震后应激障碍的认知行为治疗研究

发布时间：2018-04-02 18:39

本文选题：震后应激障碍　切入点：认知行为治疗　出处：《宁波大学》2012年硕士论文

【摘要】：震后应激障碍是指直接或间接接触地震灾害这一创伤事件的受害者、幸存者、目击者与救援者等个体延迟出现和长期持续存在的心理障碍，震后应激障碍具有创伤后应激障碍的本质特征。已有研究表明，震后应激障碍个体的终身患病率达到13.5%，，这使得对于震后应激障碍青少年个案的治疗研究有着重要的现实意义。当前青少年震后应激障碍的干预治疗研究偏向于对急性应激障碍的危机干预研究及对震后应激障碍的影响因素等进行量化研究，而对于中长期震后应激障碍患者的追踪干预研究缺乏。为此，本研究对震后应激障碍青少年患者进行地震19个月后的追踪干预研究，选取四川地震灾区青川县中地震19个月后震后应激障碍的青少年患者个体为被试，研究中将被试随机分为实验组和对照组，每组6名，共12人。实验组被试接受为期13次的以认知与行为相结合的认知行为疗法的干预治疗处理（每周一次，每次约50分钟），同时对照组接受支持性辅导的治疗处理。在研究中对两组被试进行前测、后测以及2个月后的延时测量，使用创伤后应激障碍自评量表（震后应激障碍-SS）；对实验组，每次干预治疗前都进行测量，并在3个月后进行追踪访谈。研究同时采用多基线研究设计，观察认知行为疗法对于震后应激障碍青少年个案治疗效果的微观发生规律性。在研究方法上，采用多基线设计来对震后应激障碍进行治疗的实证性研究；加入了认知行为疗法对于震后应激障碍个体疗效的微观发生规律的观察研究。研究结果表明：（1）短期疗效显著，对个体使用认知行为疗法能有效降低并改善青少年震后应激障碍的症状及水平。同时，疗效能够长期保持。虽然被试在延时测量中的PTSS总得分水平显示，震后应激障碍水平有所振荡且小幅回升，但仍属于正常稳定的振荡期。从前后测量对比来看，认知行为疗法的个案治疗对青少年震后应激障碍的症状及水平的改善与降低的疗效能够得到长期保持。（2）认知行为疗法对震后应激障碍的个案治疗存在一定的规律性。本研究所采用的认知行为疗法在干预青少年震后应激障碍个案时存在一定的微观发生规律性：基线稳定；治疗期逐步下降，包括启动的心理教育期、明显降低的掌握技术期以及小幅下降的练习巩固期；追踪期，稳定振荡中小幅回升。
[Abstract]:Post-earthquake stress disorder refers to the delayed and persistent psychological disorders of the victims, survivors, witnesses and rescuers who directly or indirectly come into contact with the traumatic event of the earthquake disaster.Post-earthquake stress disorder has the essential characteristics of post-traumatic stress disorder.It has been shown that the lifetime prevalence rate of post-earthquake stress disorder individuals is 13.5.This makes it of great practical significance to study the treatment of post-earthquake stress disorder adolescents.The current research on the intervention treatment of post-earthquake stress disorder in adolescents is inclined to the crisis intervention study on acute stress disorder and the quantitative study on the influencing factors of post-earthquake stress disorder.But for the long-term post-earthquake stress disorder patients follow-up intervention is lacking.Therefore, this study conducted a follow-up intervention study on the adolescent patients with post-earthquake stress disorder 19 months after the earthquake, and selected individual adolescent patients with post-earthquake stress disorder 19 months after the earthquake in Qingchuan County, Sichuan Province, as subjects.In the study, the subjects were randomly divided into experimental group and control group, each group of 6, a total of 12 people.The subjects in the experimental group were treated with cognitive and behavioral therapy for 13 times (once a week, about 50 minutes each time), while the control group received supportive counseling.In the study, two groups of subjects were tested by pre-test, post-test and time-delay measurement after 2 months, using the posttraumatic stress disorder self-rating scale (post-earthquake stress disorder), and the experimental group were measured before each intervention.A follow-up interview was conducted 3 months later.At the same time, a multi-baseline study was used to observe the microcosmic regularity of cognitive behavioral therapy in the treatment of post-earthquake stress disorder adolescents.In terms of research methods, multi-baseline design was used to study the treatment of post-earthquake stress disorder, and the microcosmic occurrence of cognitive behavioral therapy for post-earthquake stress disorder was observed and studied.The results showed that the short-term effect was significant. Cognitive behavioral therapy could effectively reduce and improve the symptoms and levels of post-earthquake stress disorder in adolescents.At the same time, the efficacy can be maintained for a long time.Although the total PTSS score of the subjects in the time-delay measurement showed that the level of post-earthquake stress disorder oscillated and increased slightly, it still belonged to the normal and stable oscillation period.According to the measurement and comparison before and after, the effect of cognitive behavioral therapy on symptoms and levels of post-earthquake stress disorder in adolescents can be maintained for a long time.2) Cognitive behavioral therapy has some regularity in the treatment of post-earthquake stress disorder.The cognitive behavioral therapy used in this study has some microcosmic regularity in the intervention of post-earthquake stress disorder cases in adolescents: baseline is stable, treatment period is decreasing gradually, including the initial psychological education period.The period of mastering skill and the period of practice consolidation with small drop are obviously reduced, and the stable oscillation rises in small amplitude during the tracking period.
【学位授予单位】：宁波大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.5

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