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创伤治疗中的性别差异:男孩和女孩对循证干预措施的反应相同吗?

Gender differences in trauma treatment: do boys and girls respond to evidence-based interventions in the same way?

作者信息

Craig Carlton D, Sprang Ginny

出版信息

Violence Vict. 2014;29(6):927-39. doi: 10.1891/0886-6708.vv-d-13-00016.

Abstract

This article investigates gender differences in trauma symptoms from baseline to end of treatment (trauma-focused cognitive behavioral therapy or parent-child interaction therapy) in children ages 7-18 years. Multivariate analysis of covariance (MANCOVA) and trend analysis using analysis of covariance (ANCOVA) were conducted on baseline and end of treatment University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (UCLA PTSD-RI) total scores. Results suggest that female children start at higher reported total posttraumatic stress disorder rates than males, but both groups experience significant symptom reduction during the course of treatment. At posttreatment, girls are still reporting higher symptom levels on the UCLA PTSD-RI than boys, suggesting that their clinical presentation at discharge may differ despite significant treatment gains. A full factorial model including the interaction of dose and gender was not significant. Identification of these gender-specific response patterns are an important consideration in treatment and discharge planning for children who have been trauma-exposed and are presenting for treatment with post trauma exposure disturbances.

摘要

本文调查了7至18岁儿童从基线到治疗结束(创伤聚焦认知行为疗法或亲子互动疗法)期间创伤症状的性别差异。使用协方差分析(ANCOVA)对基线和治疗结束时的加利福尼亚大学洛杉矶分校创伤后应激障碍反应指数(UCLA PTSD-RI)总分进行了多变量协方差分析(MANCOVA)和趋势分析。结果表明,女童报告的创伤后应激障碍总发生率开始时高于男童,但两组在治疗过程中症状均显著减轻。治疗后,女童在UCLA PTSD-RI上报告的症状水平仍高于男童,这表明尽管治疗取得了显著成效,但她们出院时的临床表现可能有所不同。包括剂量和性别的相互作用的全因子模型并不显著。识别这些性别特异性反应模式是为遭受创伤并因创伤后应激障碍前来治疗的儿童制定治疗和出院计划时的重要考虑因素。

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