The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University.
Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center.
J Pediatr Psychol. 2020 Oct 1;45(9):1063-1073. doi: 10.1093/jpepsy/jsaa070.
This study examined the contribution of pretrauma psychosocial factors (child emotional functioning, family resources, family functioning, and social support) and environmental factors (mother's posttraumatic stress symptoms [PTSSs], medical team support [MTS]) to PTSSs of injured or seriously ill children within a pediatric rehabilitation setting. It was hypothesized that psychosocial variables would be strongly associated with child's PTSS; that mother's PTSS and MTS would mediate the association between psychosocial factors and child's PTSS; that mother's report on child's PTSS would mediate the association between mother's PTSS and child's PTSS.
Participants were 196 children hospitalized following an injury/illness and assessed M = 47.7 days postevent. Children completed measures of PTSS, mothers completed measures of their own PTSS, child's PTSS, and pretrauma psychosocial factors. Family's therapist completed a MTS measure. Structural equation modeling was employed to evaluate the study hypotheses.
Pretrauma family structure and resources were associated with child's self-reported PTSS; each pretrauma variable and mother's report of child's PTSS was significantly associated. Although mother's PTSS was not directly associated with child's PTSS, this relationship was mediated by mother's report of child's PTSS. MTS mediated the relationship between pretrauma social support and mother's PTSS.
This study further explicates the utility of a biopsychosocial framework in predicting childhood PTSS. Findings confirm the role of pretrauma factors and environmental factors at the peritrauma period in the development of PTSS following a pediatric injury/illness. Mother's PTSS and MTS may be appropriate targets for prevention and early intervention.
本研究考察了创伤前心理社会因素（儿童情绪功能、家庭资源、家庭功能和社会支持）和环境因素（母亲创伤后应激症状[PTSS]、医疗团队支持[MTS]）对儿科康复环境中受伤或重病儿童 PTSS 的贡献。研究假设心理社会变量与儿童的 PTSS 密切相关；母亲的 PTSS 和 MTS 将在心理社会因素与儿童的 PTSS 之间起中介作用；母亲对儿童 PTSS 的报告将在母亲的 PTSS 与儿童的 PTSS 之间起中介作用。
参与者为 196 名因受伤/患病住院的儿童，在事件发生后 47.7 天进行评估。儿童完成了创伤后应激障碍量表的测量，母亲完成了自己的创伤后应激障碍量表、儿童的创伤后应激障碍量表和创伤前心理社会因素的测量。家庭治疗师完成了 MTS 测量。采用结构方程模型评估研究假设。
创伤前家庭结构和资源与儿童自我报告的 PTSS 相关；每个创伤前变量和母亲报告的儿童 PTSS 均显著相关。虽然母亲的 PTSS 与儿童的 PTSS 没有直接相关，但这种关系是通过母亲对儿童 PTSS 的报告来介导的。MTS 介导了创伤前社会支持与母亲 PTSS 之间的关系。
本研究进一步阐明了生物心理社会框架在预测儿童创伤后应激障碍中的作用。研究结果证实了创伤前因素和环境因素在儿科受伤/患病后儿童创伤后应激障碍发展中的作用。母亲的 PTSS 和 MTS 可能是预防和早期干预的合适目标。
