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针对遭受父母间暴力的儿童进行干预时的调节因素和治疗因素

Mediators and Treatment Factors in Intervention for Children Exposed to Interparental Violence.

作者信息

Overbeek Mathilde M, De Schipper J Clasien, Willemen Agnes M, Lamers-Winkelman Francien, Schuengel Carlo

机构信息

a Department of Clinical Child and Family Studies and EMGO Institute for Health and Care Research , VU University.

出版信息

J Clin Child Adolesc Psychol. 2017 May-Jun;46(3):411-427. doi: 10.1080/15374416.2015.1012720. Epub 2015 Mar 9.

Abstract

Changes in children's emotion differentiation, coping skills, parenting stress, parental psychopathology, and parent-child interaction were explored as mediators of treatment factors in two selective preventive group interventions for children exposed to interparental violence (IPV) and their parents. One hundred thirty-four IPV-exposed children (ages 6-12 years, 52% boys) and their parents were randomized to an IPV-focused or common factors community-based group intervention and completed baseline, posttest, and follow-up assessments for posttraumatic stress (PTS). A multilevel model tested mediators that included children's ability to differentiate emotions and coping skills, parenting stress, parental psychopathology, and parent-child interactions. In both conditions, exposure to nonspecific factors, specific factors unrelated to IPV and trauma-specific intervention factors was coded from videotaped child and parent sessions. Improved parental mental health mediated the link between greater exposure to nonspecific treatment factors and decreases in PTS symptoms. In addition, an increase in emotion differentiation and a decrease in parenting stress were associated with a decrease in PTS symptoms. Greater exposure to trauma-specific factors in child sessions was associated with a small decrease in emotion differentiation, an increase in coping skills, and a decrease in PTS symptoms over time. Greater exposure to nonspecific treatment factors in child and parent sessions was associated with more positive parent-child interaction. Parental mental health appears to be an important mechanism of change that can be promoted through exposure to nonspecific factors in parent intervention. For children, the effect of greater exposure to trauma-specific factors in intervention is less clear and may not have clear benefits.

摘要

在两项针对遭受父母间暴力(IPV)的儿童及其父母的选择性预防小组干预中,探讨了儿童情绪分化、应对技巧、育儿压力、父母心理病理学以及亲子互动的变化,作为治疗因素的中介变量。134名遭受IPV的儿童(6至12岁,52%为男孩)及其父母被随机分配到以IPV为重点或基于社区的共同因素小组干预中,并完成了创伤后应激(PTS)的基线、后测和随访评估。一个多层次模型测试了中介变量,包括儿童区分情绪的能力和应对技巧、育儿压力、父母心理病理学以及亲子互动。在两种情况下,从录制的儿童和父母会话中编码出非特定因素、与IPV无关的特定因素以及创伤特定干预因素的暴露情况。父母心理健康状况的改善介导了更多接触非特定治疗因素与PTS症状减轻之间的联系。此外,情绪分化的增加和育儿压力的降低与PTS症状的减轻相关。随着时间的推移,儿童会话中更多接触创伤特定因素与情绪分化略有下降、应对技巧增加以及PTS症状减轻有关。儿童和父母会话中更多接触非特定治疗因素与更积极的亲子互动相关。父母心理健康似乎是一个重要的改变机制,可以通过在父母干预中接触非特定因素来促进。对于儿童来说,在干预中更多接触创伤特定因素的效果不太明确,可能没有明显益处。

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