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澳大利亚城市贫困人群心理困扰轨迹:人际创伤的影响。

Trajectories of Psychological Distress in Australians Living in Urban Poverty: The Impact of Interpersonal Trauma.

机构信息

School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.

Office of the Deputy Vice-Chancellor of Health and Communities, University of Wollongong, South Western Sydney, Australia.

出版信息

J Trauma Stress. 2018 Jun;31(3):362-372. doi: 10.1002/jts.22297.

Abstract

Childhood maltreatment and interpersonal trauma experience is an important factor underpinning the apparent perpetuation of the cycle of social disadvantage experienced by homeless adults. This paper aimed to examine longitudinal patterns of psychological distress in a sample of 1,504 socially disadvantaged adult participants from the Journeys Home Study in Australia. The current paper utilized the "conservation of resources" theory and the concept of "risk factor caravans" to investigate the nature and implications of childhood trauma in the context of homelessness. Growth mixture modeling revealed four distinct trajectories of psychological distress as measured by the Kessler 6 across six time points (covering a period of 2.5 years): chronic, escalating, attenuating, and resistant. Our results also indicated that experiences of different types of trauma during childhood were associated with these psychological distress trajectories. In particular, adults experiencing chronic psychological distress were significantly more likely than those exhibiting distress resistance to have experienced multiple and varied childhood maltreatment, adjusted odds ratio (AOR) = 3.30, 95% CI [0.37, 6.05], p = .002. Furthermore, adult experiences of assault were found to be associated with psychological distress. These findings have important implications for mental health, as well as interventions aimed at breaking the cycle of urban poverty. Specific focus on interpersonal trauma vulnerabilities is important. Prioritizing socioecological stability, with mental health needs assessed on an individual level, may be most appropriate. This work also highlights the need to direct future attention to barriers to access and facilitation of social support services.

摘要

儿童期虐待和人际创伤经历是导致无家可归成年人持续陷入社会劣势循环的一个重要因素。本文旨在考察澳大利亚“归家之旅研究”中 1504 名社会弱势群体成年参与者样本的心理困扰的纵向模式。本文利用“资源守恒”理论和“风险因素车队”的概念,探讨了在无家可归的背景下,儿童创伤的性质和影响。增长混合模型显示,在六个时间点(涵盖 2.5 年的时间)上,使用 Kessler 6 量表衡量的心理困扰有四种不同的轨迹:慢性、逐渐加重、减轻和抵抗。我们的研究结果还表明,儿童时期经历的不同类型的创伤与这些心理困扰轨迹有关。特别是,经历慢性心理困扰的成年人比表现出抗困扰的成年人更有可能经历多种不同的儿童期虐待,调整后的优势比(AOR)=3.30,95%CI [0.37, 6.05],p =.002。此外,成人遭受攻击的经历也与心理困扰有关。这些发现对心理健康以及旨在打破城市贫困循环的干预措施具有重要意义。特别关注人际创伤的脆弱性很重要。优先考虑社会生态稳定性,在个体层面评估心理健康需求,可能是最合适的。这项工作还强调了需要将未来的注意力集中在获取和促进社会支持服务的障碍上。

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