Department of Clinical and Health Psychology, Utrecht University, PO Box 80140, 3508, TC, Utrecht, The Netherlands.
J Abnorm Child Psychol. 2013 Oct;41(7):1097-108. doi: 10.1007/s10802-013-9748-6.
This study investigated the factor structure and correlates of posttraumatic stress-disorder (PTSD) symptoms among children and adolescents confronted with the death of a loved one. Three hundred thirty-two bereaved children and adolescents (aged 8-18; 56.9 % girls) who all received some form of psychosocial support after their loss, completed self-report measures of PTSD, together with measures tapping demographic and loss-related variables, depression, prolonged grief, and functional impairment. Parent-rated indices of impairment were also collected. We first evaluated the fit of six alternative models of the factor structure of PTSD symptoms, using confirmatory factor analyses. Outcomes showed that the 4-factor numbing model from King et al. (Psychological Assessment 10, 90-96, 1998), with distinct factors of reexperiencing, avoidance, emotional numbing, and hyperarousal fit the data best. Of all participants, 51.5 % met DSM-IV criteria for PTSD. PTSD-status and scores on the PTSD factors varied as a function of age and gender, but were unrelated to other demographic and loss-related variables. PTSD-status and scores on the PTSD factors were significantly associated symptom-levels of depression, prolonged grief, and functional impairment. Findings complement prior evidence that the DSM-IV model of the factor structure of PTSD symptoms may not represent the best conceptualization of these symptoms and highlight the importance of addressing PTSD symptoms in children and adolescents seeking help after bereavement.
本研究调查了儿童和青少年在面对所爱之人去世时创伤后应激障碍（PTSD）症状的因素结构和相关性。332 名丧亲的儿童和青少年（年龄 8-18 岁；56.9%为女孩）在失去亲人后都接受了某种形式的心理社会支持，他们完成了 PTSD 的自我报告测量，以及涉及人口统计学和损失相关变量、抑郁、持续性悲伤和功能障碍的测量。还收集了父母评定的损害指标。我们首先使用验证性因素分析评估了 PTSD 症状因素结构的六种替代模型的拟合度。结果表明，King 等人（心理评估 10，90-96，1998）的 4 因素麻木模型，具有重新体验、回避、情感麻木和过度警觉的独特因素，最符合数据。所有参与者中，有 51.5%符合 DSM-IV 创伤后应激障碍标准。PTSD 状态和 PTSD 因素得分随年龄和性别而异，但与其他人口统计学和损失相关变量无关。PTSD 状态和 PTSD 因素得分与抑郁、持续性悲伤和功能障碍的症状水平显著相关。这些发现补充了先前的证据，即 DSM-IV 创伤后应激障碍症状的因素结构模型可能不能代表这些症状的最佳概念化，并强调了在丧亲后寻求帮助的儿童和青少年中解决 PTSD 症状的重要性。
