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暴力父亲、创伤后应激母亲与学龄前市中心儿科诊所样本中症状儿童的关系。

The relationship of violent fathers, posttraumatically stressed mothers and symptomatic children in a preschool-age inner-city pediatrics clinic sample.

机构信息

Division of Child & Adolescent Psychiatry, University Hospitals of Geneva, 51 Boulevard de la Cluse, Geneva, Switzerland.

出版信息

J Interpers Violence. 2011 Dec;26(18):3699-719. doi: 10.1177/0886260511403747.

Abstract

This study aims to understand if greater severity of maternal posttraumatic stress symptoms (PTSS), related to maternal report of interpersonal violence, mediates the effects of such violence on (a) child PTSS as well as on (b) child externalizing and internalizing symptoms. Study participants were mothers (N = 77) and children 18 to 48 months recruited from community pediatric clinics. Data were analyzed continuously via bivariate correlations and then multiple linear regression. Post hoc Sobel tests were performed to confirm mediation. Paternal violence accounted for 15% of the variance of child PTSS on the PCIP-OR (β = .39, p ≤ .001). While the child's father being violent significantly predicts child PTSS related to domestic violence, as mentioned, when maternal PTSS is included in the multiple regression model, father's being violent becomes less significant, while maternal PTSS remains strongly predictive. Sobel tests confirmed that maternal PTSS severity mediated effects of paternal violence on clinician-assessed child PTSS as well as on maternal report of child externalizing and internalizing symptoms. When presented with a preschool-aged child who is brought to consultation for behavioral difficulties, dysregulated aggression, and/or unexplained fears, clinicians should evaluate maternal psychological functioning as well as assess and treat the effects of interpersonal violence, which otherwise may be avoided during the consultation.

摘要

本研究旨在探讨母亲创伤后应激症状(PTSS)的严重程度是否与母亲报告的人际暴力有关,这种严重程度是否会影响(a)儿童 PTSD 症状,以及(b)儿童外化和内化症状。研究参与者为来自社区儿科诊所的母亲(N=77)和 18 至 48 个月大的儿童。通过双变量相关分析和多元线性回归对数据进行了连续分析。然后进行了事后 Sobel 检验以确认中介作用。父亲的暴力行为占 PCIP-OR 儿童 PTSD 症状的 15%(β=0.39,p≤0.001)。虽然孩子的父亲施暴确实可以预测与家庭暴力有关的儿童 PTSD 症状,但正如前文所述,当将母亲的 PTSD 纳入多元回归模型时,父亲施暴的影响变得不那么显著,而母亲的 PTSD 仍然具有很强的预测性。Sobel 检验证实,母亲 PTSD 严重程度中介了父亲暴力对临床评估的儿童 PTSD 以及对母亲报告的儿童外化和内化症状的影响。当面对因行为困难、情绪失调性攻击和/或不明原因的恐惧而前来咨询的学龄前儿童时,临床医生应评估母亲的心理功能,并评估和治疗人际暴力的影响,否则在咨询过程中可能会忽略这些影响。

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