高原军人创伤后应激障碍症状与焦虑、抑郁情绪的关系

职业与健康 ›› 2024, Vol. 40 ›› Issue (24): 3357-3361.

高原军人创伤后应激障碍症状与焦虑、抑郁情绪的关系

杨婉君¹, 杨国愉¹, 阳逸¹, 衡惠¹, 骆昕玮², 边晨¹

1.陆军军医大学医学心理系军人发展心理学教研室,重庆 400037;
2.重庆市武警总医院医学心理科,重庆 400061

收稿日期:2024-04-10 修回日期:2024-04-18 出版日期:2024-12-15 发布日期:2026-04-09
通信作者: 边晨,副教授,E-mail：bc818@163.com
作者简介:杨婉君,女,在读硕士研究生,研究方向为军事心理应激及健康促进。

Relationship between post-traumatic stress disorder symptoms and anxiety,depression in high altitude soldiers

YANG Wanjun¹, YANG Guoyu¹, YANG Yi¹, HENG Hui¹, LUO Xinwei², BIAN Chen¹

1. Teaching and Research Office of Developmental Psychology of Armyman,Department of Medical Psychology,Army Medical University,Chongqing 400037,China;
2. Medical Psychology Department,Armed Police Hospital of Chongqing,Chongqing 400061,China

Received:2024-04-10 Revised:2024-04-18 Online:2024-12-15 Published:2026-04-09
Contact: BIAN Chen,Associate professor,E-mail: bc818@163.com

摘要/Abstract

摘要： 目的了解高原军人创伤后应激障碍症状（post-traumatic stress disorder,PTSD）现状及影响因素,并探讨其与焦虑、抑郁情绪的关系,为降低高原军人PTSD的发生率提供依据。方法 2023年3—4月以整群抽样的方式抽取高原某单位军人1 908名,使用一般资料调查表、创伤后应激障碍量表（post-traumatic stress disorder checklist-civilian version,PCL-C）、患者健康问卷9项抑郁量表（patient health questionnaire-9,PHQ-9）、广泛性焦虑障碍量表（generalized anxiety disorde-7,GAD-7）进行施测,并对数据进行分析。结果高原军人PTSD症状阳性率为3.46%,总分M（P₂₅,P₇₅）为17（17,20）分,焦虑情绪阳性率为7.60%,抑郁情绪阳性率为11.01%。高原军人PTSD症状与焦虑、抑郁情绪均呈显著正相关（r=0.798、0.797,均P<0.01）,焦虑、抑郁情绪和性别均是高原军人发生PTSD症状的主要影响因素（均P<0.01）。焦虑情绪在高原军人抑郁水平和PTSD间中介效应显著,效应量为0.368,占总效应的46.2%。结论焦虑、抑郁情绪与高原军人PTSD症状的发生率呈显著正相关,且焦虑情绪在抑郁情绪和PTSD之间起到部分中介作用,即抑郁水平对PTSD有直接预测作用,同时也可通过焦虑的中介作用影响PTSD。

关键词: 高原, 军人, 创伤后应激障碍, 焦虑, 抑郁, 中介效应

Abstract: Objective To study the current situation and influencing factors of post-traumatic stress disorder（PTSD） in soldiers at high altitude,explore its relationship with anxiety and depression,so as to provide a basis for reducing the incidence of PTSD in soldiers at high altitude. Methods From March to April 2023,1 908 soldiers at high altitude were selected by the cluster sampling,measured by the general data questionnaire,post traumatic stress disorder checklist-civilian version（PCL-C）,patient health questionnaire-9（PHQ-9）,and generalized anxiety disorde-7（GAD-7）,and the data were analyzed. Results The positive rate of PTSD in soldiers at high altitude was 3.46%,with the total score M（P₂₅,P₇₅） of 17（17,20）points,and the positive rate of anxiety and depression was 7.60% and 11.01% respectively. The PTSD symptoms in high altitude soldiers were significantly positively correlated with anxiety and depression（r=0.798,0.797,both P<0.01）,while anxiety,depression and gender were the main influencing factors of PTSD symptoms in these soldiers（all P<0.01）. The anxiety had a significant mediation effect between depression level and PTSD in high altitude soldiers,effect size was 0.368,accounting for 46.2% of the total effect. Conclusion The anxiety and depression are significantly positively correlated with the incidence of PTSD symptoms in high altitude soldiers,and the anxiety plays a partial mediating role between depression and PTSD,that is,the depression level has a direct predictive effect on PTSD,and can also affect PTSD through the mediating role of anxiety.

Key words: High altitude, Soldiers, Post-traumatic stress disorder, Anxiety, Depression, Mediation effect

中图分类号:

R395.6

杨婉君, 杨国愉, 阳逸, 衡惠, 骆昕玮, 边晨. 高原军人创伤后应激障碍症状与焦虑、抑郁情绪的关系. [J]职业与健康, 2024, 40(24): 3357-3361.

YANG Wanjun, YANG Guoyu, YANG Yi, HENG Hui, LUO Xinwei, BIAN Chen. Relationship between post-traumatic stress disorder symptoms and anxiety,depression in high altitude soldiers. [J]OCCUPATION AND HEALTH, 2024, 40(24): 3357-3361.

