Overbeek Mathilde M, de Schipper J Clasien, Lamers-Winkelman Francien, Schuengel Carlo
Department of Clinical Child and Family Studies & EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands.
Child Abuse Negl. 2013 Dec;37(12):1202-14. doi: 10.1016/j.chiabu.2013.07.007. Epub 2013 Aug 12.
A community-based intervention with specific factors for children and parents exposed to interparental violence (IPV) was compared with a control intervention based on non-specific factors. We hypothesized that participation in an intervention with specific factors, focused on IPV, parenting and coping, would be associated with better recovery. IPV exposed children and parents were group randomized over a specific factors- and control intervention. Baseline, posttest and follow-up measurements of 155 parents and children (aged 6-12 years, 55.5% boys) were fitted in a multilevel model. Outcomes were parent and teacher reported children's internalizing and externalizing problems (CBCL, TRF), child self-reported depressive symptoms (CDI) and parent and child reported children's post-traumatic stress symptoms (TSCYC, TSCC). Based on intention-to-treat and completer analyses, children in the specific factors intervention did not show better recovery than children in the control intervention. Children in both interventions decreased significantly in parent-reported children's internalizing and externalizing problems and post-traumatic stress symptoms. Children reported a decrease in their mean level of depressive and post-traumatic stress symptoms. Teachers reported a decrease in internalizing problems, but not in externalizing problems. No association between time since exposure and level and course of symptoms was found. Treatment differentiation was assessed and both programs were significantly different on hypothesized effective factors. Higher treatment adherence in both programs did not result in a larger difference in recovery. IPV exposed children improve over the course and after participating in a community-based child- and parent program, but specific factors in intervention may not carry additional benefits when implemented in community settings.
将针对遭受父母间暴力（IPV）的儿童及其父母的基于特定因素的社区干预措施与基于非特定因素的对照干预措施进行了比较。我们假设，参与聚焦于IPV、育儿和应对的特定因素干预措施，将与更好的恢复情况相关联。遭受IPV的儿童及其父母被分组随机分配到特定因素干预组和对照干预组。对155名父母和儿童（年龄在6至12岁之间，男孩占55.5%）进行的基线、测试后和随访测量数据被纳入一个多层次模型。结果指标包括家长和教师报告的儿童内化和外化问题（儿童行为检查表、教师报告表）、儿童自我报告的抑郁症状（儿童抑郁量表）以及家长和儿童报告的儿童创伤后应激症状（儿童创伤后应激症状自评量表、儿童创伤后应激症状检查表）。基于意向性分析和完成者分析，特定因素干预组的儿童在恢复情况上并不比对照干预组的儿童更好。在家长报告的儿童内化和外化问题以及创伤后应激症状方面，两个干预组的儿童均有显著下降。儿童报告其抑郁和创伤后应激症状的平均水平有所下降。教师报告内化问题有所减少，但外化问题没有减少。未发现暴露时间与症状水平及病程之间存在关联。对治疗差异进行了评估，两个项目在假设的有效因素方面存在显著差异。两个项目中更高的治疗依从性并未导致恢复情况出现更大差异。遭受IPV的儿童在参与基于社区的儿童和家长项目的过程中及之后情况有所改善，但在社区环境中实施时，干预措施中的特定因素可能不会带来额外益处。
