Ashton Chandra K, O'Brien-Langer Anna, Silverstone Peter H
Department of Psychiatry, University of Alberta, Edmonton, Alberta.
CASA Child, Adolescent, and Family Mental Health, Edmonton, Alberta.
J Can Acad Child Adolesc Psychiatry. 2016 Winter;25(1):35-42. Epub 2016 Feb 1.
There is relatively little research about effective therapeutic approaches for children in middle childhood who have attachment related diagnoses as a result of experiencing significant, early developmental trauma. This study describes findings from an intensive, dyad-based intervention, aimed at stabilizing attachment relationships with primary caregivers, increasing caregiver reflective function skills, and reducing children's trauma-related behavioural sequelae.
We analyzed retrospective data from 51 caregiver/child dyads who participated in the Trauma and Attachment Group (TAG) Program from September 2011-December 2014. This data included pre- and post-intervention scores retrieved from the Parenting Relationship Questionnaire (PRQ), the Parent Report of Post-Traumatic Stress Symptoms (PROPS), and the Parental Reflective Functioning Questionnaire (PRFQ-1).
The preliminary findings show statistically significant improvements in attachment, communication, discipline practices, involvement, and relational frustration. Additionally there were statistically significant improvements in parental reflective functioning, and a trend towards a reduction in symptoms typical of post-traumatic stress disorder.
Poor quality or inconsistent interactions with early caregivers can lead to life-long impairments in physical and mental health. This intensive program shows potential as a way to improve longer-term outcomes for children exposed to early developmental trauma. Longer-term research is required to further substantiate outcomes, appraise cost analysis, as well as to consider evaluation with appropriate comparison groups.
对于童年中期因经历重大早期发育创伤而患有依恋相关诊断的儿童,有效的治疗方法相关研究相对较少。本研究描述了一项基于二元组的强化干预的结果,该干预旨在稳定与主要照料者的依恋关系,提高照料者的反思功能技能,并减少儿童与创伤相关的行为后遗症。
我们分析了2011年9月至2014年12月期间参与创伤与依恋小组(TAG)项目的51对照料者/儿童二元组的回顾性数据。这些数据包括从育儿关系问卷(PRQ)、创伤后应激症状家长报告(PROPS)和父母反思功能问卷(PRFQ - 1)中获取的干预前后得分。
初步结果显示,在依恋、沟通、管教方式、参与度和关系挫折方面有统计学上的显著改善。此外,父母的反思功能也有统计学上的显著改善,并且有创伤后应激障碍典型症状减轻的趋势。
与早期照料者的不良质量或不一致的互动可能导致身心健康的终身损害。这个强化项目显示出作为改善遭受早期发育创伤儿童长期结局的一种方式的潜力。需要进行长期研究以进一步证实结果、评估成本分析,并考虑与适当对照组进行评估。