Cluver Lucie, Gardner Frances, Operario Don
Department of Social Policy and Social Work, University of Oxford, UK.
J Child Psychol Psychiatry. 2007 Aug;48(8):755-63. doi: 10.1111/j.1469-7610.2007.01757.x.
South Africa is predicted to have 2.3 million children orphaned by Acquired Immune Deficiency Syndrome (AIDS) by 2020 (Actuarial Society of South Africa, 2005). There is little knowledge about impacts of AIDS-related bereavement on children, to aid planning of services. This study aimed to investigate psychological consequences of AIDS orphanhood in urban township areas of Cape Town, South Africa, compared to control groups of children and adolescents orphaned by other causes, and non-orphans.
One thousand and twenty-five children and adolescents (aged 10-19) were interviewed using socio-demographic questionnaires and standardised scales for assessing depression, anxiety, post-traumatic stress, peer problems, delinquency and conduct problems.
Controlling for socio-demographic factors such as age, gender, formal/informal dwelling and age at orphanhood, children orphaned by AIDS were more likely to report symptoms of depression, peer relationship problems, post-traumatic stress, delinquency and conduct problems than both children orphaned by other causes and non-orphaned children. Anxiety showed no differences. AIDS-orphaned children were more likely to report suicidal ideation. Compared to Western norms, AIDS-orphaned children showed higher levels of internalising problems and delinquency, but lower levels of conduct problems.
Children orphaned by AIDS may be a particularly vulnerable group in terms of emotional and, to a lesser extent, behavioural problems. Intervention programs are necessary to ameliorate the psychological sequelae of losing a parent to AIDS.
据预测,到2020年,南非将有230万儿童因获得性免疫缺陷综合征(艾滋病)而成为孤儿(南非精算协会,2005年)。对于与艾滋病相关的丧亲之痛对儿童的影响,人们了解甚少,这不利于服务规划。本研究旨在调查南非开普敦城市镇区艾滋病孤儿的心理后果,并与因其他原因成为孤儿的儿童和青少年对照组以及非孤儿进行比较。
使用社会人口学问卷和标准化量表对1025名儿童和青少年(年龄在10 - 19岁之间)进行访谈,以评估抑郁、焦虑、创伤后应激、同伴问题、犯罪和行为问题。
在控制年龄、性别、正式/非正式居住情况和成为孤儿时的年龄等社会人口学因素后,与因其他原因成为孤儿的儿童和非孤儿相比,艾滋病孤儿更有可能报告抑郁症状、同伴关系问题、创伤后应激、犯罪和行为问题。焦虑方面未显示出差异。艾滋病孤儿更有可能报告自杀念头。与西方标准相比,艾滋病孤儿表现出较高水平的内化问题和犯罪,但行为问题水平较低。
就情感问题以及在较小程度上的行为问题而言,艾滋病孤儿可能是一个特别脆弱的群体。需要开展干预项目来改善因父母死于艾滋病而产生的心理后遗症。