参考文献

[1] KIOUS B M,BAKIAN A,ZHAO J,et al.Altitude and risk of depression and anxiety:findings from the intern health study[J].Int Rev Psychiatry,2019,31(7-8):637-645.
[2] 杨柳,吴非,刘流,等.心理弹性对高原驻训官兵睡眠质量与情绪的影响[J].联勤军事医学,2023,37(4):340-344,359.
[3] 冯正直,陈骁.我国特殊军事环境军人心理问题研究与展望[J].第三军医大学学报,2016,38(20):2199-2204.
[4] IZQUIERDO I,FURINI C R,MYSKIW J C.Fear Memory[J].Physiol Rev,2016,96(2):695-750.
[5] BENJET C,BROMET E,KARAM E G,et al.The epidemiology of traumatic event exposure worldwide:results from the World Mental Health Survey Consortium[J].Psychol Med,2016,46(2):327-343.
[6] 邓牡红,冯崴,黄芳芳,等.军人创伤后应激障碍与焦虑情绪现状调查及影响因素分析[J].中华现代护理杂志,2017,23(33):4254-4258.
[7] 张伟,刘增训,张心华.对越自卫反击战退役军人创伤后应激障碍患病率及影响因素研究[J].精神医学杂志,2022,35(4):407-411.
[8] 邓明昱. 创伤后应激障碍的临床研究新进展(DSM-5新标准)[J].中国健康心理学杂志,2016,24(5):641-650.
[9] KOK B C,HERRELL R K,THOMAS J L,et al.Posttraumatic stress disorder associated with combat service in Iraq or Afghanistan:reconciling prevalence differences between studies[J].Nerv Ment Dis,2012, 200(5):444-450.
[10] 张亚林. 心理治疗的本土化与现代化[J].心理学通讯,2019,2(4):236-239.
[11] PIETRZAK R H,GOLDSTEIN R B,SOUTHWICK S M,et al.Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States:Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions[J].Anxiety Disord,2011,25(3):456-465.
[12] BARBANO A C,VAN DER MEI W F,DEROON-CASSINI T A,et al.Differentiating PTSD from anxiety and depression:Lessons from the ICD-11 PTSD diagnostic criteria[J].Depress Anxiety,2019,36(6):490-498.
[13] SMOLLER J W.The genetics of stress-related disorders:PTSD,depression,and anxiety disorders[J].Neuropsychopharmacol,2016,41:297-319.
[14] 彭军波,季丽莉.Anti-miR-132通过结合FXR1减轻PTSD大鼠焦虑及抑郁样行为的实验研究[J].解剖科学进展,2023,29(3):325-328.
[15] STEIN D J,CRASKE M G,ROTHBAUM B O,at al.The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management[J].World Psychiatry,2021,20(3):336-356.
[16] 杨晓云,杨宏爱,刘启贵,等.创伤后应激检查量表平民版的效度、信度及影响因素的研究[J].中国健康心理学杂志,2007,15(1):6-9.
[17] SPITZER R L,KROENKE K,WILLIAMS J B,et al.A brief measure for assessing generalized anxiety disorder:the GAD-7[J].Arch Intem Med,2006,166(10):1092-1097.
[18] KROENKE KURT.PHQ-9:Global uptake of a depression scale[J].World Psychiatry,2021,20(1):135-136.
[19] 冯正直,祖霞.军人心理健康评价——理论与模型[J].第三军医大学学报,2015,37(22):2207-2212.
[20] 明志君,陈祉妍,刘亚男,等.退役军人心理健康状况及影响因素分析[J].中国公共卫生,2022,38(2):167-171.
[21] 李昌俊,贾东立,涂燊.救援人员的主要心理问题、相关因素与干预策略[J].灾害学,2021,36(1):148-152.
[22] BROOKS S,AMLÔT R,RUBIN G J,et al.Psychological resilience and post-traumatic growth in disaster-exposed organisations:overview of the literature[J].BMJ Mil Health,2020,166(1):52-56.
[23] BERGER W,COUTINHO E S F,FIGUEIRA I,et al.Rescuers at risk:a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers[J].Soc Psych Psych Epid,2012,47(6):1001-1011.
[24] 宫媛,刘荣,贺纳斯.基层带兵士官身心健康状况及其相关因素分析[J].临床军医杂志,2013,41(3):281-282.
[25] 衣新发,赵倩,蔡曙山.中国军人心理健康状况的横断历史研究:1990~2007[J].心理学报,2012,44(2):226-236.
[26] 白鹏. 创伤后应激障碍患者的临床症状与焦虑抑郁情绪的相关性研究[J].医药论坛杂志,2016,37(8):84-85.
[27] 张跃奇,陆可可,张玉梅,等.基于BOLD-fMRI技术的创伤后应激障碍患者大脑功能局部一致性观察[J].山东医药,2016,56(34):60-62.
[28] WILLISTON S K,VOGT D S.Mental health literacy in veterans:What do U.S. military veterans know about PTSD and its treatment?[J].Psychol Serv,2022,19(2):327-334.