疫情特殊群体压力累积与应激
文献类型：学位论文
| 作者 | 贾琳 |
| 答辩日期 | 2024-06 |
| 文献子类 | 博士 |
| 授予单位 | 中国科学院大学 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 韩布新 |
| 关键词 | 压力累积 应激 COVID-19 习惯化 敏感化 |
| 学位名称 | 理学博士 |
| 学位专业 | 发展与教育心理学 |
| 其他题名 | Stress Accumulation and Stress Reactions of Special Groups during the COVID-19 Pandemic |
| 中文摘要 | The acute respiratory syndrome (COVID-19) triggered by a novel coronavirus (SARS-CoV-2) in December 2019 spread rapidly among the population, causing a global pandemic. The new coronavirus mutates rapidly and spreads widely, and in contrast to previous public health events, its repeated outbreaks are prone to cause repetitive stress reactions. Which continually threatens the mental health of the global population. Therefore, it is urgent to explore the mechanisms by which epidemic stress accumulates affect the mental health of the population. At the beginning of the outbreak, the first cohort of discharged patients suffered from health decline, property loss, and damage of social relationships. During the period of normalization of epidemic prevention and control, every time an epidemic strikes, epidemic prevention and control personnel need to rush to the front line to respond. These two groups are deeply affected by repetitive stress from the epidemic, so their mental health needs special attention. Repetitive stress studies are expected to help stress research shift from phenomenology to mechanism. However, repetitive stress studies are difficult to be experimentally manipulated by the ethical norm. Retrospective research points to a cumulative effect of the adverse effects of traumatic events on mental health. Animal physiological experiments summarize sensitization and habituation responses. Sensitization is the enhancement of the stress response with increasing stress and is associated with psychological trauma; habituation is the weakening of the stress response with increasing stress and is related to evolution, adaptation, and psychological resilience. These findings still need to be verified for their applicability to human populations. The recurrent stress brought about by the COVID-19 epidemic just provides an opportunity to scientifically study the cumulative effects of stressful events on psychological and physiological stress in real-world situations. Exploring epidemic stress accumulation and stress can help to reveal the psychological and physiological mechanisms when humans are exposed to repetitive stress, i.e., how does stress develop into psychological trauma? How to prevent the accumulation of repetitive stress from forming psychological trauma? This is not only valuable for advancing research in the field of stress, but also an important topic for maintaining and promoting the mental health of the whole population in the post-pandemic era. Therefore, this paper combs through previous theories of emotion, stress, and trauma to propose an event-processresponse model of stress and uses three studies (five sub-studies) to explore three questions based on that model: (1) Does the accumulation of epidemic stress trigger a habituation or sensitization response to psychological stress? (2) Which psychological factors mediate the accumulation of epidemic stress and the habituation/sensitization response to psychological stress? (3) How do repeated epidemics affect the physiological stress mechanisms of habituation/sensitization? Study 1 used two sub-studies to explore the relationship between subjective/objective stress accumulation and psychological stress in the first cohort of discharged COVID-19 patients, respectively. The results found that both subjective stress accumulation (self-rated degree of life change) and objective stress accumulation (number of COVID-19 sequela) increased the risk of depression, anxiety, and posttraumatic stress disorder. Results suggest that social support partially mediated the sensitization response of psychological stress in terms of subjective stress accumulation. Study 2 used two sub-studies to explore the relationship between stress accumulation from different life events/stress accumulation from repetition of the same event and psychological stress among community workers, respectively. The first substudy found that an increased number of life events triggered by the epidemic was associated with an increased risk of anxiety, depression, and post-traumatic stress disorder, with psychological security playing a partially mediating role. The second sub-study found that repeated COVID-19 outbreaks were associated with decreased risk of anxiety, depression, and PTSD, with psychological security and emotion regulation fully mediating. It