CAJ | 학술논문

通过对572名连续4～16个月高强度军事训练的军人进行SCL-90测评，研究慢性军事应激条件下军人海马形态、认知、心理特质和特质应对方式的变化特征。将其中17例焦虑因子分三3分者（焦虑或伴焦虑）设为研究组（A），并以匹配法设对照组（B）。检测两组军人血皮质醇，并用MRI观察海马形态、检测简单和复杂认知作业功能、以STAI测评状态．特质焦虑及以CCSQ测评应对方式，探讨两组对应变化。研究结果显示：（1）血皮质醇：A、B组均高于正常水平，有差异显著，A组显著高于B组。（2）海马形态：A组与B组MRI海马形态标准化后，A组海马形态显著萎缩，与B组相比有显著性差异，但各组每个同体的左右两侧之间相比无显著性差异。（3）认知作业功能：A组简单认知作业成绩与B组无显著差异，但复杂认知作业成绩与B组相比有显著性差异。（4）状态-特质焦虑：A组的状态焦虑、特质焦虑分别与B组和常模比较均有显著变化，B组与常模相比状态焦虑变化显著，特质焦虑变化不显著。（5）应对方式：A组积极应对方式平均值低于B组和常模并有显著性差异，B组高于常模；A组消极应对方式平均值高于B组和常模且有非常显著性差异，B组与常模无显著改变。结论在慢性军事应激条件下，特质焦虑个体的海马形态出现双侧萎缩，复杂认知功能下降，更易发生状态焦虑，行为取向表现出积极应对方式降低、消极应对方式增加。
통과대572명련속4～16개월고강도군사훈련적군인진행SCL-90측평，연구만성군사응격조건하군인해마형태、인지、심리특질화특질응대방식적변화특정。장기중17례초필인자분삼3분자（초필혹반초필）설위연구조（A），병이필배법설대조조（B）。검측량조군인혈피질순，병용MRI관찰해마형태、검측간단화복잡인지작업공능、이STAI측평상태．특질초필급이CCSQ측평응대방식，탐토량조대응변화。연구결과현시：（1）혈피질순：A、B조균고우정상수평，유차이현저，A조현저고우B조。（2）해마형태：A조여B조MRI해마형태표준화후，A조해마형태현저위축，여B조상비유현저성차이，단각조매개동체적좌우량측지간상비무현저성차이。（3）인지작업공능：A조간단인지작업성적여B조무현저차이，단복잡인지작업성적여B조상비유현저성차이。（4）상태-특질초필：A조적상태초필、특질초필분별여B조화상모비교균유현저변화，B조여상모상비상태초필변화현저，특질초필변화불현저。（5）응대방식：A조적겁응대방식평균치저우B조화상모병유현저성차이，B조고우상모；A조소겁응대방식평균치고우B조화상모차유비상현저성차이，B조여상모무현저개변。결론재만성군사응격조건하，특질초필개체적해마형태출현쌍측위축，복잡인지공능하강，경역발생상태초필，행위취향표현출적겁응대방식강저、소겁응대방식증가。
Many organic functions will be changed undergoing chronic strong stress, especially in the continuous activation of the HPA axis, which results in successive high level of glucocorticoid in blood. Afterward it will make hippocampal neurons become atrophic and cognitive function impairment, which has been confirmed in laboratory. This investigation studied the morphological changes of hippocampus, cognitive functions and coping styles undergoing the chronic military stress. The present investigation was intended principally to study the characteristic changes in hippocampus morphology （MRI）, cognition （simple and complex cognitive function）, psychological trait （State-trait Anxiety Inventory, STAI） and coping style （Characteristic Coping Style Questionnaire, CCSQ） in chronic strong military stress. 572 soldiers were divided into the group of investigation （A） in accordance with Anxiety factor score in SCL-90 and the control group （B）. In group A, very soldier who＇s the anxiety factor score was over 3. In control group, the soldiers were selected via matching method according to that in group A. The results showed that the level of plasma cortisol in group A and B were higher significantly higher than normal and that in group A was were higher significantly higher than group B. After standardization, there was no significant structural difference between right and left hippocampus in same subject. But, the hippocampal structural atrophy in group A and there was significant structural difference between group A and group B. In cognitive function, there were no significant change in the simple cognitive assignments between group A and B but significant difference in negative coping style between group A and B. In STAI, the estimative scores of state anxiety and trait anxiety in group A were significantly higher than group B and normal. The estimative scores of state anxiety in group B were significantly higher than normal. The estimative score of positive coping style in group A was significantly lower and that of negative coping style was significantly higher than group B and normal. The estimative score of positive coping style in group B was significantly higher than normal. The present findings indicated that chronic strong military stress can induce hippocampal structural atrophy and insult in characteristic changes in some psychological trait, cognitive function and behavior.