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发展一种用于筛查幼儿创伤后应激障碍症状的简短量表:幼儿创伤后应激障碍筛查量表。

Development of a Brief Screen for Symptoms of Posttraumatic Stress Disorder in Young Children: The Young Child PTSD Screen.

机构信息

Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA.

出版信息

J Dev Behav Pediatr. 2019 Feb/Mar;40(2):105-111. doi: 10.1097/DBP.0000000000000639.

Abstract

OBJECTIVE

The ability to reliably detect posttraumatic stress disorder (PTSD) symptoms that require treatment in young children through screening efforts is a critical step toward providing appropriate treatment. The developmental differences in this age group compared to older youths pose challenges for accurate detection. A brief age-appropriate screen has not yet been quantitatively validated. This study aimed to address that gap by creating a rapid and brief screen based on empirical data that focused on sensitivity and face validity for children aged 3 to 6 years.

METHODS

A trauma-exposed group (N = 284) and a non-trauma-exposed group (N = 46), aged 3 to 6 years, were assessed using a semistructured diagnostic interview with their primary caregivers.

RESULTS

One hundred twenty combinations of items were evaluated for sensitivity, specificity, positive predictive value, negative predictive value, associations with functional impairment, and frequency of false positives. Many combinations of items performed well on these psychometrics, and the final selection of a 6-item screener was influenced by considerations of face validity so that the screen would best reflect the unique symptoms of PTSD.

CONCLUSION

The screener proposed is a promising tool that will benefit from additional research to examine its psychometric properties as a stand-alone PTSD screen. Future research ought to include test-retest reliability and replication of these findings in other samples and settings. Eventual uses of a brief screen for PTSD in young children include screening during primary care visits and large-scale screening efforts following disasters, for which cost and time need to be considered.

摘要

目的

通过筛查工作,可靠地发现需要治疗的儿童期创伤后应激障碍(PTSD)症状,这是为儿童提供适当治疗的关键步骤。与年龄较大的青少年相比,该年龄段的发育差异给准确检测带来了挑战。目前尚未对一种简短的、适合年龄的筛查工具进行定量验证。本研究旨在通过创建一种基于关注 3 至 6 岁儿童敏感性和表面效度的经验数据的快速、简短的筛查工具来填补这一空白。

方法

对 284 名创伤暴露组和 46 名非创伤暴露组的儿童(年龄 3 至 6 岁)进行半结构式诊断访谈,由其主要照顾者进行评估。

结果

评估了 120 种项目组合的敏感性、特异性、阳性预测值、阴性预测值、与功能障碍的相关性以及假阳性的频率。许多项目组合在这些心理计量学上表现良好,最终选择 6 项筛查器受到了表面效度的考虑的影响,以便筛查器能最好地反映 PTSD 的独特症状。

结论

所提出的筛查器是一种很有前途的工具,需要进一步研究来检验其作为独立 PTSD 筛查器的心理计量学特性。未来的研究应该包括测试-重测信度以及在其他样本和环境中复制这些发现。在幼儿中使用简短的 PTSD 筛查工具,包括在初级保健访问期间进行筛查,以及在灾难后进行大规模筛查,这需要考虑成本和时间。

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