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评估与应对在预测儿童受伤后创伤后应激反应中的作用。

The role of appraisals and coping in predicting posttraumatic stress following pediatric injury.

作者信息

Marsac Meghan L, Ciesla Jeffrey, Barakat Lamia P, Hildenbrand Aimee K, Delahanty Douglas L, Widaman Keith, Winston Flaura K, Kassam-Adams Nancy

机构信息

Center for Injury Research and Prevention, The Children's Hospital of Philadelphia.

Department of Psychology, Kent State University.

出版信息

Psychol Trauma. 2016 Jul;8(4):495-503. doi: 10.1037/tra0000116. Epub 2016 Apr 11.

Abstract

OBJECTIVE

Given the millions of children who experience potentially traumatic injuries each year and the need to maximize emotional and physical health outcomes following pediatric injury, the current study examined the individual and collective contributions of the malleable variables of appraisals and coping in predicting posttraumatic stress symptoms (PTSS) in children following injury.

METHOD

This study combined data from 3 prospective investigations of recovery from pediatric injury (N = 688) in which children ages 8-17 years were recruited shortly after an injury (within 4 weeks). At baseline (T1), children completed measures of their threat appraisals of the injury event and PTSS. Six to twelve weeks later (T2), children completed a measure of coping and PTSS. Finally, PTSS was assessed again 6 months post-injury (T3).

RESULTS

Structural equation modeling analyses provide evidence that appraisals and coping contribute to PTSS. Furthermore, results suggest that escape coping mediates the relationship between threat appraisals and PTSS.

CONCLUSIONS

Early interventions designed to prevent or reduce PTSS after pediatric injury may be more successful if they primarily target modifying escape coping behaviors. To best inform clinical practice, future research should examine factors influencing the development of children's appraisals and coping behaviors in the context of potentially traumatic events. (PsycINFO Database Record

摘要

目的

鉴于每年有数百万儿童经历潜在的创伤性伤害,且为了使儿童受伤后的情绪和身体健康结果最大化,本研究考察了评估和应对这些可塑变量在预测儿童受伤后创伤后应激症状(PTSS)方面的个体和共同作用。

方法

本研究合并了来自3项关于儿童受伤后恢复情况的前瞻性调查的数据(N = 688),其中8至17岁的儿童在受伤后不久(4周内)被招募。在基线期(T1),儿童完成对受伤事件的威胁评估和PTSS测量。6至12周后(T2),儿童完成应对方式和PTSS测量。最后,在受伤后6个月(T3)再次评估PTSS。

结果

结构方程模型分析表明评估和应对方式对PTSS有影响。此外,结果表明逃避应对在威胁评估和PTSS之间起中介作用。

结论

如果早期干预主要针对改变逃避应对行为,那么旨在预防或减少儿童受伤后PTSS的早期干预可能会更成功。为了更好地指导临床实践,未来的研究应考察在潜在创伤事件背景下影响儿童评估和应对行为发展的因素。(PsycINFO数据库记录 )

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a65/4925202/32d2cadcb8a7/nihms794729f1.jpg

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