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儿童保护服务中青少年的虐待史、创伤症状及研究反应性

Maltreatment history, trauma symptoms and research reactivity among adolescents in child protection services.

作者信息

Waechter Randall, Kumanayaka Dilesha, Angus-Yamada Colleen, Wekerle Christine, Smith Savanah

机构信息

1School of Medicine, St. George's University, St. George's, West Indies Grenada.

2Pediatrics & Offord Centre for Child Studies, McMaster University, Hamilton, Canada.

出版信息

Child Adolesc Psychiatry Ment Health. 2019 Mar 11;13:13. doi: 10.1186/s13034-019-0270-7. eCollection 2019.

Abstract

OBJECTIVE

There is a well-documented link between child maltreatment and poor health across the lifespan. This provides a strong case for ongoing research with youth involved in the child welfare system to reduce negative outcomes and support resilience while being inclusive of youth voices. However, detailed inquiries about maltreatment history and health consequences may cause re-experiencing of events and psychological distress for study participants. Data that accounts for different contexts, such as severity of maltreatment history and current trauma symptomatology, have been limited in considering the question of potential harms to youth who participate in research-especially longitudinal studies.

METHODS

This study compared self-reported impact of research participation against maltreatment history and current post-traumatic stress symptomatology among a randomly selected group of adolescents (< 18 years old) in the child protection service (CPS) system.

RESULTS

Adolescents who report more serious child maltreatment and current trauma symptom severity reported higher scores on distress questions from pre- to post-assessment participation. Critically, participants who were more negatively impacted by study involvement also reported greater benefit from study involvement.

CONCLUSION

The increase in both negative and positive impact does not shift the risk/reward ratio for participation, as risks alone do not increase for this vulnerable group of CPS involved youth. These results are consistent with previous findings from studies involving non-CPS populations and underlies the importance of empirical data to address the question of change in the risk/reward ratio and what factors might play a role in any change. This information can inform inclusion/exclusion criteria for future research with these vulnerable populations, thereby reducing the risk of distress among study participants.

摘要

目的

有充分记录表明,儿童期受虐与一生的健康状况不佳之间存在关联。这有力地证明了持续对参与儿童福利系统的青少年进行研究的必要性,以减少负面结果并支持其恢复力,同时纳入青少年的声音。然而,对虐待史和健康后果的详细询问可能会使研究参与者重新经历相关事件并产生心理困扰。在考虑参与研究(尤其是纵向研究)的青少年可能受到的潜在伤害问题时,考虑不同背景(如虐待史的严重程度和当前创伤症状)的数据一直很有限。

方法

本研究比较了儿童保护服务(CPS)系统中一组随机抽取的青少年(<18岁)自我报告的研究参与影响与虐待史及当前创伤后应激症状。

结果

报告更严重儿童虐待和当前创伤症状严重程度的青少年在评估前到评估后参与期间的困扰问题上得分更高。关键的是,受研究参与负面影响更大的参与者也报告称从研究参与中受益更多。

结论

负面和正面影响的增加并未改变参与的风险/回报比,因为对于这一参与CPS系统的弱势群体而言,仅风险并未增加。这些结果与之前涉及非CPS人群的研究结果一致,强调了实证数据对于解决风险/回报比变化问题以及哪些因素可能在任何变化中起作用的重要性。这些信息可为未来针对这些弱势群体的研究提供纳入/排除标准,从而降低研究参与者的困扰风险。

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