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青少年犯罪者的暴力暴露、创伤后应激障碍和人格

Violence exposure, posttraumatic stress, and personality in juvenile delinquents.

作者信息

Ruchkin Vladislav V, Schwab-Stone Mary, Koposov Roman, Vermeiren Robert, Steiner Hans

机构信息

Child Study Center, Yale University School of Medicine, New Haven, CT 06520-7900, USA.

出版信息

J Am Acad Child Adolesc Psychiatry. 2002 Mar;41(3):322-9. doi: 10.1097/00004583-200203000-00012.

Abstract

OBJECTIVE

To assess posttraumatic stress and its relationship to comorbid psychopathology, violence exposure, and personality traits in Russian male juvenile delinquents.

METHOD

Posttraumatic stress and comorbid psychopathology were assessed by a semistructured psychiatric interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version) in 370 delinquent youths during winter-spring of 1999. In addition, violence exposure, personality, and psychopathology were assessed by self-reports.

RESULTS

Most delinquents reported some degree of posttraumatic stress: 156 subjects (42%) fulfilled partial criteria and 87 (25%) fulfilled full DSM-IV criteria for posttraumatic stress disorder (PTSD). Violence-related experiences (witnessing and victimization) were the most common types of trauma. Higher levels of posttraumatic stress were accompanied by higher rates of comorbid psychopathology, with the most striking differences occurring between the groups with full versus partial PTSD criteria. Violence exposure was related to temperamental behavior activation (novelty seeking), whereas PTSD symptom scores were predominantly related to behavior inhibition and poor coping (high harm avoidance and low self-directedness).

CONCLUSIONS

Similar to findings from American samples, Russian juvenile delinquents represent a severely traumatized population, mainly due to high levels of violence exposure. Those with full PTSD are the most severely traumatized and have highest rates of psychopathology, as compared to those with no or partial PTSD, and they require the most clinical attention and rehabilitation. Both exposure to violence and levels of posttraumatic stress are related to personality traits, which influence degree of exposure and individual perception of stress. The latter should be considered in individualized approaches to rehabilitation.

摘要

目的

评估俄罗斯男性青少年罪犯的创伤后应激及其与共病精神病理学、暴力暴露和人格特质的关系。

方法

1999年冬春期间,通过半结构化精神科访谈(学龄儿童情感障碍和精神分裂症量表-目前和终生版)对370名犯罪青年进行创伤后应激和共病精神病理学评估。此外,通过自我报告评估暴力暴露、人格和精神病理学情况。

结果

大多数罪犯报告有一定程度的创伤后应激:156名受试者(42%)符合部分标准,87名(25%)符合创伤后应激障碍(PTSD)的完整DSM-IV标准。与暴力相关的经历(目睹和受害)是最常见的创伤类型。创伤后应激水平较高伴随着共病精神病理学发生率较高,在符合完整与部分PTSD标准的组之间差异最为显著。暴力暴露与气质性行为激活(寻求新奇)有关,而PTSD症状评分主要与行为抑制和应对能力差(高伤害回避和低自我导向)有关。

结论

与美国样本的研究结果相似,俄罗斯青少年罪犯是受创伤严重的人群,主要是由于暴力暴露程度高。与无PTSD或部分PTSD的人相比,患有完整PTSD的人受创伤最严重,精神病理学发生率最高,他们需要最临床关注和康复治疗。暴力暴露和创伤后应激水平均与人格特质有关,人格特质会影响暴露程度和个体对压力的感知。在个性化康复方法中应考虑后者。

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