创伤后应激反应的相关因素分析及眼动疗法干预研究

发布时间：2018-08-10 17:36

【摘要】： 创伤后应激障碍是近年来在精神病学界和心理学界逐渐引起重视的反应性精神障碍,它在普通人群中发病率约7%～12%,其中男性发病率为5%,女性为10.4%。而心理创伤后存在应激反应者作为应激障碍发生的高危人群,尤其应该引起我们的重视。因此,本研究旨在:1.探讨影响心理创伤后应激反应的相关因素,为心理干预提供理论依据。2.验证标准化眼动画面对应激反应者进行眼动治疗的有效性。研究一:医学生应对、情绪调节方式与心理创伤后应激反应的相关研究研究方法:对405例有过心理创伤事件经历的医学生进行问卷调查和量表测评。使用开放式问卷、创伤后应激反应评定量表来评定创伤症状,使用应对方式问卷,情绪调节方式问卷评定应对风格和情绪调节特点,使用90项症状自评量表(SCL-90)来评定被试的心理健康程度。研究结果:1.在对正性情绪的忽视、抑制和对负性情绪的重视调节上,存在创伤后应激反应组要高于对照组,而对正性情绪的宣泄方面,创伤后应激反应组低于对照组。2.在应对方式上,创伤后应激反应组比对照组更倾向于选择幻想、自责、退避和合理化。3.创伤后应激反应的发生与对正性情绪的忽视,对负性情绪的重视和自责等呈正相关,而与对负性情绪的抑制、解决问题、求助等呈负相关。4.多元逐步回归分析显示,对负性情绪的重视调节,负性情绪的感受频率,幻想等是创伤后应激反应症状总分的独立预测变量。研究二:眼动疗法对创伤后应激反应者的干预研究研究方法:在前期调查问卷中抽出创伤后应激反应分数在35分以上的被试41人,随机分配到眼动画面组和手动组。分别接受标准化眼动画面训练和手动的眼动训练,并保存其皮电和脑电数据。训练前后被试填写恐惧情绪等级表。研究结果:1.眼动画面组和手动组的皮电数据表明,训练结束时的皮电值明显低于开始时。2.眼动画面组与手动组训练结束后的脑波α%值与皮电值有明显的相关性,且α脑波的数量较训练前显著增加。3.标准化眼动画面中,三个眼动方向的生理指标未发现有统计学差异。通过以上研究得出以下结论: 1.创伤后应激反应者的心理健康状况普遍较差。 2.创伤后应激反应者感受的负性情绪较多,与其情绪调节方式有关。对正性情绪多为忽视,而对负性情绪多为重视和宣泄。 3.创伤后应激反应者多采取不成熟的应对方式进行行为应对,缺乏积极的、有效的应对方式。 4.不良的情绪感受频率,特定的情绪调节方式和不成熟的应对与应激反应症状密切相关。因此临床实践中,可以从改善情绪调节和应对方式入手,指导心理干预。 5.眼动脱敏对应激反应的治疗是有效的,且标准化眼动画面基本可以代替传统的手动方式进行眼动治疗。 6.标准化眼动画面中,三个眼动方向的效果没有差异。可以推广到临床应用, 避免单一方向的训练带来的治疗的枯燥性和患者的耐受性。
[Abstract]:Posttraumatic stress disorder (PTSD) is a kind of reactive mental disorder which has attracted more and more attention in psychiatric and psychologic circles in recent years. The incidence of PTSD is about 7%-12% in the general population. The incidence of PTSD is 5% in males and 10.4% in females. Therefore, the purpose of this study is: 1. To explore the related factors affecting post-traumatic stress response and provide theoretical basis for psychological intervention. 2. To verify the effectiveness of standardized eye animation in the treatment of stress responders.
Study 1: correlation between emotion regulation and post-traumatic stress response in medical students
Methods: 405 medical students who had experienced psychological traumatic events were investigated by questionnaires and questionnaires. Traumatic symptoms were assessed by open-ended questionnaires, post-traumatic stress response scale, coping style questionnaire, emotion regulation questionnaire, and 90 symptom Checklist-90 (SCL-9). 0) to assess the mental health of the subjects.
The results showed that: 1. In the neglect of positive emotions, inhibition and attention to the regulation of negative emotions, the post-traumatic stress response group was higher than the control group, and in the catharsis of positive emotions, the post-traumatic stress response group was lower than the control group. 2. In coping style, the post-traumatic stress response group was more inclined to choose fantasy and self-blame than the control group. 3. The occurrence of post-traumatic stress response is positively correlated with the neglect of positive emotions, the emphasis on negative emotions and self-blame, but negatively correlated with the inhibition of negative emotions, problem-solving, help-seeking, etc. 4. Multiple stepwise regression analysis showed that the emphasis on the regulation of negative emotions, the frequency of negative emotions, fantasy and so on are. An independent predictor of total score of post traumatic stress response.
Study two: intervention of eye movement therapy on post-traumatic stress response
Methods: Forty-one subjects with post-traumatic stress scores above 35 were randomly assigned to the eye animation group and the manual group. They received standardized eye animation training and manual eye movement training respectively, and their electrodermic and EEG data were saved.
The results showed that: 1. Electrodermic data of eye animation face group and manual group showed that the electrodermal value at the end of training was significantly lower than that at the beginning. No statistical difference was found in physiological indexes.
The following conclusions can be drawn from the above research.
1. the mental health status of post-traumatic stress responders is generally poor.
2. Positive emotions were mostly neglected, while negative emotions were mostly emphasized and vented.
3. Post-traumatic stress responders usually adopt immature coping styles and lack active and effective coping styles.
4. Bad emotional frequency, specific emotional regulation and immature coping are closely related to stress reaction symptoms. Therefore, in clinical practice, psychological intervention can be guided by improving emotional regulation and coping style.
5. Eye movement desensitization is effective in the treatment of stress response, and standardized animation surface can basically replace the traditional manual way of eye movement treatment.
6. There is no difference in the effect of three directions of eye movement in standardized eye animation.
Avoid the monotonous treatment and patient tolerance caused by single directional training.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R395

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