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纵向研究创伤后应激障碍症状和问题性饮酒对青少年受害的风险因素。

Longitudinal examination of PTSD symptoms and problematic alcohol use as risk factors for adolescent victimization.

机构信息

Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.

出版信息

J Clin Child Adolesc Psychol. 2012;41(6):822-36. doi: 10.1080/15374416.2012.717872. Epub 2012 Sep 10.

Abstract

The current study examined associations between posttraumatic stress disorder (PTSD) symptoms and future interpersonal victimization among adolescents, after accounting for the impact of early victimization exposure, gender, ethnicity, and household income. In addition, problematic alcohol use was tested as a mediator of the relation between PTSD symptoms and subsequent victimization. Participants included a national longitudinal sample of adolescents (N = 3,604) who were ages 12 to 17 at the initial assessment: 50% were male, and 67% were White, 16% African American, and 12% Hispanic. Cohort-sequential latent growth curve modeling was used to examine associations among the study variables. Baseline PTSD symptoms significantly predicted age-related increases in interpersonal victimization, even after accounting for the effects of earlier victimization experiences. In addition, alcohol problems emerged as a partial mediator of this relation, such that one fourth to one third of the effect of PTSD symptoms on future victimization was attributable to the impact of PTSD symptoms on alcohol problems (which, in turn, predicted additional victimization risk). Collectively, the full model accounted for more than half of the variance in age-related increases in interpersonal victimization among youth. Results indicate that PTSD symptoms serve as a risk factor for subsequent victimization among adolescents, over and above the risk conferred by prior victimization. This increased risk occurred both independently and through the impact of PTSD symptoms on problematic alcohol use. Based on these findings, it is hypothesized that the likelihood of repeated victimization among youth might be reduced through early detection and treatment of these clinical problems.

摘要

本研究在考虑到早期受害经历、性别、种族和家庭收入的影响后,调查了创伤后应激障碍(PTSD)症状与青少年未来人际受害之间的关系。此外,还测试了问题性饮酒作为 PTSD 症状与随后受害之间关系的中介因素。参与者包括一个全国性的青少年纵向样本(N=3604),他们在初始评估时的年龄在 12 至 17 岁之间:50%为男性,67%为白人,16%为非裔美国人,12%为西班牙裔。队列序列潜增长曲线模型用于检验研究变量之间的关联。基线 PTSD 症状显著预测了人际受害的年龄相关增长,即使考虑到早期受害经历的影响也是如此。此外,酒精问题是这种关系的部分中介因素,即 PTSD 症状对未来受害的影响中有四分之一到三分之一归因于 PTSD 症状对酒精问题的影响(这反过来又预示着额外的受害风险)。总体而言,完整模型解释了青少年人际受害年龄相关增长的一半以上。结果表明,PTSD 症状是青少年随后受害的一个风险因素,超过了先前受害带来的风险。这种增加的风险是通过 PTSD 症状对问题性饮酒的独立影响和影响而发生的。基于这些发现,可以假设通过早期发现和治疗这些临床问题,可以降低青少年反复受害的可能性。

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