的影响:中介和调节效应. 心理发展与教育, 29(6), 641-648.

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