焦点解决短期心理治疗对青少年家庭创伤后应激障碍的干预效果

郅利聪; 张函

doi:10.16835/j.cnki.1000-9817.2021.09.021

焦点解决短期心理治疗对青少年家庭创伤后应激障碍的干预效果

doi: 10.16835/j.cnki.1000-9817.2021.09.021

郅利聪,
张函

河南科技大学应用工程学院，三门峡 472000

基金项目:

河南省教育厅十三五规划课题项目 (2017)-JKGHYB-0386)

详细信息

作者简介:
郅利聪(1969-)，女，河南巩义人，硕士，副教授，主要研究方向为师生心理健康教育

中图分类号: G 78 B 844.2 R 179
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- 被引次数: 0
出版历程
- 收稿日期: 2020-12-15
- 修回日期: 2021-03-02
- 网络出版日期: 2021-09-24
- 刊出日期: 2021-09-24

Effectiveness of solution-focused brief therapy for adolescents with family post-traumatic stress disorder

School of Applied Engineering, Henan University of Science and Technology, Sanmenxia(472000), Henan Province, China

摘要

摘要: 目的研究焦点解决短期心理治疗(SFBT)对青少年家庭创伤后应激障碍(PTSD)的干预效果，为青少年PTSD的心理干预提供参考。方法 2017年1月至2018年6月，在河南科技大学附属中学通过老师推荐、招募选取青少年家庭PTSD共42名，随机分为观察组与对照组各21例，另选取21名健康青少年为健康组。3组青少年入组后均测定埃森创伤问卷-儿童青少年版(ETI-CA)、Rosenberg自尊量表(RSES)、自我和谐量表(SCCS)、心理健康诊断测验(MHT)评分，观察组采取SFBT干预6次后复测，对照组不予特殊干预并于同时间点复测，比较3组各量表评分的差异。结果干预前，观察组和对照组RSES评分为(26.68±3.12)(27.58±3.72)分，低于健康组的(31.25±6.73)分(F=13.63，P < 0.05)；SCCS评分为(109.89±21.85)(108.60±20.46)分，高于健康组的(78.21±15.71)分(F=12.69，P < 0.05)；ETI-CA评分分别为(28.10±8.12)(27.98±7.89)分，高于健康组的(12.02±2.13)分(F=13.62，P < 0.05)；MHT评分分别为(25.20±6.81)(25.03±6.64)分，高于健康组的(17.55±4.69)分(F=11.90，P < 0.05)。干预后，观察组RSES评分为(31.31±4.65)分，高于对照组的(28.04±4.11)分(P < 0.05)；观察组ETI-CA、SCCS、MHT评分分别为(14.95±2.03)(96.66±17.02)(18.55±5.17)分，低于对照组的(26.57±7.34)(111.29±21.71)(25.81±7.12)分(P值均 < 0.05)。结论 SFBT干预可减轻家庭PTSD青少年的PTSD水平，改善自尊心、自我和谐及心理健康水平。
- 应激障碍，创伤后 /
- 精神卫生 /
- 干预性研究 /
- 青少年
Abstract: Objective To investigate the effectiveness of solution-focused brief therapy(SFBT) for adolescents with family post-traumatic stress disorder(PTSD), and to provide a reference for the mental intervention for adolescents of PSTD. Methods From January 2017 to June 2018, 42 cases of PTSD adolescents with family trauma were randomly divided into observation group and control group, with 21 cases in each group; 21 healthy adolescents were enrolled as healthy group. The scores of Essen Trauma Inventor for children and adolescents(ETI-CA), Rosenberg Self-Esteem Scale(RSES), Self-Consistency and Congruence Scale(SCCS) and Mental Health Test(MHT) were evaluated. The observation group received SFBT intervention 6 times, the control group received no special intervention. The scores of the three groups were compared. Results Before the intervention, the RSES scores of the observation group and the control group were(26.68±3.12) and(27.58±3.72), significantly lower than(31.25±6.73) of the healthy group(F=13.63, P < 0.05); the SCCS score was(109.89±21.85) and(108.60±20.46), significantly higher than(78.21±15.71) of the healthy group(F=12.69, P < 0.05); The ETI-CA scores was(28.10±8.12) and(27.98±7.89), significantly higher than(12.02±2.13) of the healthy group(F=13.62, P < 0.05); The MHT scores was(25.20±6.81) and(25.03±6.64), significantly higher than(17.55±4.69) of the healthy group(F=11.90, P < 0.05). After intervention, the RSES score of the observation group was(31.31±4.65), significantly higher than(28.04±4.11) of the control group(P < 0.05); The ETI-CA, SCCS and MHT scores of the observation group were respectively(14.95±2.03)(96.66±17.02) and(18.55±5.17), significantly lower than(26.57±7.34)(111.29±21.71) and(25.81±7.12) of the control group(P < 0.05). Conclusion SFBT intervention can reduce PTSD level in adolescents with family PTSD, improve self-esteem, self-harmony and mental health.
- Stress disorders, post-traumatic /
- Mental health /
- Intervention studies /
- Adolescent