was shown that psychological security partially mediated the accumulation of life event stress and the sensitization response to psychological stress, and psychological safety and emotion regulation fully mediated the recurrent epidemic and the habituation response to psychological stress. Study 3 further explored the relationship between epidemic recurrence and physiological stress. Results found that epidemic recurrence was associated with reduced hair cortisol levels. After controlling for baseline levels, community workers who experienced two outbreaks within six months had significantly lower hair cortisol levels compared with those who experienced fewer COVID-19 outbreaks. A steeling response was found in physiological stress after repeated COVID-19 outbreaks. Fluctuating trends were observed in the hair cortisol levels of Beijing community workers in the months when epidemic outbreaks. It suggests that hair cortisol is an effective indicator for detecting the effects of repeated epidemics on physiological stress and that community workers may have alternative reinforcing responses to the COVID-19 outbreak. Combined analysis of physiological and psychological stress indicators revealed no correlation between hair cortisol level and psychological stress. However, high volatility of hair cortisol content trajectories within six months was associated with higher anxiety. The possibility of using cortisol trajectory volatility to predict psychological stress is suggested. This paper verifies the habituation and sensitization effects of repeated stressful events in humans and finds that both subjective and objective stress accumulation is associated with sensitizing responses to psychological stress. While the accumulation of different stressful events increases the sensitization response to psychological stress, the repetition of the same event reduces psychological stress and induces a habituation response. In addition, this paper validates the event-process-response model of stress and finds that psychological factors mediate between stress accumulation and psychological stress. Interpersonal secure connections and better emotional regulation are important factors that promote psychological adaptation when people repeatedly face untoward encounters. Physiological data support the habituation response to the same event repeatedly with stress, and the possibility of using longitudinal variability in physiological stress to predict psychological stress is also explored in the paper. The above findings can be used to inform the maintenance and promotion of mental health in the population during current and future major health emergencies, and also provide more ecologically valid evidence to unravel the psychological and physiological mechanisms of stress and trauma. |
| 英文摘要 | 2019 年 12 月新型冠状病毒（SARS-CoV-2）引发急性呼吸综合征（COVID19）在人群迅速传播，构成全球性大流行病。新冠病毒变异快、传播广，对比以往公共卫生事件，其反复暴发易引起重复应激反应，持续威胁全球居民心理健康。 因此，探讨疫情压力累积影响民众心理健康机制有现实紧迫性。疫情暴发初期， 首批康复患者遭遇健康下滑、财产损失、社会关系损坏。疫情防控常态化时期， 每次疫情发作，疫情防控人员均需冲上一线响应。两类群体受疫情影响深，重复应激多，心理健康需特别关注。重复性应激研究有望助力应激研究从现象学向机 制转变。然而，重复应激研究不宜实验操纵。回溯调研指出创伤事件累积心理健康不良影响。动物生理实验总结敏感化和刚化反应。敏感化，也称敏化，指随应 激次数增加，应激反应增强，关乎心理创伤；习惯化，也称敏化，是随应激次数增加，应激反应减弱，关乎进化、适应和心理弹性。这些结论在人类被试群体的 适用性仍需验证。 新冠肺炎疫情持续、反复带来重复性应激，也提供科学研究现实情境人类心理、生理应激受压力事件累积影响机会。探讨疫情压力累积与应激有助于揭示人 类遭遇重复性应激过程心理、生理机制，即应激如何发展为心理创伤？如何预防 重复应激累积形成心理创伤？这不仅对推动应激领域研究有重要价值，也是后疫 情时代维护和促进全民心理健康重要课题。因此，本文梳理以往情绪理论、应激 理论和创伤理论，提出应激事件-过程-反应模型，并用三个研究（5 个子研究） 在该模型基础上探讨三个问题：（1）疫情压力累积引发心理应激习惯化反应还是 敏感化反应？（2）哪些心理因素在疫情压力累积和心理习惯化/敏感化反应中起 中介作用？（3）疫情反复如何影响习惯化/敏感化生理应激机制？ 研究一用两个子研究分别探讨新冠康复患者主观压力累积和客观压力累积与心理应激关系。结果发现无论主观压力累积（自评生活改变程度）还是客观压力累积（新冠后遗症数量）均增加抑郁、焦虑和创伤后应激障碍风险，社会支持部分中介主观压力累积与心理应激的敏感化反应。 研究二用两个子研究分别探讨不同生活事件压力累积和同一事件反复造成压力累积与社区工作者心理应激关系。第一个子研究发现，疫情引发生活事件数 量增多与焦虑、抑郁和创伤后应激障碍风险增加有关，心理安全起部分中介作用。 第二个子研究发现，疫情反复与焦虑、抑郁和创伤后应激障碍风险降低有关，心理安全和情绪调节起完全中介作用。表明心理安全部分中介生活事件压力累积与 心理应激的敏感化反应，心理安全和情绪调节完全中介疫情反复与心理应激的习 惯化反应。 研究三进一步探讨疫情反复与生理应激关系。结果发现疫情反复与头发皮质醇水平降低有关。控制基线水平后，半年内经历两次疫情社区工作者头发皮质醇 含量显著降低。表明疫情反复对生理应激习惯化反应。追踪数据显示，疫情暴发月份北京市社区工作者头发皮质醇含量均呈现波动趋势；说明头发皮质醇是探测疫情反复对生理应激影响的有效指标，社区工作者可能出现替代性强化反应。联合生理、心理应激指标分析表明，头发皮质醇含量与心理应激无相关关系，然而，半年内头发皮质醇含量轨迹波动性高与焦虑有关；提示用皮质醇轨迹波动性预测心理应激可能性。 本文验证人类对重复应激事件的习惯化和敏感化效应，发现主、客观压力累积均与心理应激敏感化反应有关。不同压力事件累积增加心理应激敏感化反应， 同一事件反复却会减轻心理应激，引起习惯化反应。此外，本文验证应激事件-过 程-反应模型有效性，发现心理因素在压力累积与心理应激起中介作用。人际安全联结及较好情绪调节是人反复面对不测遭遇时促进心理适应重要因素。生理数 据支持同一事件反复与应激习惯化反应，文中同时探讨用生理应激纵向变异性预 测心理应激可能性。以上发现可供当前和未来重大卫生突发事件期间维护和促进民众心理健康参考，也为揭示应激与创伤心理、生理机制提供了更具生态效度证据。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/47987]  |
| 专题 | 心理研究所_健康与遗传心理学研究室 |
| 推荐引用方式 GB/T 7714 | 贾琳. 疫情特殊群体压力累积与应激[D]. 中国科学院心理研究所. 中国科学院大学. 2024. |
入库方式： OAI收割
来源：心理研究所
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