災難因子與心理症狀間之關係－以921地震為例

The Relationship of Disaster Factors and Psychological Symptoms-The Example of Chi-Chi Earthquake in Taiwan

10.6550/ACP.200406_1(1).0004

許文耀(Wen-Yau Hsu)；曾幼涵(Yo-Han Tzeng)

災難 ； 多變危險因子模式 ； 心理症狀 ； 921地震 ； Disaster ； Multivariate Risk Factor Model ； Psychological Symptoms ； Chi-Chi Earthquake

臨床心理學刊

1卷1期（2004 / 06 / 30）

30 - 39

繁體中文

目的：本研究依據Freedy等人(1992)提出之「多變危險因子模式」，將影響災民心理健康的因素分成災難前（如性別、年齡等人口學變項）、災難當下（災難暴露程度及對災難的主觀感受）及災難後（次級壓力資源、因應方式、社會支持及資源流失）三大類，並試圖了解此三類災難因子如何影響不同時間點的災難後心理症狀。 方法：本研究於921地震後約兩年在地震災區－埔里收集了354位受試，於隔年再做追蹤（流失率約四成，但兩時間之樣本在背景變項上差異不大），並以階層迴歸分析計算三類災難因子對兩時間點的四種心理症狀（身心症候群、惡兆預測／影像反覆、刻意逃避／心理麻木、功能不良之因應）之解釋力。 結果：在第一時間點，災難後因子對四類心理症狀之解釋力均較災難前及災難當下因子為高；而在第二時間點，控制了第一時間點之同類症狀後，災難前、災難當下以及第一時間點的災難後因子對第二時間點的各類症狀之影響相對較小，而第二時間點的災難後因子依然對四類症狀提供了最高的解釋力。 結論：此研究結果說明，災難本身雖會立即影響到人們的身心健康，但這種影響是否會持續惡化，受到創傷所衍生之次級壓力的影響。

Objective: In the multivariate risk factor model, Freedy et al. (1992) suggested that three important variables will influence the health of people after a disaster. These are pre-disaster factors (e.g., sex, age), within-disaster factors (e.g., the degree of disaster exposure and subjective feelings about the disaster) and post-disaster factors (e.g., secondary stressors, coping, loss of resources, and social support). This study examined how these three variables affected the psychological symptoms of people after the Chi-Chi earthquake at two different times. Method: This study collected data from 354 subjects two years after the earthquake and from 222 subjects at a one-year follow-up. Although there was an attrition rate of 37.3%, there was no significant difference between the initial and final subject samples on most background variables. Results: Results of hierarchical regression analysis showed that pre-disaster and within-disaster variables only accounted for little variance on psychological symptoms (psychosomatic complaints, re-experiencing, avoidance and maladaptive adjustment) at time one, while the post-disaster variable accounted for the most variances. At time two, after controlling for psychological symptoms at time one, little variance was contributed by pre-disaster, within-disaster, and time one post-disaster variables; instead the time two post-disaster variable accounted for the most variance. Conclusion: Results from this study suggest that while the disaster itself has immediate effects on psychological health, stresses after the disaster have even more detrimental effect.

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