ISSN 0439-755X
CN 11-1911/B

心理学报 ›› 2022, Vol. 54 ›› Issue (12): 1503-1516.doi: 10.3724/SP.J.1041.2022.01503

• 研究报告 • 上一篇    下一篇


王文超1, 原昊2,1, 伍新春1()   

  1. 1北京师范大学心理学部, 应用实验心理北京市重点实验室, 心理学国家级实验教学示范中心(北京师范大学), 北京 100875
    2深圳市坪山区同心外国语学校, 广东 深圳 518118
  • 收稿日期:2021-09-26 发布日期:2022-09-23 出版日期:2022-12-25
  • 通讯作者: 伍新春
  • 基金资助:

Co-morbidity patterns of posttraumatic stress disorder and depressive symptoms: A network analysis of post-earthquake primary and secondary school students

WANG Wenchao1, YUAN Hao2,1, WU Xinchun1()   

  1. 1Beijing Key Laboratory of Applied Experimental Psychology; National Demonstration Center for Experimental Psychology Education (Beijing Normal University); Faculty of Psychology, Beijing Normal University, Beijing 100875, China
    2Pingshan Foreign Languages School, Shenzhen 518118, China
  • Received:2021-09-26 Online:2022-09-23 Published:2022-12-25
  • Contact: WU Xinchun


为揭示灾后中小学生创伤后应激障碍(PTSD)和抑郁在症状层面的共存模式, 本研究分别在汶川地震和雅安地震1年后, 对灾区的中小学生进行问卷调查, 并基于高斯图形模型和贝叶斯爬山算法构建了二者的共存症状网络。结果发现, 在DSM-IV的框架下, PTSD和抑郁的重叠症状以及情绪麻木症状在二者的共存网络中起到了桥接作用; 子网络探测结果与DSM-IV划分的症状边界不同, PTSD中的闯入性症状和回避性症状是其区别于抑郁的特异性症状, 且多为闯入性症状激发回避性症状; 在二者的共存模式中, 多为抑郁症状激发PTSD症状。上述结果在汶川和雅安两个样本中均得到了交叉验证, 具有一定的可推广性。

关键词: 创伤后应激障碍(PTSD), 抑郁, 网络分析, 中小学生


Post-traumatic stress disorder (PTSD) and depression have high rates of co-morbidity among primary and secondary school students who have experienced a major natural disaster. Some researchers have suggested that overlapping symptoms and dysphoria symptoms of PTSD contribute to co-morbidity, while others have attempted to explain the co-morbidity through a causal relationship between them. However, most of these studies have been based on the hypothesis of common causes, explaining co-morbidity at level of disorders or dimensions, while few studies have investigated patterns of the co-morbidity from the perspective of symptoms.

The Child PTSD Symptoms Scale (CPSS) and Center for Epidemiologic Studies Depression Scale for Children (CES-DC) were administered to two samples of primary and secondary school students one year after the earthquake (Wenchuan earthquake, N = 2530, 47.0% males, Mage = 12.86, SD = 1.96; Ya'an earthquake, N = 723, 47.7% males, Mage = 13.40, SD = 2.29). Gaussian graphical models (GGM) and Bayesian hill climbing algorithms were used to describe patterns of the co-morbidity between PTSD and depression.

Overlapping symptoms and emotional numbness were the bridging symptoms. Detachment and future- limited symptoms were bridge symptoms in DSM-IV, were not bridge symptoms in the absence of DSM-IV, and fear, startle response and hypervigilance symptom were bridge symptoms. DSM-IV inaccurately defines the boundaries of PTSD, while intrusion and avoidance symptoms are core symptoms of PTSD. Depressive symptoms were more likely to trigger PTSD symptoms, while intrusive symptoms triggered avoidance symptoms.

The above findings were cross-validated in both Wenchuan and Ya'an samples, enhancing the generalizability of the findings and responding to the reproducibility crisis of psychological research. This enlightens clinical practitioners to prioritize the identification of bridging symptoms in the early assessment of clients who have suffered from traumatic events, in order to screen out clients at high-risk of co-morbid with depression. Secondly, the bridge symptoms should also be used as a breakthrough in the intervention process to develop intervention strategies. Finally, during the prognostic process, special attention should be paid to the recurrence of bridging symptoms to prevent the re-emergence of co-morbidity.

Key words: PTSD, depression, network analysis, primary and secondary school students