一至五歲幼童九二一震災三年後之心理健康研究

Mental Health Problems of 1-5 Year-Old Children Exposed to 921 Earthquake：3 Years Later

畢新慧(Shin-Huey Bih)

指導教授 ： 宋維村

國立臺灣大學/醫學院/臨床醫學研究所/碩士(2004年)

https://doi.org/10.6342/NTU.2004.00039

摘要

中文摘要：
目的：研究921地震時1-5歲幼童在地震後三個月創傷後障礙症（PTSD）症狀及 PTSD診斷，及與震災暴露經驗之關係；並研究地震後三年兒童之情緒行為問題，及其與幼童氣質特性、震災暴露經驗，幼童PTSD症狀，家長健康，家庭功能、家庭壓力之關係。

方法：選取台中縣東勢鎮921地震時1-5歲，研究時就讀一所公立托兒所和三所小學的853名兒童為研究對象，以自編之地震經驗問卷、PTSD幼兒問卷、兒童行為檢核表（CBCL）、中國人健康問卷（CHQ-12），家庭凝聚力及適應力量表（FACES-III）及家庭生活事件與變化問卷（FILE）為研究工具。經取得父母書面同意後，由主要照顧者填寫。問卷回收後之資料，以描述性統計，T檢定，邏輯式迴歸，線性迴歸，階層式迴歸分析資料，驗證目的所述各項。

結果：1.有效樣本712人，其中17.1%至少有一項震災暴露經驗，7.9%有兩項、2.01%有三項、0.8%有四項。震災暴露無年齡和性別差異。
2.有62人(8.7%)合於Sherringa等人(1995)幼童PTSD診斷準則。PTSD的症狀中，以新的恐懼/攻擊、重新經驗和機警的出現率較高，麻木症狀少出現。
3.幼童氣質特性（A,C兩種）、震災暴露經驗和PTSD症狀數有顯著關係。
4.CBCL得分和震災暴露經驗僅有極小關係，和幼童氣質特性（A,B兩種）、震災暴露經驗、幼童PTSD症狀、家長健康、家庭壓力有小而顯著之關係。

結論：重大天然災害對1-5歲幼兒會增加其PTSD症狀及PTSD發生率，PTSD症狀會影響兒童三年後的行為和情緒問題，應進一步研究其影響之相關機轉及保護之因素。

關鍵字

家庭壓力 ； 幼童 ； 創傷後障礙症 ； 震災暴露 ； 情緒行為問題 ； 父母心理健康

並列摘要

ENGLISH ABSTRACT：
Objectives: To study the PTSD symptoms in young children 1-5 years of age during 921 Earthquake and their relation to earthquake exposure(EE) experience. The study also explored the behavioral emotional problems of these children three years later and their relation with EE experience, PTSD symptoms , parental mental health, and family stressors.

Method: EE experience and PTSD symptoms of child, CHQ-12 for parent, FACES-III and FILE were completed by parents or main caregivers of 712 children who were 1-5 years of age during 921 Earthquake.

Result: 1. Valid sample is 712 used in analysis. 17.1% of them had at least 1 EE experience.
2. 62 (8.7%) fulfilled PTSD criteria for young children (Sherringa et al., 1995). Among PTSD symptoms, new Fears/Aggression, Reexperiencing and Arousal are more common, while Numbing is rarely observed.
3. Temperament of Child（Cluster A,C）and EE experience are significantly associated with PTSD symptoms 3 months after the quakes.
4. CBCL scores are marginally associated with EE experience. CBCL scores are significantly predicted by Temperament of Child（Cluster A,B）, PTSD score, Parental CHQ, and intrafamily strains
.
Conclusions. 1. Earthquake will increase PTSD among young Children. 2. PTSD predicts children’s later emotional behavioral problems.

並列關鍵字

family stress ； parental mental health ； emotional and behavioral problem ； earthquake exposure ； young children ； PTSD

參考文獻

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