Langeland Willie, Olff Miranda
Department of Psychiatry, Center for Psychological Trauma, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands.
Neurosci Biobehav Rev. 2008;32(1):161-74. doi: 10.1016/j.neubiorev.2007.07.002. Epub 2007 Aug 6.
Research suggests that about a quarter to a third of children with traffic-related injuries develop posttraumatic stress disorder (PTSD). Early symptoms of PTSD have been found to predict poor mental and physical outcome in studies of medically injured children. However, these symptoms are rarely recognized by physicians who provide emergency care for these children. In addition, there is insufficient knowledge about predictors of posttraumatic stress symptoms in this specific pediatric population. Early identification of those children at particular risk is needed to target preventive interventions appropriately. After some introducing remarks on the classification and the nature of posttraumatic stress reactions, current research findings on psychological and biological correlates of PTSD in pediatric injury patients are presented. The particular focus in this paper is on the neurobiological mechanisms that influence psychological responses to extreme stress and the development of PTSD. Continued study of the psychobiology of trauma and PTSD in pediatric injury patients, both in terms of neurobiology and treatment is needed.
研究表明，在因交通相关伤害而受伤的儿童中，约四分之一至三分之一会患上创伤后应激障碍（PTSD）。在对因医疗受伤儿童的研究中，已发现创伤后应激障碍的早期症状可预测不良的心理和身体后果。然而，为这些儿童提供急诊护理的医生很少能识别出这些症状。此外，对于这一特定儿科人群中创伤后应激症状的预测因素，人们了解不足。需要尽早识别出那些有特定风险的儿童，以便适当地开展预防性干预措施。在对创伤后应激反应的分类和性质作了一些介绍性评论之后，本文介绍了目前关于儿科受伤患者创伤后应激障碍的心理和生物学相关因素的研究结果。本文特别关注影响对极端压力的心理反应以及创伤后应激障碍发展的神经生物学机制。需要继续从神经生物学和治疗方面对儿科受伤患者的创伤心理生物学和创伤后应激障碍进行研究。
