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海地街头儿童的多重创伤与适应能力:生存的精神病理学。

Multiple traumas and resilience among street children in Haiti: Psychopathology of survival.

机构信息

Université du Québec à Montréal, Montréal, Québec, Canada.

Université de Bourgogne Franche-Comté, Laboratoire de Psychologie Psy-Drepi, EA 7458, France.

出版信息

Child Abuse Negl. 2018 May;79:85-97. doi: 10.1016/j.chiabu.2018.01.024. Epub 2018 Feb 20.

Abstract

In Haiti, as in several developing countries, the phenomenon of street children has become a major public health issue. These children are often victims of traumas and adverse life events. This article aimed to investigate traumas experienced by street children and their coping and resilience strategies used to deal with adversities in a logic of survival, relying on a mixed method approach. A group of 176 street children, aged 7-18 (n = 21 girls), recruited in Port-au-Prince, completed measures assessing PTSD, social support and resilience. Semi-structured interviews were conducted to document traumatic experiences, factors related to resilience and coping strategies. After performing statistical analyses to evaluate prevalence and predictors associated with PTSD, and level of social support satisfaction and resilience, qualitative analysis using a grounded theory approach was conducted. Results showed that street children experienced multiple traumas such as neglect, maltreatment, psychological, physical and sexual abuse. However, they also showed self-efficacy to face their traumatic experiences and few of them (less than 15%) obtained scores reaching clinical rates of PTSD, while a large majority presented a level of resilience between moderate to very high. A socio-ecological model of multiple traumas and a model of coping, survival and resilience strategies are conceptualized. Data provide a better understanding of the traumas experienced by street children, their coping and resilience strategies. Results underscore ways to develop practices to offer psychological support, social and vocational integration based on the real needs of these children, in a perspective of social justice.

摘要

在海地和其他一些发展中国家,街头儿童问题已经成为一个主要的公共卫生问题。这些儿童往往是创伤和不良生活事件的受害者。本文旨在通过混合方法研究,调查街头儿童所经历的创伤,以及他们在生存逻辑下应对逆境的应对和适应策略。在太子港,一组 176 名年龄在 7-18 岁的街头儿童(21 名女孩)完成了创伤后应激障碍、社会支持和适应力的评估措施。进行了半结构化访谈,记录创伤经历、与适应力相关的因素和应对策略。在对 PTSD 的患病率和预测因素以及社会支持满意度和适应力水平进行统计分析后,采用扎根理论方法进行了定性分析。结果表明,街头儿童经历了多种创伤,如忽视、虐待、心理、身体和性虐待。然而,他们也表现出面对创伤经历的自我效能,只有不到 15%的人达到了临床 PTSD 水平,而大多数人表现出从中度到高度的适应力。提出了一个多创伤的社会生态学模型和一个应对、生存和适应策略的模型。这些数据提供了对街头儿童所经历的创伤、他们的应对和适应策略的更好理解。结果强调了如何根据这些儿童的实际需求,制定提供心理支持、社会和职业融合的实践方法,以实现社会正义。

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