Vivrette Rebecca L, Briggs Ernestine C, Lee Robert C, Kenney Krista T, Houston-Armstrong Tina R, Pynoos Robert S, Kiser Laurel J
1Department of Psychiatry, University of Maryland School of Medicine, 737 W. Lombard St., Baltimore, MD 21201 USA.
2Department of Psychiatry, UCLA/Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, 411 West Chapel Hill Street, Suite 200, Durham, NC 27701 USA.
J Child Adolesc Trauma. 2016 Jun 1;11(2):187-196. doi: 10.1007/s40653-016-0105-0. eCollection 2018 Jun.
Impairments in Caregiving (ICG) secondary to mental illness and substance use have been linked to adverse outcomes in children. Little is known, however, about whether outcomes vary by type of ICG, exposure to co-occurring traumas, or mechanisms of maladaptive outcomes. Clinic-referred youth age 7-18 years ( = 3988) were compared on ICG history, demographics, trauma history, and mental health symptoms. Child trauma exposure was tested as a mediator of ICG and child symptoms. Youth with ICG were at heightened risk for trauma exposure, PTSD, internalizing symptoms, total behavioral problems, and attachment problems, particularly youth with multiple types of ICG. Effect sizes were moderate to large for PTSD, internalizing symptoms, and total behavioral problems. Number of trauma types mediated the relationship between ICG and child symptoms. ICG was related to trauma exposure within and outside the family context. Understanding these links has important implications for interrupting intergenerational trauma and psychopathology.
继发于精神疾病和物质使用的照料受损（ICG）与儿童的不良后果有关。然而，对于ICG的类型、同时发生的创伤暴露或适应不良后果的机制是否会导致不同的结果，我们知之甚少。对3988名7至18岁的临床转诊青少年进行了ICG病史、人口统计学、创伤史和心理健康症状方面的比较。儿童创伤暴露被作为ICG与儿童症状之间的中介进行测试。有ICG的青少年遭受创伤暴露、创伤后应激障碍（PTSD）、内化症状、总体行为问题和依恋问题的风险更高，尤其是患有多种类型ICG的青少年。PTSD、内化症状和总体行为问题的效应大小为中等至较大。创伤类型的数量介导了ICG与儿童症状之间的关系。ICG与家庭内外的创伤暴露有关。了解这些联系对于阻断代际创伤和精神病理学具有重要意义。
