| ObjectiveChina has a vast territory with a plateau border of more than 4,000 kilometers.It is the country with the largest plateau area and the highest altitude in the world.There are many countries bordering China in plateau areas with a complex and changeable situation.The plateau is an important military strategic location for our country.Recruits are an important part of plateau soldiers.Their physical and mental qualities are more demanding than others.Good mental quality is an important guarantee for recruits’ combat capability.The special natural and social environment of plateau brings great physical and mental pressure to soldiers.Recruits who rush to the plateau not only face the adapting to the plateau environment,but also stay in the process of continuous adaptation to the military environment.Faced with huge physical and mental pressure,their physical and mental health,especially the mental adaption problems should be taken into consideration seriously.Most of the previous studies only conducted a cross-sectional survey on the mental health of plateau soldiers.There were few dynamic tracking studies.These studies concentrated on soldiers stationed in the plateau more than soldiers rushing into the plateau and more more than recruits rushing into the plateau.Therefore,this study will take recruits rushing into the plateau as the research subjects,conducting a dynamic follow-up survey on the mental health of recruits at different time points,analyzing their mental health characteristics and dynamic changes,and eventually providing support for scientific and effective training program on the their physical and mental adaptation.Methods800 recruits from a certain unit who rushed into the plateau was selected with cluster sampling as the research subjects,among whom 500 recruits were grouped as the fixed tracking sample.The test conducted at 3 time points: the training period,the initial period of rushing into the plateau,and 3 months after entering the plateau.Status-trait anxiety Questionnaire(STAI),Self-rating Depression Scale(SDS),Athens Insomnia Scale(AIS),PTSD Checklist-Civilian Version(PCL-C),Nervousness Factor Scale(Nf),Barratt Impulsiveness Scale-11 th version(BIS-11-C),Self-rating Idea of Suicide Scale(SIOSS),etc.were used as evaluation tools to track and investigate the dynamic changes of the state-trait anxiety,depression,insomnia,high altitude reaction and other dynamic changes of recruits rushing into the plateau.At the same time,the self-compiled mental health needs questionnaire was used to investigate the needs of mental health service in order to providing a basis for the psychological service for recruits.Results1.The initial characteristics of state-trait anxiety and depression of the recruits rushing into the plateau(1)The positive rate of state anxiety for recruits rushing into the plateau is 30.1%,the positive rate of trait anxiety is 31.4%,and the positive rate of depression is 19.5%.(2)The scores of SDS of plateau recruits were significantly higher than those of plain recruits(P<0.01).Scores of SAI and TAI were significantly lower than those of plain recruits(P<0.01).(3)The TAI scores of the recruits "≤18 years" group were significantly higher than that of the "≥21 years" group(P<0.05).TAI scores of the high school(or technical secondary school)and below group were significantly higher than the junior college and above group(P<0.05).(4)State anxiety were positively correlated with post-traumatic stress disorder,insomnia,neurotism and high altitude sickness.Trait anxiety were positively associated with post-traumatic stress disorder,insomnia and neurotism.The depression were positively correlated with post-traumatic stress disorder,neurotism and high altitude sickness.2.The phase characteristics of state-trait anxiety and depression of recruits rushing into the plateau(1)There was a significant phase difference in the anxiety positive rate and STAI scores(P<0.01).The state-trait anxiety scores showed a decreasing trend,while the depression scores increased firstly and then decreased.(2)Except for the SDS scores of "20 years old" and "≥21 years old" groups,the phase changes of STAI and SDS scores of the other age groups were significantly different(P<0.05).Except for the TAI scores of the "20 years old" and "≥21 years old" groups,the STAI scores of the rest of the age groups during the training period and the initial period of rushing into the plateau were significantly higher than those of the 3 months after entering the plateau(P<0.05).The TAI scores of the "≥21 years old" group were significantly higher than those of 3 months after entering the plateau(P<0.05),but there was no significant difference compared with the initial period of rushing into the plateau(P>0.05).During the training period,the SAI scores of the "19 years old" and "20 years old" groups were significantly lower than those of the "≤18years old" group.The TAI scores of "≤18 years old" were significantly lower than other groups(3)For SAI and TAI scores of high school(or technical secondary school)and below group: SAI in training period > initial period of rushing into the plateau > 3 months after entering into plateau(P<0.05).For junior college and above group: SAI and TAI scores in training period and initial period of rushing into the plateau were significantly higher than that of3 months after entering the plateau.TAI scores of the high school(or technical secondary school)and below group were significantly higher than that of the junior college and above group during the training period(P<0.05).SDS scores during the training period and the initial period of entering the plateau were significantly higher than those of 3 months entering the plateau(P<0.05).