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表 1 不同调查时间3组青少年ETI-CA评分比较(x±s)

Table 1. Comparison of ETI-CA scores among three groups adolescent at different investigation times(x±s)

时间	组别	人数	统计值	闯入	回避	高警觉	分离	总分
前测	健康组	21		3.01±0.83	3.24±0.85	2.78±0.76	2.99±0.84	12.02±2.13
	观察组	21		6.13±1.24^*	9.14±2.31^*	6.24±2.31^*	6.59±2.41^*	28.10±8.12^*
	对照组	21		6.09±1.21^*	9.16±2.36^*	6.19±2.28^*	6.54±2.36^*	27.98±7.89^*
			F值	8.02	10.24	7.26	9.30	13.62
			P值	0.03	0.01	0.04	0.02	0.00
后测	观察组	21		3.62±1.01^#	4.13±2.11^#	3.09±1.13^#	4.11±1.62^#	14.95±2.03^#
	对照组	21		5.76±1.14	8.84±2.17	5.96±2.23	6.01±2.11	26.57±7.34
			t值	-4.36	-6.05	-4.95	-5.74	-8.63
			P值	0.00	0.00	0.00	0.00	0.00
注：与健康组比较，*P < 0.05；与本组前测比较，#P < 0.05。

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表 2 不同调查时间3组青少年RSES与SCCS评分比较(x±s)

Table 2. Comparison of RSES and SCCS scores among three groups adolescent at different investigation times(x±s)

时间	组别	人数	统计值	RSES	自我刻板性	自我灵活性	自我与经验不和谐	SCCS总分
前测	健康组	21		31.25±6.73	16.11±3.94	24.08±4.43	38.02±8.17	78.21±15.71
	观察组	21		26.68±3.12^*	23.79±4.23^*	33.41±7.69^*	52.69±10.43^*	109.89±21.85^*
	对照组	21		27.58±3.72^*	23.04±4.15^*	33.29±7.25^*	52.27±9.85^*	108.60±20.46^*
			F值	13.63	10.65	9.74	11.68	12.69
			P值	0.00	0.01	0.02	0.00	0.00
后测	观察组	21		31.31±4.65^#	20.85±3.02^#	28.13±5.43^#	47.68±8.25^#	96.66±17.02^#
	对照组	21		28.04±4.11	24.17±4.43	32.11±7.01	55.01±10.71	111.29±21.71
			t值	6.90	-5.43	-6.71	-5.65	-14.85
			P值	0.00	0.00	0.00	0.00	0.00
注：与健康组比较，*P < 0.05；与本组前测比较，#P < 0.05。

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表 3 不同调查时间3组青少年MHT评分比较(x±s)

Table 3. Comparison of MHT scores among three groups and the control group adolescent at different investigation times(x±s)

