寄养儿童和青少年创伤后症状与 ICD-11 创伤后应激障碍的关系：感知凝聚力的中介作用
The relationship between cumulative traumatic experiences and ICD-11 post-traumatic symptoms in children and adolescents in foster care: The mediating effect of sense of coherence.
机构信息
Unit of Psychotraumatology, Department of Applied Psychology, Faculty of Psychology, University of Vienna, Wächtergasse 1, 1010 Vienna, Austria.
Unit of Psychotraumatology, Department of Applied Psychology, Faculty of Psychology, University of Vienna, Wächtergasse 1, 1010 Vienna, Austria.
出版信息
Child Abuse Negl. 2020 Mar;101:104388. doi: 10.1016/j.chiabu.2020.104388. Epub 2020 Jan 31.
BACKGROUND
Children and adolescents in foster care show a high prevalence of cumulative traumatic experiences (CTE), symptoms of posttraumatic stress disorder (PTSD) and symptoms related to disturbances in self-organization (DSO). PTSD and DSO constitute the ICD-11 diagnosis Complex PTSD (CPTSD). Sense of coherence (SOC) has been shown to alleviate the impact of CTE.
OBJECTIVE
This study aimed to investigate the mediating role of SOC in the relationship between CTE, PTSD, and DSO.
PARTICIPANTS AND SETTING
Trauma history (CTE), PTSD, DSO and SOC were assessed in a sample of 140 children and adolescents in foster care aged 10-18 using self-report questionnaires.
METHOD
Mediation analysis determined the direct, indirect and total effect of the mediation of SOC in the relationship between CTE, PTSD and DSO.
RESULTS
The results showed no mediation of SOC in the relationship between CTE and PTSD symptoms (indirect effect of b = -.001, 95 %CI: -.088-.086). However, SOC mediated the relationship between CTE and DSO symptoms (indirect effect b = .128, 95 %CI: 0.045-.211).
CONCLUSIONS
Those results may point to a promotive function of SOC for the overall development and different areas of self-organization, but not for PTSD symptoms. It is possible that the influence of the trauma on symptoms of PTSD is too pervasive for the promotive function of SOC. The present findings strengthen the assumption that PTSD and DSO are separate second-order factors, which characterize different groups of trauma survivors. The present findings are vital to inform tailored prevention and intervention strategies for survivors of early CTE.
背景
寄养儿童和青少年普遍存在创伤后应激障碍（PTSD）和与自我组织障碍相关的症状（DSO）。PTSD 和 DSO 构成了 ICD-11 诊断中的复杂性创伤后应激障碍（CPTSD）。已有研究表明，心理一致感（SOC）可以减轻创伤后应激障碍的影响。
目的
本研究旨在探讨 SOC 在创伤后应激障碍、自我组织障碍与累积创伤经历（CTE）之间的关系中的中介作用。
参与者和设置
采用自陈式问卷对 140 名 10-18 岁寄养儿童和青少年的创伤史（CTE）、PTSD、DSO 和 SOC 进行评估。
方法
中介分析确定了 SOC 在 CTE、PTSD 和 DSO 之间关系中的直接、间接和总效应。
结果
结果表明，SOC 在 CTE 和 PTSD 症状之间没有中介作用（间接效应 b=-.001，95%CI：-.088-.086）。然而，SOC 中介了 CTE 和 DSO 症状之间的关系（间接效应 b=0.128，95%CI：0.045-.211）。
结论
这些结果可能表明 SOC 对整体发展和自我组织的不同领域具有促进作用，但对 PTSD 症状没有影响。创伤对 PTSD 症状的影响可能过于普遍，以至于 SOC 的促进作用无法发挥。本研究结果进一步支持了 PTSD 和 DSO 是两个独立的二阶因素，它们描述了不同创伤后应激障碍患者群体的观点。本研究结果对于为早期 CTE 幸存者提供有针对性的预防和干预策略具有重要意义。
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