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接受创伤专项服务的青少年中童年不良经历的发展模式及当前症状与损伤情况

Developmental Patterns of Adverse Childhood Experiences and Current Symptoms and Impairment in Youth Referred For Trauma-Specific Services.

作者信息

Grasso Damion J, Dierkhising Carly B, Branson Christopher E, Ford Julian D, Lee Robert

机构信息

Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, 06030, USA.

School of Criminal Justice and Criminalistics, California State University, Los Angeles, CA, USA.

出版信息

J Abnorm Child Psychol. 2016 Jul;44(5):871-86. doi: 10.1007/s10802-015-0086-8.

Abstract

By the time children reach adolescence, most have experienced at least one type of severe adversity and many have been exposed to multiple types. However, whether patterns of adverse childhood experiences are consistent or change across developmental epochs in childhood is not known. Retrospective reports of adverse potentially traumatic childhood experiences in 3 distinct developmental epochs (early childhood, 0- to 5-years-old; middle childhood, 6- to 12-years-old; and adolescence, 13- to 18-years-old) were obtained from adolescents (N = 3485) referred to providers in the National Child Traumatic Stress Network (NCTSN) for trauma-focused assessment and treatment. Results from latent class analysis (LCA) revealed increasingly complex patterns of adverse/traumatic experiences in middle childhood and adolescence compared to early childhood. Depending upon the specific developmental epoch assessed, different patterns of adverse/traumatic experiences were associated with gender and with adolescent psychopathology (e.g., internalizing/externalizing behavior problems), and juvenile justice involvement. A multiply exposed subgroup that had severe problems in adolescence was evident in each of the 3 epochs, but their specific types of adverse/traumatic experiences differed depending upon the developmental epoch. Implications for research and clinical practice are identified.

摘要

到儿童进入青春期时,大多数儿童至少经历过一种严重的逆境,许多儿童还接触过多种类型的逆境。然而,儿童期不良经历的模式在儿童发展的各个阶段是否一致或有所变化尚不清楚。我们从被转介到国家儿童创伤应激网络(NCTSN)接受创伤聚焦评估和治疗的青少年(N = 3485)中,获取了他们在3个不同发展阶段(幼儿期,0至5岁;童年中期,6至12岁;青春期,13至18岁)潜在创伤性童年不良经历的回顾性报告。潜在类别分析(LCA)结果显示,与幼儿期相比,童年中期和青春期的不良/创伤经历模式日益复杂。根据所评估的具体发展阶段,不同的不良/创伤经历模式与性别、青少年精神病理学(如内化/外化行为问题)以及青少年司法参与有关。在这3个阶段中,每个阶段都有一个在青春期存在严重问题的多重暴露亚组,但他们不良/创伤经历的具体类型因发展阶段而异。本文还确定了对研究和临床实践的启示。

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