Neugebauer Richard, Forde Allana, Fodor Kinga E, Fisher Prudence W, Turner J Blake, Stehling-Ariza Tasha, Yamabe Saori
J Nerv Ment Dis. 2018 Jan;206(1):11-18. doi: 10.1097/NMD.0000000000000582.
Whether children or adolescents exhibit higher levels of posttraumatic stress symptoms (PTSS) in response to violence is an unresolved research question. We examine this issue in UNICEF's 1995 National Trauma Survey (NTS) of 8-19-year-olds (n = 942) who survived the Rwandan Genocide and lived and attended schools in the community. PTSS were assessed with a symptom checklist based on DSM-IV indexed using an overall score comprising the sum of scores on all items and mean item scores of each of five distinct factors identified in a factor analysis within this sample. Eighty percent of the sample had witnessed massacres; 25%, rape/sexual mutilation. The overall symptom score among children was significantly (p < 0.05) lower than among adolescents. Among the five separate factors, this direct association of age with symptom levels held for two: re-experiencing (p < 0.001) and dysphoric arousal (p < 0.05), but not for the remaining three: avoidance, numbing, and anxious arousal. This discordance in factorial response to violence may help explain prevailing inconsistencies in the age-PTSS association reported to date.
儿童或青少年在面对暴力时是否会表现出更高水平的创伤后应激症状（PTSS），这是一个尚未解决的研究问题。我们在联合国儿童基金会1995年对8至19岁（n = 942）经历过卢旺达种族灭绝并在社区生活和上学的儿童进行的全国创伤调查（NTS）中研究了这个问题。PTSS通过基于《精神疾病诊断与统计手册》第四版（DSM-IV）的症状清单进行评估，该清单使用一个综合得分来索引，该综合得分包括所有项目得分的总和以及在该样本的因素分析中确定的五个不同因素中每个因素的平均项目得分。80%的样本目睹过屠杀；25%的样本目睹过强奸/性残害。儿童的总体症状得分显著低于青少年（p < 0.05）。在五个单独的因素中，年龄与症状水平的这种直接关联在两个因素上成立：重新体验（p < 0.001）和烦躁不安的唤醒（p < 0.05），但在其余三个因素上不成立：回避、麻木和焦虑唤醒。对暴力的因素反应中的这种不一致可能有助于解释迄今为止报道的年龄与PTSS关联中普遍存在的不一致情况。
