Department of Psychology, Division of Child and Adolescent Health Psychology, University of Zurich, Zurich, Switzerland.
Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany.
J Trauma Stress. 2019 Aug;32(4):496-505. doi: 10.1002/jts.22422. Epub 2019 Jul 10.
Dysfunctional posttraumatic cognitions seem to play an important role in adjustment after traumatic experiences. However, little research has been done on maltreated children and adolescents. Furthermore, possible causal associations between cognitions, posttraumatic stress symptoms, and internalizing and externalizing problems have rarely been investigated. In the current study, 263 maltreated children and adolescents (8-17 years of age) were assessed at baseline and again at time points 6 and either 12 or 18 months later. Cross-lagged panel analyses were used to gain a better understanding of the course of and associations among dysfunctional maltreatment-related cognitions, posttraumatic stress symptoms, and internalizing and externalizing problems. Ratings of all variables significantly decreased over time. Moderate to strong autoregressive paths emerged for all variables, denoting stability. Furthermore, the variables showed moderate to high correlations at every assessment. Posttraumatic stress symptoms moderately predicted dysfunctional maltreatment-related cognitions as well as internalizing and externalizing problems 6 months after baseline. Cross-lagged paths from the cognitions as well as from internalizing and externalizing problems to all other variables were not significant. Age, gender, and maltreatment characteristics did not play a relevant role in these cross-lagged associations when they were included as covariates. Our results underline the cognitive scar model, in which preceding posttraumatic stress symptoms adversely impact cognitions. Posttraumatic stress symptoms appear to be an important target for treatment as their reduction may help decrease internalizing and externalizing problems as well.
创伤后认知功能障碍似乎在创伤后调整中起着重要作用。然而,针对受虐待的儿童和青少年的研究却很少。此外,认知、创伤后应激症状以及内化和外化问题之间的可能因果关联也很少被调查。在当前的研究中,263 名受虐待的儿童和青少年(8-17 岁)在基线时进行了评估,并在 6 个月后以及 12 或 18 个月后再次进行评估。交叉滞后面板分析用于更好地理解功能失调的与虐待相关认知、创伤后应激症状以及内化和外化问题的发生过程和关联。所有变量的评分随时间显著下降。所有变量都出现了中等至强的自回归路径,表示稳定性。此外,在每次评估中,这些变量都显示出中等至高度的相关性。创伤后应激症状在基线后 6 个月中度预测了功能失调的与虐待相关认知以及内化和外化问题。从认知以及内化和外化问题到所有其他变量的交叉滞后路径并不显著。当将年龄、性别和虐待特征作为协变量纳入时,这些交叉滞后关联中它们并没有起到相关作用。我们的研究结果强调了认知创伤模型,即先前的创伤后应激症状对认知产生不利影响。创伤后应激症状似乎是治疗的一个重要目标,因为减轻这些症状可能有助于减少内化和外化问题。