Marsac Meghan L, Kassam-Adams Nancy, Delahanty Douglas L, Ciesla Jeffrey, Weiss Danielle, Widaman Keith F, Barakat Lamia P
The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia.
Department of Psychology, Kent State University.
Health Psychol. 2017 Aug;36(8):787-796. doi: 10.1037/hea0000508. Epub 2017 Jun 26.
Each year millions of children suffer from unintentional injuries that result in poor emotional and physical health. This study examined selected biopsychosocial factors (i.e., child heart rate, peritrauma appraisals, early coping, trauma history) to elucidate their roles in promoting emotional recovery following injury. The study evaluated specific hypotheses that threat appraisals (global and trauma-specific) and coping would predict subsequent posttraumatic stress symptoms (PTSS), that coping would mediate the association between early and later PTSS, and that heart rate would predict PTSS and appraisals would mediate this association.
Participants were 96 children hospitalized for injury and assessed at 3 time points: T1 (within 2 weeks of injury), T2 (6-week follow-up), and T3 (12-week follow-up). Participants completed measures of trauma history and appraisals at T1, coping at T2, and PTSS at T1, T2, and T3. Heart rate was abstracted from medical records. Structural equation modeling was employed to evaluate study hypotheses.
Heart rate was not associated with PTSS or appraisals. Models including trauma history, appraisals, coping, and PTSS were constructed to test other study hypotheses and fit the data well. T1 global and trauma-specific threat appraisals were associated with T1 PTSS; T2 avoidant coping was a significant mediator of the relation between T1 and T3 PTSS.
Findings confirm a role for appraisals and coping in the development of PTSS over the weeks following pediatric injury. Early appraisals and avoidant coping may be appropriate targets for prevention and early intervention. Future researchers should further explicate the utility of a biopsychosocial framework in predicting PTSS. (PsycINFO Database Record
每年有数百万儿童遭受意外伤害，导致身心健康不佳。本研究考察了选定的生物心理社会因素（即儿童心率、创伤期间评估、早期应对方式、创伤史），以阐明它们在促进受伤后情绪恢复中的作用。该研究评估了特定假设，即威胁评估（总体和特定创伤的）及应对方式可预测随后的创伤后应激症状（PTSS），应对方式可调节早期和晚期PTSS之间的关联，心率可预测PTSS且评估可调节这种关联。
参与者为96名因伤住院的儿童，在3个时间点进行评估：T1（受伤后2周内）、T2（6周随访）和T3（12周随访）。参与者在T1完成创伤史和评估测量，在T2完成应对方式测量，在T1、T2和T3完成PTSS测量。心率从医疗记录中提取。采用结构方程模型评估研究假设。
心率与PTSS或评估无关。构建了包括创伤史、评估、应对方式和PTSS的模型来检验其他研究假设，且模型与数据拟合良好。T1时的总体和特定创伤威胁评估与T1时的PTSS相关；T2时的回避应对方式是T1和T3时PTSS之间关系的重要调节因素。
研究结果证实了评估和应对方式在儿童受伤后数周内PTSS发展中的作用。早期评估和回避应对方式可能是预防和早期干预的合适目标。未来的研究人员应进一步阐明生物心理社会框架在预测PTSS方面的效用。（PsycINFO数据库记录）
