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儿童在自然灾害后的创伤后应激和抑郁症状:共病和危险因素。

Children's symptoms of posttraumatic stress and depression after a natural disaster: comorbidity and risk factors.

机构信息

Department of Psychology, University of Miami, FL 33124-9117, USA.

出版信息

J Affect Disord. 2013 Mar 20;146(1):71-8. doi: 10.1016/j.jad.2012.08.041. Epub 2012 Sep 10.

Abstract

BACKGROUND

The current study examined rates of comorbidity among children's symptoms of posttraumatic stress (PTS) and depression after a natural disaster, Hurricane Ike. We also compared children with comorbid symptoms to children without comorbid symptoms, examining recovery, severity of symptoms, and risk factors.

METHOD

Children (n=277; 52% girls; 38% Hispanic, 28% White, 19% Black; grades 2-4) were assessed at 8 and 15 months postdisaster. Children completed measures of PTS and depressive symptoms at both time points and measures of exposure and recovery stressors at 8 months postdisaster.

RESULTS

At 8 months postdisaster, 13% of children reported elevated PTS-only, 11% depression-only, and 10% comorbid symptoms of PTS and depression. At 15 months postdisaster, 7% of children reported elevated PTS-only, 11% depression-only, and 7% comorbid symptoms of PTS and depression. Children with comorbid symptoms of PTS and depression had poorer recovery, more severe symptoms, and they reported greater exposure and recovery stressors.

LIMITATIONS

We lacked information on children's predisaster functioning and diagnostic interview of psychological distress symptoms.

CONCLUSIONS

Children with comorbid symptoms need to be identified early postdisaster. Levels of stressors should be monitored postdisaster, as highly stressed youth have difficulties recovering and may need help. Interventions should be tailored for children with comorbid symptoms of PTS and depression.

摘要

背景

本研究考察了自然灾害“艾克”飓风后儿童创伤后应激(PTS)和抑郁症状的共病率。我们还将共病症状的儿童与无共病症状的儿童进行了比较,考察了他们的恢复情况、症状严重程度和风险因素。

方法

在灾难发生后 8 个月和 15 个月,对 277 名儿童(52%为女孩;38%为西班牙裔,28%为白人,19%为黑人;2-4 年级)进行了评估。儿童在两个时间点都完成了 PTS 和抑郁症状的测量,以及在灾难发生后 8 个月时完成了暴露和恢复应激源的测量。

结果

在灾难发生后 8 个月时,有 13%的儿童报告 PTS 症状升高,11%报告抑郁症状升高,10%报告 PTS 和抑郁症状共病。在灾难发生后 15 个月时,有 7%的儿童报告 PTS 症状升高,11%报告抑郁症状升高,7%报告 PTS 和抑郁症状共病。共病 PTS 和抑郁症状的儿童恢复情况较差,症状更严重,并且报告了更多的暴露和恢复应激源。

局限性

我们缺乏儿童受灾前功能和心理困扰症状诊断访谈的信息。

结论

需要在灾难后早期识别出共病症状的儿童。应在灾后监测应激源水平,因为压力大的儿童恢复困难,可能需要帮助。应针对 PTS 和抑郁共病症状的儿童量身定制干预措施。

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