(4)For SAI and TAI scores of recruits from the western area: the training period> initial period of entering into the plateau > 3 months after entering the plateau(P<0.05).During the initial period of rushing into the plateau,the scores of SAI and SDS of eastern recruits were significantly higher than those of western and central recruits(P<0.05)).(5)The SAI scores of the recruits of parents group showed a gradual decline over time(P<0.05).The TAI scores were highest in the initial period of rushing to the plateau and the lowest during the 3 months after entering the plateau.SAI and TAI scores of the recruits of the single parent group in the training period and the initial period of rushing into the plateau were significantly higher than those of 3 months after entering the plateau(P<0.05).There was no significant difference of SDS scores during the training period and the initial period of rushing into the plateau(P>0.05),but the scores significantly reduced after entering the plateau 3 months later(P<0.05)(6)The scores of SAI,TAI,and SDS of recruits who were left-behind children did not change significantly during the training period and the initial period of rushing into the plateau(P>0.05),but significantly decreased 3 months after entering the plateau(P<0.05).The scores of recruits’ state anxiety and trait anxiety who had no left-behind children experience showed a gradual decreasing trend over time(P<0.01).There was no significant difference in depression scores between the training period and the initial period of rushing into the plateau(P>0.05),but the scores decreased significantly 3 months after entering the plateau(P<0.05).3.The characteristics of insomnia changes of recruits(1)The total AIS scores of recruits showed significant phase changes(P<0.01),of which the highest were in the initial period of rushing into the plateau,and the lowest were 3 months after entering the plateau.(2)The phase changes of the total AIS scores of each age group are significantly different(P<0.01),of which the highest were in the initial period of rushing into the plateau(P<0.05).(3)The total AIS score of the "high school(or technical secondary school)and below" group at the initial period of rushing into the plateau > the training period> 3 months after entering the plateau(P<0.05).For junior college and above group,it was higher than the training period and 3 months after entering the plateau(P<0.05).During the initial period of rushing into the plateau,the total AIS scores of the "junior college and above" group was significantly higher than those of the "high school(or technical secondary)and below group(P<0.05).(4)The total AIS scores of the recruits from the western area: the initial period of rushing into the plateau > the training period > 3 months after entering the plateau(P<0.05).The total scores of the recruits from the eastern area were significantly higher than those from the central and western area(P<0.05).(5)The total AIS scores of recruits with different family structures are significantly different at different periods of rushing into the plateau(P<0.01): the initial stage of the rushing into the plateau > the training period > 3 months after entering the plateau(P<0.05).(6)The total AIS scores of recruits with no left-behind children’s experience: the initial period of rushing into the plateau> the training period> 3 months after entering the plateau(P<0.05).The total scores of insomnia of recruits with left-behind children’s experience during the initial period of rushing into the plateau were significantly higher than those in the training period.The total AIS scores of recruits with no left-behind children’s experience were significantly lower than those of left-behind children’s recruits during period of 3 after entering the plateau(P<0.05).4.Phase changes of suicide ideation of recruits(1)The positive rate of suicide ideation among recruits was 1.7%～2.8%.There was no significant difference in the positive rate of suicide ideation at each stage of rushing to the plateau(P>0.05).(2)Except for the optimism factor,the difference in the scores of the suicidal ideation factors were statistically significant(P<0.01).Scores of the despair factor,sleep factor and the total scores of SIOSS during the training period and the initial period of rushing into the plateau were significantly higher than those of the 3 months after entering the plateau.(P<0.05).(3)Except for the "21 years old" group,the total SIOSS scores of the other age groups were significantly different(P<0.05).During the training period,the total scores of "≤18 years" and "19 years old" were significantly higher than "20 years old" group(P<0.05).(4)The phase changes of SIOSS scores of high school(or technical secondary school)and below group were statistically significant(P<0.01).The scores of training period and the initial period of rushing into the plateau were significantly higher than those of the 3 months after entering the plateau(P<0.05).The differences in SIOSS scores at the level of education were not significant(P>0.05).(5)The changes in SIOSS scores of recruits from different areas were statistically significant(P<0.05).For recruits from the western area,the scores of training period and the initial period of rushing into the plateau were significantly higher than those of the 3 months after entering the plateau(P<0.05).(6)The SIOSS scores of recruits with different family structures were significantly different at different phases of the rushing into the plateau(P<0.01).The SIOSS scores of the recruits in the parents group during the training period and the initial period of rushing into the plateau were significantly higher than those of 3 months after entering the plateau(P<0.01).The SIOSS score of recruits in the single parent group decreased during 3 months after entering the plateau(P<0.05).