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儿童暴露于暴力和痛苦症状:看护者心理功能的影响。

Children's exposure to violence and distress symptoms: influence of caretakers' psychological functioning.

机构信息

Department of Pediatrics, Boston University School of Medicine, 88 East Newton Street, Boston, MA 02118, USA.

出版信息

Int J Behav Med. 2011 Mar;18(1):35-43. doi: 10.1007/s12529-010-9090-0. Epub 2010 Apr 20.

Abstract

BACKGROUND

Previous studies linking violence exposure to adverse child behavior have typically relied on parental report of child symptoms without accounting for the informant's mental well-being, despite evidence that parental mental health can influence children's mental health and the parent's report of distress symptoms.

PURPOSE

We assess the influence of maternal depression on the violence exposure and child distress association in a subset of the Maternal Infant Smoking Study of East Boston, a prospective birth cohort.

METHODS

Mothers reported on their children's violence exposure using the Survey of Children's Exposure to Community Violence (ETV) and completed the Checklist of Child Distress Symptoms (CCDS). The children also completed the ETV survey and the self-report version of the CCDS. Linear regression was used to assess the influence of violence exposure on distress symptoms adjusting for potential confounders, first using parent's report of exposure and outcome and a second time using the child's self-report. The mediating effect of maternal depression on the violence and distress association was also tested.

RESULTS

Among the 162 children ages 7 to 11, 51% were boys and 43% self-identified as Hispanic. When using child self-report, increased violence exposure was significantly associated with a broader range of distress symptoms (numbness, arousal, intrusion, avoidance subscales) compared to parent reported findings, which were only significantly related to the intrusion and avoidance subscales. Moreover, a significant mediation effect of maternal depression on the violence and distress association was noted only when mother's report of exposure and outcome was used.

CONCLUSION

Considering both parent and child self-report of violence is necessary to obtain a complete picture of violence exposure because parents and children may be offering different, although equally valid information. The influence of maternal depressive symptoms on preadolescent's distress symptoms may be attributed to reporting bias as opposed to more direct effects; thus, the parent's psychological functioning should be taken into consideration when relying on parental report of the child's psychological functioning.

摘要

背景

先前将暴力暴露与儿童不良行为联系起来的研究通常依赖于父母报告儿童的症状,而没有考虑到告知者的心理健康状况,尽管有证据表明父母的心理健康会影响儿童的心理健康和父母对痛苦症状的报告。

目的

我们评估了在东波士顿母婴吸烟研究的一个子集中,母亲抑郁对暴力暴露和儿童痛苦关联的影响,该研究是一个前瞻性的出生队列。

方法

母亲使用社区暴力暴露儿童调查(ETV)报告其子女的暴力暴露情况,并完成儿童痛苦症状检查表(CCDS)。孩子们还完成了 ETV 调查和 CCDS 的自我报告版本。线性回归用于评估在调整潜在混杂因素后,暴力暴露对痛苦症状的影响,首先使用父母对暴露和结果的报告,其次使用儿童的自我报告。还测试了母亲抑郁对暴力和痛苦关联的中介效应。

结果

在 162 名 7 至 11 岁的儿童中,51%为男孩,43%自我认定为西班牙裔。当使用儿童自我报告时,与父母报告的发现相比,暴力暴露的增加与更广泛的痛苦症状(麻木、觉醒、入侵、回避子量表)显著相关,而父母报告的发现仅与入侵和回避子量表显著相关。此外,仅当使用母亲对暴露和结果的报告时,才注意到母亲抑郁对暴力和痛苦关联的显著中介效应。

结论

考虑到父母和儿童自我报告的暴力情况,对于获得暴力暴露的全貌是必要的,因为父母和儿童可能提供不同的、尽管同样有效的信息。母亲抑郁对青春期前儿童痛苦症状的影响可能归因于报告偏差,而不是更直接的影响;因此,在依赖父母对孩子心理功能的报告时,应该考虑到父母的心理功能。

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