Meiser-Stedman Richard, Smith Patrick, Glucksman Edward, Yule William, Dalgleish Tim
Department of Psychology (P77), Institute of Psychiatry, De Crespigny Park, London, UK.
J Abnorm Child Psychol. 2007 Apr;35(2):191-201. doi: 10.1007/s10802-006-9068-1.
Examining parent-child agreement for Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD) in children and adolescents is essential for informing the assessment of trauma-exposed children, yet no studies have examined this relationship using appropriate statistical techniques. Parent-child agreement for these disorders was examined by structured interview in a prospective study of assault and motor vehicle accident (MVA) child survivors, assessed at 2-4 weeks and 6 months post-trauma. Children were significantly more likely to meet criteria for ASD, as well as other ASD and PTSD symptom clusters, based on their own report than on their parent's report. Parent-child agreement for ASD was poor (Cohen's kappa = -.04), but fair for PTSD (Cohen's kappa = .21). Agreement ranged widely for other emotional disorders (Cohen's kappa = -.07-.64), with generalised anxiety disorder found to have superior parent-child agreement (when assessed by phi coefficients) relative to ASD and PTSD. The findings support the need to directly interview children and adolescents, particularly for the early screening of posttraumatic stress, and suggest that other anxiety disorders may have a clearer presentation post-trauma.
研究儿童和青少年急性应激障碍(ASD)和创伤后应激障碍(PTSD)的亲子一致性对于指导对遭受创伤儿童的评估至关重要,但尚无研究使用适当的统计技术来检验这种关系。在一项针对袭击和机动车事故(MVA)儿童幸存者的前瞻性研究中,通过结构化访谈对这些障碍的亲子一致性进行了检查,在创伤后2 - 4周和6个月进行评估。与父母报告相比,儿童根据自己的报告更有可能符合ASD以及其他ASD和PTSD症状群的标准。ASD的亲子一致性较差(科恩kappa系数= -0.04),但PTSD的一致性一般(科恩kappa系数= 0.21)。其他情绪障碍的一致性差异很大(科恩kappa系数= -0.07 - 0.64),发现广泛性焦虑障碍相对于ASD和PTSD具有更好的亲子一致性(通过phi系数评估)。研究结果支持直接对儿童和青少年进行访谈的必要性,特别是对于创伤后应激的早期筛查,并表明其他焦虑障碍在创伤后可能表现得更明显。