J Trauma Stress. 2013 Dec;26(6):686-94. doi: 10.1002/jts.21866.
Young children are disproportionately exposed to interpersonal trauma (maltreatment, witnessing intimate partner violence [IPV]) and appear particularly susceptible to negative sequelae. Little is known about the factors influencing vulnerability to traumatic stress responses and other negative outcomes in early life. This study examined associations among interpersonal trauma exposure, sociodemographic risk, developmental competence, and posttraumatic stress disorder (PTSD) symptoms in 200 children assessed from birth to first grade via standardized observations, record reviews, and maternal and teacher interviews. More severe PTSD symptoms were predicted by greater trauma exposure (r = .43), greater sociodemographic risk (r = .22), and lower developmental competence (rs=−.31 and −.54 for preschool and school-age developmental competence, respectively). Developmental competence partially mediated the association between trauma exposure and symptoms. Trauma exposure fully mediated the association between sociodemographic risk and symptoms. Neither sociodemographic risk nor developmental competence moderated trauma exposure effects on symptoms. The findings suggest that (a)exposure to maltreatment and IPV has additive effects on posttraumatic stress risk in early life, (b) associations between sociodemographic adversity and poor mental health may be attributable to increased trauma exposure in disadvantaged populations, and (c) early exposures have a negative cascade effect on developmental competence and mental health.
儿童特别容易受到人际创伤(虐待、目睹亲密伴侣暴力)的影响,并且似乎特别容易受到负面后果的影响。对于影响创伤后应激反应和生命早期其他负面结果的脆弱性的因素知之甚少。本研究通过标准化观察、记录审查以及对 200 名儿童的母亲和教师访谈,从出生到一年级评估了人际创伤暴露、社会人口风险、发展能力和创伤后应激障碍(PTSD)症状之间的关联。更严重的 PTSD 症状与更多的创伤暴露(r =.43)、更高的社会人口风险(r =.22)和更低的发展能力(学龄前和学龄期发展能力分别为 rs=−.31 和−.54)相关。发展能力部分中介了创伤暴露与症状之间的关系。创伤暴露完全中介了社会人口风险与症状之间的关系。社会人口风险和发展能力都不能调节创伤暴露对症状的影响。研究结果表明:(a)虐待和亲密伴侣暴力的暴露对生命早期的创伤后应激风险有累加效应;(b)社会人口劣势与心理健康状况不佳之间的关联可能归因于弱势群体中创伤暴露的增加;(c)早期暴露对发展能力和心理健康有负面影响的级联效应。