Stallard Paul, Smith Elisabeth
University of Bath/Avon and Wiltshire Mental Health Partnership NHS Trust, UK.
J Child Psychol Psychiatry. 2007 Feb;48(2):194-201. doi: 10.1111/j.1469-7610.2006.01692.x.
Comparatively little is known about the cognitive appraisals and coping styles of child road traffic accident (RTA) survivors that are associated with chronic post-traumatic reactions.
Seventy-five children and young people aged 7-18 who were involved in a road traffic accident and attended an accident and emergency department were assessed 8 months after their accident. Post-traumatic symptoms were assessed by diagnostic interview (CAPS-C) and self-report questionnaires (IES). Demographic, accident and injury severity variables were recorded. Informed by the Ehlers and Clark (2000) model, trauma memory, subjective appraisals of the trauma and cognitive coping styles were assessed.
Gender was the only non-cognitive variable associated with significant post-traumatic reactions and explained 5-6% of the overall variance. Trauma memory did not significantly contribute to the final regression model. The addition of the remaining cognitive factors assessing subjective appraisals of the trauma and cognitive coping style resulted in the model accounting for 61-65% of the variance of post-traumatic stress disorder (PTSD) symptoms 8 months post trauma.
This study adds support to the applicability of the Ehlers and Clark (2000) cognitive model to children. The results indicate that the theoretically determined appraisals and cognitive coping styles are associated with chronic post-traumatic reactions. The findings suggest the need to develop trauma-focused interventions for children that directly address these key cognitions during therapy.
对于与慢性创伤后反应相关的儿童道路交通事故（RTA）幸存者的认知评估和应对方式，我们了解得相对较少。
对75名年龄在7至18岁之间、遭遇道路交通事故并前往事故与急诊科就诊的儿童和青少年，在事故发生8个月后进行评估。通过诊断访谈（儿童创伤后应激障碍临床评定量表，CAPS-C）和自我报告问卷（事件影响量表，IES）评估创伤后症状。记录人口统计学、事故及损伤严重程度变量。依据埃勒斯和克拉克（2000年）的模型，评估创伤记忆、对创伤的主观评估以及认知应对方式。
性别是唯一与显著创伤后反应相关的非认知变量，解释了总体方差的5%至6%。创伤记忆对最终回归模型的贡献不显著。加入评估创伤主观评估和认知应对方式的其余认知因素后，该模型解释了创伤后8个月创伤后应激障碍（PTSD）症状方差的61%至65%。
本研究支持埃勒斯和克拉克（2000年）认知模型对儿童的适用性。结果表明，理论上确定的评估和认知应对方式与慢性创伤后反应相关。研究结果表明，有必要为儿童开发以创伤为重点的干预措施，在治疗期间直接针对这些关键认知。
