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功能失调的创伤后认知在创伤适应中起中介作用吗?来自儿童和青少年人际创伤与意外创伤样本的研究结果。

Do dysfunctional posttraumatic cognitions play a mediating role in trauma adjustment? Findings from interpersonal and accidental trauma samples of children and adolescents.

作者信息

de Haan Anke, Tutus Dunja, Goldbeck Lutz, Rosner Rita, Landolt Markus A

机构信息

Department of Psychology - Division of Child and Adolescent Health Psychology, University of Zurich, Zurich, Switzerland.

Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland.

出版信息

Eur J Psychotraumatol. 2019 Apr 16;10(1):1596508. doi: 10.1080/20008198.2019.1596508. eCollection 2019.

Abstract

: Trauma adjustment varies in children and adolescents. Studies on objective risk factors of posttraumatic stress symptoms (PTSS) yielded inconsistent results. Dysfunctional posttraumatic cognitions (PTCs) might play a mediating role between risk factors and posttraumatic symptomatology. : To investigate the interplay of the characteristics of the trauma (e.g. trauma type), the characteristics of the individual (e.g. age, sex), and the characteristics of the social environment (e.g. parental distress, marital status) on PTSS and depression, taking the child's dysfunctional PTCs into account as a possible mediator. : Structural equation modelling was used to better understand trauma adjustment in two heterogeneous samples of children and adolescents: a sample of 114 participants aged 7-16 after accidental trauma and a sample of 113 participants aged 6-17 after interpersonal trauma. : In the accidental trauma sample, dysfunctional PTCs mediated the positive associations of younger age and lower parental educational level on child PTSS, but not on depression. In the interpersonal trauma sample, being female positively predicted child depression. Furthermore, parental dysfunctional PTCs positively predicted both child PTSS and depression. No mediation effect of child dysfunctional PTCs was found in the interpersonal trauma sample. Child dysfunctional PTCs moderately to strongly predicted child PTSS and depression in both trauma samples. : The impact of the characteristics of the individual and the characteristics of the social environment on child PTSS and depression might depend on the type of trauma experienced. Dysfunctional PTCs mediated between the characteristics of the individual and the characteristics of the social environment and the severity of PTSS in the aftermath of accidental trauma, but not of interpersonal trauma.

摘要

创伤适应在儿童和青少年中存在差异。关于创伤后应激症状(PTSS)客观风险因素的研究结果并不一致。功能失调的创伤后认知(PTC)可能在风险因素与创伤后症状之间起中介作用。

为了研究创伤特征(如创伤类型)、个体特征(如年龄、性别)和社会环境特征(如父母苦恼、婚姻状况)对PTSS和抑郁的相互作用,并将儿童功能失调的PTC作为可能的中介因素考虑在内。

采用结构方程模型来更好地理解儿童和青少年两个异质样本中的创伤适应情况

一个是114名7 - 16岁意外创伤后的参与者样本,另一个是113名6 - 17岁人际创伤后的参与者样本。

在意外创伤样本中,功能失调的PTC介导了年龄较小和父母教育水平较低与儿童PTSS之间的正相关关系,但与抑郁无关。在人际创伤样本中,女性正向预测儿童抑郁。此外,父母功能失调的PTC正向预测儿童PTSS和抑郁。在人际创伤样本中未发现儿童功能失调的PTC的中介作用。在两个创伤样本中,儿童功能失调的PTC都中度到强烈地预测了儿童PTSS和抑郁。

个体特征和社会环境特征对儿童PTSS和抑郁的影响可能取决于所经历的创伤类型。在意外创伤后,功能失调的PTC在个体特征和社会环境特征与PTSS严重程度之间起中介作用,但在人际创伤中不起作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c089/6493315/bd9da9db72f8/ZEPT_A_1596508_F0001_B.jpg

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