时间	组别	例数	统计值	学习焦虑	对人焦虑	孤独倾向	自责倾向	过敏倾向	身体症状	恐怖倾向	冲动倾向	效度量表	总均分
前测	健康组	21		3.19±0.75	1.51±0.32	0.78±0.22	2.27±0.41	2.29±0.45	1.82±0.40	2.15±0.56	2.23±0.71	1.31±0.42	17.55±4.69
	观察组	21		3.61±0.82	2.73±0.41^*	1.68±0.37^*	2.54±0.48	2.93±0.75^*	3.25±0.81^*	3.07±0.72^*	4.05±0.89^*	1.34±0.45	25.20±6.81^*
	对照组	21		3.57±0.79	2.75±0.43	1.72±0.38	2.47±0.46	2.95±0.79	3.21±0.76	3.04±0.69	3.99±0.82	1.33±0.43	25.03±6.64
			F值	1.65	8.69	7.25	2.30	6.95	7.99	8.09	10.32	1.82	11.90
			P值	0.10	0.03	0.04	0.07	0.04	0.03	0.02	0.01	0.07	0.00
后测	观察组	21		3.32±0.78	1.82±0.35^#	1.01±0.29^#	2.32±0.43	2.35±0.44^#	2.01±0.51^#	2.03±0.57^#	2.33±0.72^#	1.36±0.41	18.55±5.17^#
	对照组	21		3.60±0.81	2.80±0.45	1.79±0.41	2.50±0.49	3.01±0.74	3.51±0.79	3.10±0.71	4.07±0.85	1.34±0.41	25.81±7.12
			t值	-0.76	-4.62	-5.95	-0.82	-3.96	-2.95	-6.01	-6.82	0.25	-10.34
			P值	0.17	0.01	0.00	0.14	0.03	0.04	0.00	0.00	0.34	0.00
注：与健康组比较，*P < 0.05；与本组前测比较，#P < 0.05。

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参考文献(17)

