Copeland William E, Keeler Gordon, Angold Adrian, Costello E Jane
Center for Developmental Epidemiology, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
Arch Gen Psychiatry. 2007 May;64(5):577-84. doi: 10.1001/archpsyc.64.5.577.
Traumatic events are common and are related to psychiatric impairment in childhood. Little is known about the risk for posttraumatic stress disorder (PTSD) across different types of trauma exposure in children.
To examine the developmental epidemiology of potential trauma and posttraumatic stress (PTS) in a longitudinal community sample of children.
A representative population sample of 1420 children aged 9, 11, and 13 years at intake were followed up annually through 16 years of age. Main Outcome Measure Traumatic events and PTS were assessed from child and parent reports annually to 16 years of age. Risk factors and DSM-IV disorders were also assessed.
More than two thirds of children reported at least 1 traumatic event by 16 years of age, with 13.4% of those children developing some PTS symptoms. Few PTS symptoms or psychiatric disorders were observed for individuals experiencing their first event, and any effects were short-lived. Less than 0.5% of children met the criteria for full-blown DSM-IV PTSD. Violent or sexual trauma were associated with the highest rates of symptoms. The PTS symptoms were predicted by previous exposure to multiple traumas, anxiety disorders, and family adversity. Lifetime co-occurrence of other psychiatric disorders with traumatic events and PTS symptoms was high, with the highest rates for anxiety and depressive disorders.
In the general population of children, potentially traumatic events are fairly common and do not often result in PTS symptoms, except after multiple traumas or a history of anxiety. The prognosis after the first lifetime trauma exposure was generally favorable. Apart from PTSD, traumatic events are related to many forms of psychopathology, with the strongest links being with anxiety and depressive disorders.
创伤事件很常见，且与儿童期的精神障碍有关。对于儿童在不同类型创伤暴露下患创伤后应激障碍（PTSD）的风险知之甚少。
在一个纵向社区儿童样本中研究潜在创伤和创伤后应激（PTS）的发展流行病学。
选取1420名9岁、11岁和13岁的儿童作为代表性人群样本，从入组开始每年进行随访直至16岁。主要结局指标 通过儿童和家长报告，每年评估直至16岁的创伤事件和PTS。还评估了风险因素和DSM-IV障碍。
超过三分之二的儿童在16岁前报告至少经历过1次创伤事件，其中13.4%的儿童出现了一些PTS症状。首次经历创伤事件的个体很少出现PTS症状或精神障碍，且任何影响都是短暂的。不到0.5%的儿童符合全面的DSM-IV PTSD标准。暴力或性创伤与最高的症状发生率相关。PTS症状可由既往多次创伤暴露、焦虑症和家庭逆境预测。创伤事件和PTS症状与其他精神障碍的终生共病率很高，焦虑症和抑郁症的共病率最高。
在儿童总体人群中，潜在创伤事件相当常见，除多次创伤或有焦虑病史外，通常不会导致PTS症状。首次终生创伤暴露后的预后通常良好。除PTSD外，创伤事件与多种形式的精神病理学有关，与焦虑症和抑郁症的联系最为紧密。
