解析儿童早期暴力暴露的影响：建模发展途径。
Parsing the effects violence exposure in early childhood: modeling developmental pathways.
机构信息
Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030, USA.
出版信息
J Pediatr Psychol. 2012 Jan-Feb;37(1):11-22. doi: 10.1093/jpepsy/jsr063. Epub 2011 Sep 8.
OBJECTIVE
To prospectively examine pathways from early childhood violence exposure and trauma-related symptoms to school-age emotional health.
METHODS
A longitudinal, birth cohort (N = 437) was assessed with parent reports of lifetime violence exposure and trauma-related symptoms at 3 years of age and later, internalizing and externalizing symptoms, and social competence at school age.
RESULTS
Early family and neighborhood violence correlated significantly with early trauma-related symptoms and also significantly predicted school-age internalizing and externalizing symptoms and poorer competence, independent of sociodemographic risk and past-year violence exposure. Longitudinal pathways were significantly mediated by arousal and avoidance symptoms at 3 years of age, which increased risk for clinically significant emotional problems and lower competence at school age (adjusted odds ratios = 3.1-6.1, p < 0.01).
CONCLUSIONS
Trauma-related symptoms may mediate developmental pathways from early violence exposure to later emotional health. Interventions that prevent or reduce early trauma-related symptoms may ameliorate the long-term deleterious impact of violence exposure.
目的
前瞻性研究儿童早期暴力暴露和与创伤相关症状对学龄期情绪健康的影响途径。
方法
对一个纵向出生队列（N=437）进行了评估，在 3 岁及以后通过父母报告评估终生暴力暴露和与创伤相关的症状、学龄期的内化和外化症状以及社交能力。
结果
早期家庭和邻里暴力与早期创伤相关症状显著相关，并且独立于社会人口风险和过去一年的暴力暴露，也显著预测了学龄期的内化和外化症状以及较差的社交能力。3 岁时的唤醒和回避症状显著介导了纵向途径，这增加了学龄期出现临床显著情绪问题和社交能力较低的风险（调整后的优势比=3.1-6.1，p<0.01）。
结论
与创伤相关的症状可能在早期暴力暴露与后期情绪健康之间的发展途径中起中介作用。预防或减少早期与创伤相关的症状的干预措施可能会减轻暴力暴露的长期有害影响。
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