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遭受自然灾害的青少年中社会支持与创伤后应激症状之间的关系。

The relationship between social support and posttraumatic stress symptoms among youth exposed to a natural disaster.

作者信息

Lai Betty S, Osborne Melissa C, Piscitello Jennifer, Self-Brown Shannon, Kelley Mary Lou

机构信息

School of Public Health, Georgia State University, Atlanta, GA, USA.

Department of Psychology, Louisiana State University, Baton Rouge, LA, USA.

出版信息

Eur J Psychotraumatol. 2018 Mar 22;9(Suppl 2):1450042. doi: 10.1080/20008198.2018.1450042. eCollection 2018.

Abstract

: Children are a vulnerable population following a natural disaster, due to their age and dependence on adults. The primary presenting problem children report after disasters is posttraumatic stress symptoms (PTSS). Prior research suggests that PTSS is inversely related to social support, which is often disrupted after a disaster. : This study examined the relationship between social support (from parents, teachers, and peers) and PTSS in children affected by Hurricane Katrina. The research contributes to the literature by examining the mechanisms that drive this relationship over time. : In this study, 426 children were followed over four timepoints, beginning 3-7 months after Hurricane Katrina and concluding 25-27 months post-hurricane. Three path models analysed the relationship between social support (from parents, teachers, and peers, measured by the Social Support Scale for Children) and PTSS (measured by the UCLA PTSD Reaction Index). Covariates included child age, minority status, gender, perceived life threat, and actual life threat. Nonsignificant paths were trimmed from the final models. Global fit indices were examined to determine model fit. : In the parent and peer social support models, PTSS exhibited statistically significant effects on social support from one wave to the next. In the teacher model, this was only true between Waves 2 and 3. Social support showed a statistically significant effect on PTSS between Wave 2 and Wave 3 in the peer model (standardized estimate = -0.26,  < .0001). No paths from social support to PTSS were significant in the parent and teacher models. : Findings support a social selection model in which PTSS undermine social support, particularly in the first two years post-disaster. If these findings are replicated, this suggests that, in cases of limited funding, PTSS should be prioritized, given their cascading effects on social support.

摘要

由于年龄和对成年人的依赖,儿童是自然灾害后的弱势群体。儿童在灾难后报告的主要问题是创伤后应激症状(PTSS)。先前的研究表明,PTSS与社会支持呈负相关,而社会支持在灾难后往往会受到干扰。本研究考察了受卡特里娜飓风影响的儿童中社会支持(来自父母、教师和同伴)与PTSS之间的关系。该研究通过考察随时间推移驱动这种关系的机制,为相关文献做出了贡献。在本研究中,对426名儿童进行了四个时间点的跟踪,从卡特里娜飓风过后3 - 7个月开始,到飓风过后25 - 27个月结束。三个路径模型分析了社会支持(由儿童社会支持量表测量,来自父母、教师和同伴)与PTSS(由加州大学洛杉矶分校创伤后应激障碍反应指数测量)之间的关系。协变量包括儿童年龄、少数族裔身份、性别、感知到的生命威胁和实际生命威胁。无显著意义的路径从最终模型中剔除。通过检查整体拟合指数来确定模型拟合情况。在父母和同伴社会支持模型中,PTSS在前一波到下一波对社会支持表现出统计学上的显著影响。在教师模型中,只有在第2波和第3波之间才是如此。在同伴模型中,社会支持在第2波和第3波之间对PTSS表现出统计学上的显著影响(标准化估计值 = -0.26,< 0.0001)。在父母和教师模型中,从社会支持到PTSS的路径均无显著意义。研究结果支持一种社会选择模型,即PTSS会破坏社会支持,尤其是在灾难后的头两年。如果这些研究结果得到重复验证,这表明在资金有限的情况下,鉴于PTSS对社会支持的连锁效应,应优先处理PTSS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5051/5912434/901ba3499e0b/ZEPT_A_1450042_F0001_B.jpg

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