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模拟战争暴露和日常压力源对母亲心理健康、育儿及儿童心理社会适应的影响:一项针对黎巴嫩叙利亚难民的横断面研究

Modeling the effects of war exposure and daily stressors on maternal mental health, parenting, and child psychosocial adjustment: a cross-sectional study with Syrian refugees in Lebanon.

作者信息

Sim Amanda, Bowes Lucy, Gardner Frances

机构信息

Department of Social Policy & Intervention, University of Oxford, Oxford, UK.

Department of Experimental Psychology, University of Oxford, Oxford, UK.

出版信息

Glob Ment Health (Camb). 2018 Dec 4;5:e40. doi: 10.1017/gmh.2018.33. eCollection 2018.

Abstract

BACKGROUND

The psychological effects of war trauma are well-documented, but comparatively little research has focused on the mechanisms underlying intergenerational impacts of war and displacement. Specifically, the effects of armed conflict on family processes such as parenting behavior, and subsequent impacts on child psychosocial outcomes, are less understood.

METHODS

This study tests a conceptual model linking past war trauma and current displacement-related stressors to maternal mental health, parenting behavior, and child psychosocial problems. Cross-sectional data were collected in 2016-2017 from a sample of 291 Syrian refugee mothers in Lebanon. We used structural equation modeling to examine associations between war trauma, daily stressors, mothers' general psychological distress and post-traumatic stress (PTS), negative parenting, and child psychosocial problems.

RESULTS

Exposure to war-related events was directly associated with maternal PTS and general psychological distress, as well as indirectly via daily stressors. Mothers' general psychological distress, but not PTS, was directly associated with negative parenting and child psychosocial difficulties. Negative parenting mediated the association between maternal general psychological distress and child psychosocial problems. Model fit statistics indicate that the measurement and structural models provided a good fit to the data.

CONCLUSIONS

Results suggest that the adverse effects of past war trauma and ongoing displacement on refugee mothers' general mental health can increase the risk of negative parenting behavior, and in turn contribute to poorer psychosocial outcomes for children. Interventions should focus on psychosocial and parenting support for war-affected caregivers, as well as address structural challenges that debilitate caregiver and child mental health.

摘要

背景

战争创伤的心理影响已有充分记录,但相对而言,很少有研究关注战争和流离失所的代际影响背后的机制。具体来说,武装冲突对诸如养育行为等家庭过程的影响,以及随后对儿童心理社会结果的影响,人们了解较少。

方法

本研究测试了一个概念模型,该模型将过去的战争创伤和当前与流离失所相关的压力源与母亲的心理健康、养育行为和儿童心理社会问题联系起来。2016 - 2017年从黎巴嫩的291名叙利亚难民母亲样本中收集了横断面数据。我们使用结构方程模型来检验战争创伤、日常压力源、母亲的一般心理困扰和创伤后应激(PTS)、消极养育以及儿童心理社会问题之间的关联。

结果

接触与战争相关的事件与母亲的创伤后应激和一般心理困扰直接相关,也通过日常压力源间接相关。母亲的一般心理困扰而非创伤后应激与消极养育和儿童心理社会困难直接相关。消极养育介导了母亲一般心理困扰与儿童心理社会问题之间的关联。模型拟合统计表明,测量模型和结构模型与数据拟合良好。

结论

结果表明,过去的战争创伤和持续的流离失所对难民母亲一般心理健康的不利影响会增加消极养育行为的风险,进而导致儿童心理社会结果更差。干预措施应侧重于为受战争影响的照顾者提供心理社会和养育支持,以及应对削弱照顾者和儿童心理健康的结构性挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9de/6315283/d48549a1b45f/S205442511800033X_fig1.jpg

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