Florida International University, Center for Children and Families, Main Office DM 256, 11200 S.W. 8th Street, Miami, FL 33199, United States; Florida International University, United States.
Child Abuse Negl. 2017 May;67:182-192. doi: 10.1016/j.chiabu.2017.02.025.
Victimization by violence elevates adolescents' risk for developing internalizing and externalizing psychopathology. Recent findings suggest that disruptions in developmental processes associated with post-traumatic stress (PTS) reactions may partially account for the relationship between victimization and the subsequent development of psychopathology during adolescence. The present study tested the temporal sequencing of these associations using multi-informant measurements in a large, diverse sample of adolescents at high-risk for victimization.
Data were collected from a multi-site consortium of prospective studies, the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Information about 833 youth's victimization experiences (i.e., direct, indirect, familial, and non-familial violence), PTS, and affective, anxiety, attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms were gathered from youth and their caregivers during biannual face-to-face interviews when youth were between the ages of 4 and 14 years, and continuously from official child protective services records.
Structural equation modeling revealed that cumulative victimization contributed to elevations in youth and caregiver reported late childhood and early adolescent psychopathology. While PTS mediated the association between victimization and youth reported ADHD, ODD, CD, major depressive, and generalized anxiety symptoms during adolescence, it only mediated the association between victimization and caregiver reported affective symptoms.
PTS reactions following childhood victimization partially accounted for escalations in psychopathology during the transition to adolescence. These findings underscore the importance of integrating trauma-informed assessment and intervention approaches with at-risk adolescents. Researchers should determine whether trauma-focused interventions sufficiently ameliorate other psychopathology among victimized adolescents or if additional interventions components are necessary.
暴力侵害会增加青少年出现内化和外化精神病理学的风险。最近的研究结果表明，与创伤后应激（PTS）反应相关的发育过程中断可能部分解释了侵害与青少年时期随后出现精神病理学之间的关系。本研究使用高风险受害青少年的大型、多样化样本中的多信息测量，测试了这些关联的时间顺序。
数据来自一个多地点的前瞻性研究联盟，即儿童虐待和忽视纵向研究（LONGSCAN）。当青少年年龄在 4 至 14 岁之间时，通过青少年及其照顾者之间的每两年一次的面对面访谈收集了 833 名青少年受害经历（即直接、间接、家庭和非家庭暴力）、PTS 以及情感、焦虑、注意缺陷/多动障碍（ADHD）、对立违抗性障碍（ODD）和品行障碍（CD）症状的信息，并从官方儿童保护服务记录中持续收集这些信息。
结构方程模型显示，累积受害导致青少年和照顾者报告的儿童后期和青少年早期精神病理学增加。虽然 PTS 中介了受害与青少年报告的 ADHD、ODD、CD、重度抑郁和广泛性焦虑症状之间的关联，但仅中介了受害与照顾者报告的情感症状之间的关联。
童年受害后的 PTS 反应部分解释了向青少年期过渡时精神病理学的加剧。这些发现强调了将创伤知情评估和干预方法与高危青少年相结合的重要性。研究人员应该确定创伤焦点干预是否足以改善受害青少年的其他精神病理学，或者是否需要其他干预成分。
