Bonanno George A, Mancini Anthony D
Department of Counseling and Clinical Psychology, Teachers College, Columbia University, 525 W 120th St, New York, NY 10027, USA.
Pediatrics. 2008 Feb;121(2):369-75. doi: 10.1542/peds.2007-1648.
For decades, researchers have documented remarkable levels of resilience in children who were exposed to corrosive early environments, such as those in which poverty or chronic maltreatment were present; however, relatively little research has examined resilience in children or adults who were exposed to isolated and potentially traumatic events. The historical emphasis on psychological and physiologic dysfunction after potentially traumatic events has suggested that such events almost always produce lasting emotional damage. Recent research, however, has consistently shown that across different types of potentially traumatic events, including bereavement, serious illness, and terrorist attack, upward of 50% of people have been found to display resilience. Research has further identified substantial individual variation in response to potentially traumatic events, including 4 prototypical and empirically derived outcome trajectories: chronic dysfunction, recovery, resilience, and delayed reactions. Factors that promote resilience are heterogeneous and include a variety of person-centered variables (eg, temperament of the child, personality, coping strategies), demographic variables (eg, male gender, older age, greater education), and sociocontextual factors (eg, supportive relations, community resources). It is surprising that some factors that promote resilience to potentially traumatic events may be maladaptive in other contexts, whereas other factors are more broadly adaptive. Given the growing evidence that resilience is common, psychotherapeutic treatment should be reserved for those in genuine need.
几十年来,研究人员记录了那些身处恶劣早期环境(如贫困或长期遭受虐待的环境)中的儿童所展现出的非凡适应力;然而,相对较少的研究考察了那些经历过孤立且可能具有创伤性事件的儿童或成年人的适应力。过去对潜在创伤性事件后心理和生理功能障碍的关注表明,此类事件几乎总会造成持久的情感伤害。然而,最近的研究一致表明,在包括丧亲、重病和恐怖袭击等不同类型的潜在创伤性事件中,超过50%的人被发现具有适应力。研究进一步确定了个体对潜在创伤性事件反应的显著差异,包括4种典型的、基于实证得出的结果轨迹:慢性功能障碍、恢复、适应力和延迟反应。促进适应力的因素多种多样,包括各种以个人为中心的变量(如儿童的气质、个性、应对策略)、人口统计学变量(如男性、年龄较大、受教育程度较高)以及社会环境因素(如支持性的关系、社区资源)。令人惊讶的是,一些促进对潜在创伤性事件适应力的因素在其他情境中可能是适应不良的,而其他因素则具有更广泛的适应性。鉴于越来越多的证据表明适应力很常见,心理治疗应留给真正有需要的人。