Lansing Amy E, Plante Wendy Y, Beck Audrey N
University of California, San Diego, Psychiatry Department, 8950 Villa la Jolla Dr, Suite A109, La Jolla, CA 92037, USA; San Diego State University, Sociology Department, 5500 Campanile Dr, San Diego, CA 92182, USA.
University of California, San Diego, Psychiatry Department, 8950 Villa la Jolla Dr, Suite A109, La Jolla, CA 92037, USA; San Diego State University, Sociology Department, 5500 Campanile Dr, San Diego, CA 92182, USA.
J Anxiety Disord. 2017 May;48:36-44. doi: 10.1016/j.janxdis.2016.09.007. Epub 2016 Oct 6.
Despite growing recognition that cumulative adversity (total stressor exposure, including complex trauma), increases the risk for psychopathology and impacts development, assessment strategies lag behind: Adversity-related mental health needs (symptoms, functional impairment, maladaptive coping) are typically assessed in response to only one qualifying Criterion-A traumatic event. This is especially problematic for youth at-risk for health and academic disparities who experience cumulative adversity, including non-qualifying events (separation from caregivers) which may produce more impairing symptomatology. Data from 118 delinquent girls demonstrate: (1) an average of 14 adverse Criterion-A and non-Criterion event exposures; (2) serious maladaptive coping strategies (self-injury) directly in response to cumulative adversity; (3) more cumulative adversity-related than worst-event related symptomatology and functional impairment; and (4) comparable symptomatology, but greater functional impairment, in response to non-Criterion events. These data support the evaluation of mental health needs in response to cumulative adversity for optimal identification and tailoring of services in high-risk populations to reduce disparities.
尽管人们越来越认识到累积性逆境（接触的应激源总数，包括复杂创伤）会增加精神病理学风险并影响发育，但评估策略却滞后了：与逆境相关的心理健康需求（症状、功能损害、适应不良的应对方式）通常仅针对一个符合标准A的创伤性事件进行评估。对于面临健康和学业差距风险且经历累积性逆境的青少年来说，这一问题尤为突出，他们经历的累积性逆境包括不符合标准的事件（与照顾者分离），这些事件可能会产生更具损害性的症状。来自118名违法少女的数据表明：（1）平均有14次符合标准A的不良事件和不符合标准的事件暴露；（2）直接因累积性逆境而产生的严重适应不良应对策略（自我伤害）；（3）与累积性逆境相关的症状和功能损害多于与最严重事件相关的症状和功能损害；（4）对不符合标准的事件有类似的症状，但功能损害更大。这些数据支持针对累积性逆境评估心理健康需求，以便在高危人群中进行最佳识别和定制服务，以减少差距。
