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儿童逆境后创伤症状的发展:保护因素的调节作用。

Development of trauma symptoms following adversity in childhood: The moderating role of protective factors.

机构信息

University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. NW, 3B2X9, Calgary, AB, Canada.

University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada.

出版信息

Child Abuse Negl. 2020 Mar;101:104375. doi: 10.1016/j.chiabu.2020.104375. Epub 2020 Jan 31.

Abstract

BACKGROUND

Although the buffering effect of protective factors on children's outcomes following exposure to adverse childhood experiences has been well documented, research gaps remain as to whether this buffering effect differs based on the type of adversity experienced (i.e., maltreatment versus household dysfunction).

OBJECTIVE

To examine whether protective factors moderate the association between cumulative adversity, as well as adversity subtypes (i.e., maltreatment and household dysfunction) and child trauma-related distress in a clinical sample referred for treatment following exposure to adversity.

PARTICIPANTS AND SETTING

One-hundred and seventy-six children (aged 3-18) referred to a child abuse treatment clinic and who's files were opened between January 2016 and June 2017 were included.

METHODS

Data were collected, extracted, and coded from clinical files using a standardized data extraction protocol. Protective factors included: using individual coping strategies, peer support, individual social skills, caregiver physical caregiving, caregiver psychological caregiving, and educational involvement.

RESULTS

Cumulative childhood adversity (b = .16, p = .04) positively predicted child trauma-related distress. The link between exposure to cumulative adversity and child trauma-related distress varied as a function of protective factors: there was a positive association between adversity and child trauma-related distress for children who had low levels of protective factors, but not for those with high levels of protective factors (b=-0.56, p=<.001). Similar findings were observed when data was stratified by maltreatment and household dysfunction.

CONCLUSIONS

Bolstering children's protective factors prior to, and during child abuse treatment, may reduce trauma-related distress following exposure to adversity.

摘要

背景

尽管保护因素对儿童在经历逆境后产生的结果具有缓冲作用已得到充分证明,但研究仍存在空白,即这种缓冲作用是否因所经历的逆境类型(即虐待与家庭功能障碍)而异。

目的

研究保护因素是否能调节累积逆境以及逆境亚型(即虐待和家庭功能障碍)与经历逆境后接受治疗的临床样本中儿童创伤相关痛苦之间的关联。

参与者和环境

176 名(年龄 3-18 岁)儿童被转介到儿童虐待治疗诊所,他们的档案于 2016 年 1 月至 2017 年 6 月期间开放。

方法

使用标准化数据提取协议从临床档案中收集、提取和编码数据。保护因素包括:使用个体应对策略、同伴支持、个体社交技能、照顾者身体关怀、照顾者心理关怀和教育参与。

结果

累积童年逆境(b=0.16,p=0.04)正向预测儿童创伤相关痛苦。暴露于累积逆境与儿童创伤相关痛苦之间的联系取决于保护因素:对于保护因素水平较低的儿童,逆境与儿童创伤相关痛苦之间存在正相关,但对于保护因素水平较高的儿童则没有(b=-0.56,p<.001)。当按虐待和家庭功能障碍对数据进行分层时,也观察到了类似的发现。

结论

在儿童虐待治疗之前和期间增强儿童的保护因素,可能会减少经历逆境后与创伤相关的痛苦。

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