Villalta Laia, Khadr Sophie, Chua Kia-Chong, Kramer Tami, Clarke Venetia, Viner Russell M, Stringaris Argyris, Smith Patrick
Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, University of Barcelona (UB), Barcelona, Spain.
Population, Policy & Practice Research Programme, UCL Institute of Child Health, London, UK.
Eur J Psychotraumatol. 2020 Jan 10;11(1):1710400. doi: 10.1080/20008198.2019.1710400. eCollection 2020.
: Adolescents are at high risk of sexual assault compared to any other age group. The pattern of post-traumatic stress symptoms plus life-impairing disturbances in self-organization (emotion dysregulation, negative self-concept and interpersonal problems) is termed Complex Post-Traumatic Stress Disorder (CPTSD). Research about CPTSD after sexual assault in adolescents is limited owing to the challenges associated with assessing this group. This study aims to determine the frequency and structure of CPTSD, and the relationship of emotion dysregulation with impairment and additional trauma exposure among adolescents who have been sexually assaulted. : Prospective cohort study of adolescents attending the Sexual Assault Referral Centres serving London over a 2-year period. We conducted cross-sectional analyses (n = 99) on data collected 4-5 months after sexual assault, and Confirmatory Factor Analyses (CFA) and Latent Class Analyses (LCA) to determine the CPTSD profile. CTPSD was defined according to the ICD-11, selecting symptom indicators from the following measures: Strengths and Difficulties Questionnaire (SDQ), Children's Revised Impact of Event Scale (CRIES-13), Short version of the Mood and Feelings Questionnaire (S-MFQ), The Development and Well-Being Assessment (DAWBA). We analysed the association of CPTSD symptom domains with impairment (measured with the SDQ, and the Children's Global Assessment Scale; C-GAS) and with additional trauma exposure. : The frequency of ICD-11 PTSD was 59%, and of ICD-11 CPTSD was 40%. CPTSD symptoms showed a strong fit for a correlated 4-factor model, and LCA distinguished a class of participants with high levels of CPTSD symptoms. Emotion dysregulation was associated with impairment in functioning and exposure to trauma beyond other self-organization disturbances and core PTSD symptoms. : Disturbances in self-organization are frequent in sexually assaulted adolescents, and emotion dysregulation is associated with impairment and further exposure to trauma. Emotion dysregulation should be considered in preventive and treatment strategies for these vulnerable youth.
与其他任何年龄组相比，青少年遭受性侵犯的风险很高。创伤后应激症状加上自我组织方面影响生活的紊乱（情绪失调、消极的自我概念和人际关系问题）的模式被称为复杂性创伤后应激障碍（CPTSD）。由于评估该群体存在挑战，关于青少年性侵犯后CPTSD的研究有限。本研究旨在确定CPTSD的频率和结构，以及情绪失调与遭受性侵犯青少年的功能损害和额外创伤暴露之间的关系。：对在两年期间前往伦敦性侵犯转诊中心就诊的青少年进行前瞻性队列研究。我们对性侵犯后4至5个月收集的数据进行了横断面分析（n = 99），并进行了验证性因素分析（CFA）和潜在类别分析（LCA）以确定CPTSD概况。CPTSD根据《国际疾病分类第11版》（ICD - 11）进行定义，从以下测量方法中选择症状指标：优势与困难问卷（SDQ）、儿童事件影响量表修订版（CRIES - 13）、情绪与感受问卷简版（S - MFQ）、发展与幸福感评估（DAWBA）。我们分析了CPTSD症状领域与功能损害（用SDQ和儿童总体评估量表；C - GAS测量）以及额外创伤暴露之间的关联。：ICD - 11创伤后应激障碍（PTSD）的发生率为59%，ICD - 11 CPTSD的发生率为40%。CPTSD症状与一个相关的四因素模型高度拟合，LCA区分出了一类CPTSD症状水平较高的参与者。与其他自我组织紊乱和核心PTSD症状相比，情绪失调与功能损害和创伤暴露相关。：自我组织紊乱在遭受性侵犯的青少年中很常见，情绪失调与功能损害和进一步的创伤暴露相关。对于这些脆弱的青少年，预防和治疗策略应考虑情绪失调。
