University of Nevada, Las Vegas, USA.
University of Nevada, Las Vegas, USA.
Child Abuse Negl. 2017 Jul;69:177-187. doi: 10.1016/j.chiabu.2017.04.028. Epub 2017 May 5.
Individual psychological factors have been shown to exacerbate risk for posttraumatic stress disorder (PTSD) symptoms in youth following maltreatment, but the novel contribution of the present study includes a focus on interactive relationships between these factors on specific PTSD symptom clusters. This study identified maltreated youth at highest risk for re-experiencing, avoidance, and hyperarousal symptom clusters via cognitive, affective, and demographic variables. Participants (n=400) included ethnically diverse maltreated youth. Classification and regression tree (CART) analysis, a form of binary recursive partitioning (BRP), identified subgroups of maltreated youth at highest risk for three core PTSD symptom clusters. Posttraumatic cognitions, anhedonia, negative mood, processing speed, and ethnicity best predicted re-experiencing symptoms. Depersonalization/derealization, verbal comprehension, sexual maltreatment, and age best predicted avoidance symptoms. Negative cognitions about self, IQ, dissociation, working memory, and posttraumatic cognitions best predicted hyperarousal symptoms. Core PTSD symptom clusters may thus be associated with unique collections of risk factors for maltreated youth. Clinical protocols for this population could be recalibrated to be more sensitive to specific profiles that more accurately identify highest risk maltreated youth and better inform evidence-based treatment practices.
个体心理因素已被证明会加剧虐待后青少年创伤后应激障碍（PTSD）症状的风险，但本研究的新贡献包括关注这些因素在特定 PTSD 症状群上的相互关系。本研究通过认知、情感和人口统计学变量确定了最容易出现再体验、回避和过度警觉症状群的受虐待青少年。参与者（n=400）包括不同种族的受虐待青少年。分类和回归树（CART）分析，一种二进制递归分区（BRP）形式，确定了三组 PTSD 核心症状群中风险最高的受虐待青少年亚组。创伤后认知、快感缺失、负性情绪、加工速度和种族最能预测再体验症状。去人格化/现实解体、言语理解、性虐待和年龄最能预测回避症状。对自我、智商、解离、工作记忆和创伤后认知的消极认知最能预测过度警觉症状。因此，PTSD 的核心症状群可能与受虐待青少年的独特风险因素有关。针对该人群的临床方案可以进行重新调整，以更敏感地识别特定的风险概况，从而更准确地确定风险最高的受虐待青少年，并为循证治疗实践提供更好的信息。
