Department of Psychology, University of Konstanz, Box 23/25, 78457 Konstanz, Germany.
Child Adolesc Psychiatry Ment Health. 2011 Sep 25;5:29. doi: 10.1186/1753-2000-5-29.
The number of orphans in Sub-Saharan Africa is constantly rising. While it is known that family or community care is preferable over institutional care of African orphans, little is known about the quality of care in orphanages and possibilities of improvement. STUDY 1:
Exposure to traumatic stress, experiences of violence in the home, school and orphanage, as well as mental ill-health and aggression of 38 children (mean age of M = 8.64 years) living in an orphanage in rural Tanzania were assessed at two time points. The severity of post-traumatic stress disorder symptoms (PTSD), depressive symptoms, and internalizing and externalizing problems were used as indicators of mental ill-health.
Violence experienced in the orphanage correlated more strongly with all indicators of mental ill-health than violence in the former home, school or neighborhood at time point 1. Additionally, violence experienced in the orphanage had a positive relationship with the aggressive behavior of the children at time point 2. STUDY 2:
With the help of the pre-post assessment of Study 1, the implementation of a new instructional system and psychotherapeutic treatment (KIDNET) for trauma-related illness were evaluated.
In response to both, a change in the instructional system and psychotherapeutic treatment of PTSD, a massive decline in experienced violence and in the severity of PTSD-symptoms was found, whereas depressive symptoms and internalizing and externalizing problems exhibited little change.
These studies show that violence, especially in the orphanage, can severely contribute to mental ill-health in orphans and that mental health can be improved by implementing a new instructional system and psychotherapeutic treatment in an orphanage. Moreover, the results indicate that the experience of violence in an orphanage also plays a crucial role in aggressive behavior of the orphans.
撒哈拉以南非洲的孤儿人数不断增加。虽然人们知道家庭或社区照顾优于对非洲孤儿的机构照顾，但对于孤儿院的照顾质量和改进的可能性知之甚少。
研究 1：
在坦桑尼亚农村的一家孤儿院，对 38 名儿童（平均年龄为 8.64 岁）在两个时间点的创伤性应激暴露、家庭、学校和孤儿院的暴力经历、心理健康问题和攻击行为进行了评估。创伤后应激障碍症状（PTSD）、抑郁症状以及内化和外化问题的严重程度被用作心理健康问题的指标。
孤儿院的暴力经历与所有心理健康问题的指标的相关性都比前家、学校或社区的暴力经历更强。此外，孤儿院的暴力经历与儿童在时间点 2 的攻击行为呈正相关。
研究 2：
在研究 1 的前后评估的帮助下，评估了创伤相关疾病的新教学系统和心理治疗（KIDNET）的实施效果。
针对教学系统和 PTSD 的心理治疗的改变，在经历的暴力行为和 PTSD 症状的严重程度方面都有了显著的下降，而抑郁症状以及内化和外化问题的变化则较小。
这些研究表明，暴力，特别是在孤儿院，会严重影响孤儿的心理健康，通过在孤儿院实施新的教学系统和心理治疗，可以改善心理健康。此外，研究结果表明，孤儿院的暴力经历也对孤儿的攻击行为起着关键作用。
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