[1]	刘力勇, 王力, 青于兰. 创伤暴露青少年群体中创伤后应激障碍的症状结构分析[J]. 中国临床心理学杂志, 2015, 23(4): 600-603. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201504008.htm LIU L Y, WANG L, QING Y L. Structural analysis of posttraumatic stress disorder symptoms in trauma-exposed adolescents[J]. Chin J Clin Psychol, 2015, 23(4): 600-603. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201504008.htm
[2]	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. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL201605001.htm DENG M Y. New progress in clinical research of post-traumatic stress disorder(DSM-5 new standard)[J]. Chin J Health Psychol, 2016, 24(5): 641-650. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL201605001.htm
[3]	KRAUSE D J, GREEN S A, KOURY S P, et al. Solution-Focused Trauma-Informed Care(SF-TIC): an integration of models[J]. J Public Child Welfare, 2017, 12(1): 1-19. doi: 10.1080/15548732.2017.1348312?scroll=top
[4]	周宵, 伍新春, 曾旻, 等. 青少年的情绪调节策略对创伤后应激障碍和创伤后成长的影响: 社会支持的调节作用[J]. 心理学报, 2016, 48(8): 969-980. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXB201608006.htm ZHOU X, WU X C, ZENG M, et al. The relationship between emotion regulation and PTSD/PTG among adolescents after the Ya'an earthquake: the moderating role of social support[J]. Acta Psychol Sinica, 2016, 48(8): 969-980. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXB201608006.htm
[5]	庞焯月, 席居哲, 左志宏. 儿童青少年创伤后应激障碍(PTSD)治疗的研究热点: 基于美国文献的知识图谱分析[J]. 心理科学进展, 2017, 25(7): 1182-1196. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXD201707010.htm PANG Z Y, XI J Z, ZUO Z H. A knowledge-mapping analysis of U.S. research on treatments for children and adolescents with post-traumatic stress disorder(PTSD)[J]. Advanc Psychol Sci, 2017, 25(7): 1182-1196. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXD201707010.htm
[6]	周娟, 周肖榕, 李航, 等. 埃森创伤问卷中文版的信度和效度研究[J]. 中华物理医学与康复杂志, 2010, 32(2): 121-124. ZHOU J, ZHOU X R, LI H, et al. The reliability and validity of the Chinese version of essen trauma inventory[J]. Chin J Physic Med Rehabil, 2010, 32(2): 121-124.
[7]	王孟成, 蔡炳光, 吴艳, 等. 项目表述方法对中文Rosenberg自尊量表因子结构的影响[J]. 心理学探新, 2010, 30(3): 63-68. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXT201003013.htm WANG M C, CAI B G, WU Y, et al. The influence of item expression method on Chinese rosenberg's self-esteem psychometric effect will also increase the influence of table factor structure[J]. Psychol Explor, 2010, 30(3): 63-68. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXT201003013.htm
[8]	王登峰. 自我和谐量表的编制[J]. 中国临床心理学杂志, 1994, 2(1): 19-22. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY401.004.htm WANG D F. Development of self-consistency and congruence scale[J]. Chin J Clinic Psychol, 1994, 2(1): 19-22. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY401.004.htm
[9]	郑全全, 温廼, 徐飞舟, 等. 《中学生心理健康诊断测验》结构的探索及修改[J]. 应用心理学, 2004, 10(2): 3-7. https://www.cnki.com.cn/Article/CJFDTOTAL-YXNX200402000.htm ZHENG Q Q, WEN N, XU F Z, et al. Exploration and modification of the structure of mental health diagnostic test for middle school students[J]. Appl Psychol, 2004, 10(2): 3-7. https://www.cnki.com.cn/Article/CJFDTOTAL-YXNX200402000.htm
[10]	郭秀红, 陈恋, 李维萍, 等. 心理护理干预对青少年创伤后应激障碍的影响[J]. 西北国防医学杂志, 2018, 39(3): 196-198. https://www.cnki.com.cn/Article/CJFDTOTAL-XBGY201803021.htm GUO X H, CHEN L, LI W P, et al. Effect of psychological intervention on posttraumatic stress mental disorders in adolescents[J]. Med J National Defend Forces Northwest Chin, 2018, 39(3): 196-198. https://www.cnki.com.cn/Article/CJFDTOTAL-XBGY201803021.htm
[11]	姜帆, 安媛嫒, 伍新春. 面向儿童青少年的创伤聚焦的认知行为治疗: 干预模型与实践启示[J]. 中国临床心理学杂志, 2014, 22(4): 756-760. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201404044.htm JIANG F, AN Y Y, WU X C. Trauma-focused cognitive-behavioral therapy for children and adolescent[J]. Chin J Clinic Psychol, 2014, 22(4): 756-760. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201404044.htm
[12]	李红政, 陈海燕, 雷美英, 等. 童年期创伤经历与自尊对新兵抑郁的影响[J]. 广东医学, 2015, 16(1): 23-26. https://www.cnki.com.cn/Article/CJFDTOTAL-GAYX201501013.htm LI H Z, CHEN H Y, LEI M Y, et al. Effects of childhood traumatic experience and self-esteem on depression in recruits[J]. Guangdong Med J, 2015, 16(1): 23-26. https://www.cnki.com.cn/Article/CJFDTOTAL-GAYX201501013.htm
[13]	陈孜, 申敏, 李彦章. 创伤后应激障碍对高中生心理健康状况的影响[J]. 中华行为医学与脑科学杂志, 2014, 23(2): 152-155. CHEN Z, SHEN M, LI Y Z. Effect of symptoms of posttraumatic stress disorder on the psychological states among high school students in the earthquake regions[J]. Chin J Behav Med Brain Sci, 2014, 23(2): 152-155.
[14]	吴歌. 短程焦点解决辅助团体疗法对青少年焦虑、抑郁情绪的改善作用[J]. 重庆医学, 2016, 45(6): 787-789. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX201606021.htm WU G. Improvement role of short-range focus solving auxiliary group therapy for teenagers anxiety and depression emotions[J]. Chongqing Med, 2016, 45(6): 787-789. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX201606021.htm
[15]	徐文明, 梁芹生, 罗苏梅, 等. 焦点解决短期疗法改善大学生手机依赖的对照研究[J]. 中国特殊教育, 2017, 45(2): 78-83. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDTJ201702015.htm XU W M, LIANG Q S, LUO S M, et al. A Comparative study of the solution-focused brief therapy in the treatment of college students with mobile phone addiction[J]. Chin J Spec Educ, 2017, 45(2): 78-83. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDTJ201702015.htm
[16]	徐睿, 许文锋. 焦点解决短期治疗在公安院校大学生心理危机干预中的应用[J]. 学校党建与思想教育, 2017, 35(16): 48-50. https://www.cnki.com.cn/Article/CJFDTOTAL-XXDJ201716018.htm XU R, XU W F. Application of sfbt in psychological crisis intervention of police college students[J]. Party Build Ideologic Educ Sch, 2017, 35(16): 48-50. https://www.cnki.com.cn/Article/CJFDTOTAL-XXDJ201716018.htm
[17]	梁明明, 李晓敏, 曾超超, 等. 焦点解决团体治疗的应用与展望[J]. 重庆医学, 2017, 46(27): 3872-3874. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX201727044.htm LIANG M M, LI X M, ZENG C C, et al. Application and prospect of focus group therapy[J]. Chongqing Med, 2017, 46(27): 3872-3874. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX201727044.htm