Exploratory Study On PTSD And Influence Factors Caused By Severe Acute Stress In Shidu Parents

BackgroundsSevere acute stress is a sharp,unexpected,or dangerous situation,which generally causes short-run and long-term traumatic responses to the individuals,seriously influcing the physical and mental health.Contemporary society is sometimes portrayed as dominated by the experience of high risk.Losing the only child takes away all the hope of the family,meaning a great blow to their parents,which is a kind of serious acute stress.At present,there are more than one million Shidu families in our country.They are stepping into old age,and their mental health problems become a hot research topic.Therefore,it is of great social significance to systematically study the psychological problems of Shidu parents.ObjectivesThis study attempted to systematically explore long-term effects of severe acute stress in Shidu parents,including Posttraumatic Stress Disorder(PTSD),Prolonged Grief Disorder(PGD),depression and general mental health problems.Further,we explored the influence factors of psychological reaction posttrauma:1)Demographic factors,including gender,age,marriage,education,religion and family income;2)Trauma exposure factors: the age,gender,cause of death and time history of the lost child;3)Suicidal ideation in early days post loss and Sense-making.We analyzed which factors were risk factors that led to the psychological problems,and which factors were the protective factors of psychological health,to provide empirical evidence for the early identification of susceptible to psychological problems among Shidu parents and enacting corresponding strategy.MethodsTwo kinds of experimental design,case-control and cross-sectional study,were used in this study.A stratified random sample of 100 Shidu parents was draw from all streets in Yangpu District of Shanghai,in the case-control study.Normal parents according to the ratio of 1:1 were selected randomly as control group from the same area with demographic data matched with the case group.Adopting questionnaire investigation and interview survey,we household survey accompanied by social workers.The PTSD Checklist-Civilian version(PCL-C),the Center for Epidemiological Studies Depression Scale(CES-D),General Health Questionaire-12(GHQ-12)and physical health questionnaire were adopted as the target.On the basis of the case-control study,the cross-sectional study expanded sample size to 155 Shidu parents.PCL-C,Prolonged Grief-13(PG-13),CES-D,GHQ-12,Demographic data questionnaire,lost children questionnaire,early Suicide Ideation and Sense-making questionnaire were adopted as the target.Results1.The scores of PCL-C?CES-D?GHQ-12 of Shidu parents were statistically significantly much higher than the normal parents.And the prevalence of common chronic diseases of Shidu parents were statistically significantly much higher than normal parents: Coronary Heart Disease(28.4% VS 3.1%),Tumors(7.4% VS 1.0%)and other non-classified diseases(11.6% VS 2.1%).2.The incidence of PTSD?PGD?Depression and General Health problems of Shidu parents was separately 30.87%,28.86%,30.87%and 33.56%.PTSD was co-morbided with other mental health problems.The highest co-morbidity existed between PTSD and PGD,reaching 24.83%,followed by the co-morbidity of PTSD and Depression,which was 24.16%?3.Gender observably impacted the mental health problems of Shidu parents,and the scores of psychological scales of the famale is remarkably higher than the men's: PCL-C(47.24 VS 35.85,P<0.001),PG-13(31.52 VS 24.53,P<0.001),CES-D(18.76 VS 9.59,P<0.001),GHQ-12(4.01 VS 1.92,P<0.001).Women were more likely to suffer from PTSD,PGD,Depression and General Health problems,and the risk ratio was separately 3.878,3.373,3.267 and 2.470.4.Low-income was another risk factor which affect the PTSD,PGD,Depression and General Health problems of Shidu parents,compared to the higher income earners: PCL-C(47.33 VS 40.12,P<0.01),PG-13(31.93 VS 26.95,P<0.01)and CES-D(17.13 VS 13.99,P<0.05).The low-income earners were more likely to suffer from PTSD and Depression,with the risk ratio to be 2.323 and 2.034.5.The causes of the only child's death affect the PTSD symptoms of Shidu parents.The score of PCL-C of parents whose child died by accident was higher than them who had a child died of illnesses.The accidental death of the only child effects the Depression symptoms of Shidu parents,with CES-D(19.24 VS 13.51,P=0.06).6.The age of the lost children and time history post loss significantly impacted the symptoms of PTSD,PGD and Depression of Shidu parents.The PTSD,PGD and depressive symptoms were more severe in the parents whose children died on an older age.And parents' PTSD,PGD,and depressive symptoms eased over time.7.Early Suicide Ideation was an important warning factor that gives rise to Shidu parents' PTSD,PGD,Depression and General Health problems.The scores of PCL-C?PG-13?CES-D?GHQ-12 were higher in the high-SI group than low-SI ones.8.Sense-making was a protective factor to the psychological health of Shidu parents.Having Searched for positive meaning(SP)and Found positive meaning(FP)were negatively correlated with the scores of PCL-C,PG-13,CES-D and GHQ-12.9.The analysis of multivariate linear stepwise regression was adopted,with PCL-C scale score as a dependent variable,and female,low income levels,accidental death of children,lost adult offspring,time history post loss,Early Suicide Ideation,sense-making as the independent variables.The independent variables could explain 40.3% of the total variation.The contribution rate of Early Suicide Ideation and sense-making was highest,reaching 18.5%.And Early Suicide Ideation was an important early warning factor for Shidu parents' PTSD symptoms.Conclusions1.Having lost the only child seriously affected the parents' mental health and physical health.The incidence of PTSD?PGD?Depression and General Health problems of Shidu parents was significantly much higher than normal parents.So was the prevalence of common chronic diseases(Coronary Heart Disease,Tumors and other non-classified diseases).2.Female,low income levels,accidental death of children,lost adult offspring,duration post loss and Early Suicide Ideation were risk factors affecting the psychological health of Shidu parents,and Early Suicide Ideation was an important early warning factor for Shidu parents' PTSD symptoms.3.Sense-making is a protective factor to the psychological health of Shidu parents.Searched for positive meaning and already Found positive meaning could help the parents recover from the trauma of lost the only child.