Division of Child and Adolescent Psychiatry, Columbia University, New York, NY 10032, USA.
J Trauma Stress. 2011 Aug;24(4):422-9. doi: 10.1002/jts.20664. Epub 2011 Jul 28.
This study considers demographic, offense, and disorder contributors to exposure and posttraumatic stress disorder (PTSD) in a large (N = 9,611) dataset of standardized psychiatric assessments resulting from nationwide collaborations with justice agencies. Youths' antisocial history may elevate risk for traumatic exposure and PTSD; additionally, traumatic victimization increases risk for externalizing behavior. Rates of all types of traumatic exposure and PTSD were clearly elevated and expectably related to disorder and antisocial behavior. Males were significantly more likely than females to report assaultive violence, whereas females were significantly more likely than males to report forced sexual activity. Gender interactions with disorder and antisocial behavior were contributory only in predicting forced sexual activity: females' exposure was not conditional on features characterizing males' exposure. Findings highlight the high levels of trauma exposure at all levels of juvenile justice processing, and the particular vulnerability of males with internalizing psychopathology. Consistent with increased recent interest in the diagnosis of developmental trauma disorder, and given the likely interconnectedness between traumatic exposure and externalizing symptoms, treatment approaches for justice youths should address their co-occurrence.
本研究考虑了人口统计学、犯罪和障碍因素对暴露和创伤后应激障碍（PTSD）的影响，这是一项来自全国范围内与司法机构合作的标准化精神评估的大型数据集（N=9611）。青少年的反社会历史可能会增加创伤暴露和 PTSD 的风险；此外，创伤性受害会增加外化行为的风险。所有类型的创伤暴露和 PTSD 的发生率明显升高，并且可以预期与障碍和反社会行为有关。男性报告攻击暴力的可能性明显高于女性，而女性报告被迫性行为的可能性明显高于男性。性别与障碍和反社会行为的相互作用仅在预测被迫性行为方面有贡献：女性的暴露不受男性暴露特征的限制。研究结果强调了在青少年司法处理的各个层面都存在高度的创伤暴露，以及具有内化心理病理学的男性的特殊脆弱性。考虑到创伤暴露与外化症状之间的相互关联，以及最近对发展性创伤障碍诊断的兴趣增加，对于司法青少年的治疗方法应该解决它们的共同发生。