(7)The SIOSS scores of recruits who had left-behind children’s experience or not had significant differences at different phases(P<0.01).(8)The SIOSS scores of recruits in the "non-only child" group during the training period and the initial period of rushing into the plateau were significantly higher than those in the 3 months after entering the plateau(P<0.01).The phase difference in the "only child" group was not significant(P>0.05).During the same stage,the differences of SIOSS scores in different structure of children were not significant(P>0.05).5.The dynamic characteristics of post-traumatic stress response in recruits(1)The positive rate of post-traumatic stress disorder in recruits was 1.9%～4.0%.There was no significant difference in the positive rate of PTSD in each period(P>0.05).(2)The PTSD scores of recruits entering the plateau had significant changes in periods(P<0.01).Both the training period and the initial period of the rushing into the plateau are significantly higher than those of 3 months after entering the plateau(P<0.05).(3)The PTSD scores of the "≤18 years old" and "19 years old" groups showed significant differences(P<0.05).The "≤18 years old" PTSD scores at the initial period of rushing into the plateau were significantly higher than those of 3 months after entering the plateau(P<0.05)).The "19-year-old" group scores of the training period and the initial period of rushing into the plateau were significantly higher than those of the 3 months after entering into the plateau(P<0.05).(4)The phase changes of PTSD scores in high school(or technical secondary school)and below group showed significant differences(P<0.05).Both the training period and the initial period of rushing into the plateau were significantly higher than those in the 3 months after entering the plateau(P<0.05).(5)Except for the central area,the PTSD scores of recruits had a statistically significant change in phases(P < 0.05).The initial period of recruits from the eastern area scored significantly higher than those of 3 months after entering the plateau(P<0.05).The scores of recruits from the western area showed a gradual decreasing change over time and stayed lowest 3months after entering the plateau(P<0.05).(6)The PTSD scores of recruits in the single-parent group showed a gradual decline over time,and were the lowest 3 months after entering the plateau(P<0.01).The PTSD scores of recruits in the parents group were significantly higher in the initial period of rushing into the plateau(P<0.05).(7)The PTSD scores of non-left-behind children were significantly different at different phases(P<0.01).Scores of the training period and the initial period of rushing into the plateau were significantly higher than those of 3 months after entering the plateau(P<0.05).(8)The scores of PTSD of recruits who were not only-child were significantly different at different phases(P<0.01).Scores of the training period and the initial period of rushing into the plateau were significantly higher than those of 3 months after entering the plateau(P<0.05).6.Characteristics of mental health needs of recruitsThe main reasons for the mental problems of recruits were: poor self-regulation ability,too much pressure on study and training,family reasons,and poor relationship with comrades.The most favorite mental health service methods were: listening to mental health lectures,physical activities,psychological training and communicating with psychological professionals.Mental health education in favor mainly included: psychological knowledge,emotional and stress management,psychological adjustment in interpersonal communication and role changes during service.The most expected psychological training were: self-awareness,interpersonal communication,emotional regulation,teamwork and role adaptation.7.Mental health maintenance mode for recruitsThrough the analysis of the mental health status of recruits rushing into the plateau,the characteristics of phase changes,influencing factors,and potential mental health service demands,combined with the psychological intervention theory and practical experience of intervention for the soldiers on plateau,the mental health maintenance mode for the recruits rushing into the plateau was formulated: Set the objective as “to adapt to the army life and the plateau environment quickly to reduce the occurrence of stress reactions,and to improve mental adaptability and psychological quality”;We should focus on the two key phases of “the training period and the initial period of rushing into the plateau”,follow the “developmental,educational and preventive” principles,conduct "mental health survey,mental health education,group psychological training,and individual psychological counseling"-the four forms of services and carry out "role adaptation,self-knowledge,emotion and stress management,interpersonal communication and teamwork" activities to maintain mental health.Conclusion1.The mental health of the recruits rushing into the plateau showed obvious phase and crowd characteristics.For the key population,such as the phases from the training period to the initial period of rushing into the plateau,the younger ones,who came from areas that were much different from plateau,and the poor family situation,they need more attention and help to adapt to the life of the army and the plateau environment as soon as possible.2.To carry out mental health maintenance,we must fully consider the phase change characteristics of the mental health of the recruits rushing into the plateau,the differences between various groups and the characteristics of mental health service needs. |
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