高低受災成人之創傷後心理症狀與社會心理變動：九二一集集地震三個月後的比較研究

Trauma and Psychosocial Aftermath among High- and Low-Exposure Adults Three Months post the 921 Chi-Chi Earthquake in Taiwan

本研究的目的旨在瞭解九二一地震三個月後，受災輕重程度不同的地區之成人在地震發生當下的身心反應、創傷後心理症狀、與短期內受創者之身心健康、人際關係、以及人生觀的改變狀態。本研究選取居住在台中縣及南投縣兩區的197名高受災區成人與台北郊區的117名低受災區成年居民為受試，以地震損傷問卷、災難當下的身心反應量表、PTSD症狀指標量表、與震災後社會心理變動問卷為工具。研究結果顯示：（1）高受災區成人不僅在地震發生當下出現較多的身心反應，同時在震災三個月後也呈現出較多的創傷後心理症狀；（2）高受災區成人雖也呈現與心理病理有關之負面反應現象，但朝向正面的人際網絡與積極人生觀之轉變的人數比例也不容輕忽。最後，本研究指出創傷後心理復健計畫宜以揭顯創傷經驗的正向性與適應性之轉化過程為依歸。

This study evaluated the peri-and post-traumatic psychological responses as well as changes of physical and psychological health, outlook on life, and interpersonal relationships three months after the devastating 921 Chi-Chi Earthquake among two groups of middle-aged adults in Taiwan. One hundred and ninety-seven adults from high-impact areas, Taichung and Nantou Counties, and 117 adults from Taipei, a low-imapct area, were evaluated. Self-report measures included demographic and earthquake exposure information, the Peritraumatic Psychological Reaction Index (PPRI), the Posttraumatic Stress Reaction Index (PTSRI), and the Psychosocial Change Questionnaire (PCQ). The results indicated that: 1) high-exposure adults manifested significantly more immediate and persistent posttraumatic psychological responses, and endorsed more negative reports concerning physical/psychological health and intimate/general interpersonal relationships; and 2) while previous trauma studies often reported more negative and pathology-toned behavioral manifestations, this study found both positive and negative changes among high-exposure adults after the disaster. Regarding outlooks on life, there were relatively equal proportions of high-exposure adults becoming more optimistic, staying unchanged, and becoming more pessimistic. Similar trisection patterns were noted in their interpersonal relationships, i.e., getting closer, staying unchanged, and getting more distant/detached. This study demonstrates the utility of the instruments in evaluating individuals affected by natural disasters and feasibility of developing psychometrically sound measures for future study on traumatic responses and treatment. The results also suggest the importance of implementing post-disaster psychosocial rehabilitation programs aimed at transformation of traumatic experiences into a more adaptive direction.