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创伤性生活事件、多重受害经历和有智力和发育障碍及精神健康问题的儿童的外化症状。

Traumatic life events, polyvictimization, and externalizing symptoms in children with IDD and mental health problems.

机构信息

Faculty of Education, University of Western Ontario, Canada.

Faculty of Education, University of Western Ontario, Canada.

出版信息

Res Dev Disabil. 2021 Sep;116:104028. doi: 10.1016/j.ridd.2021.104028. Epub 2021 Jul 30.

Abstract

BACKGROUND AND AIMS

This study aims to examine the rates of potentially traumatic events (PTEs) and polyvictimization, as well as interrelationships among PTE types in children and youth with intellectual developmental disorder (IDD) and co-occurring mental health issues. It also examines the association between polyvictimization (experiencing three or more PTEs) and externalizing symptoms, controlling for IDD severity, sex and age.

METHOD

The study utilized archival data collected from 2012 to 2020 by trained assessors (e.g., nurses, social workers, psychologists) at intake into clinical mental health services in the Province of Ontario, Canada. The sample included 502 children and youth (age range: 4-18 years) who were assessed using the interRAI Child and Youth Mental Health and Developmental Disability (ChYMH-DD) instrument. Using this standardized assessment, trained clinicians reported on children's demographics, traumatic life events, and externalizing symptoms (proactive and reactive aggression) among other physical and mental health indicators.

RESULTS

64.74 % of the children had experienced at least one type of PTE, whereas 33.06 % experienced lifetime polyvictimization. Most of the PTE types were positively correlated, with the strongest associations between physical, emotional abuse, witnessing domestic violence, and parental addiction. In a multivariate model, experiences of three or more PTEs (vs. none), mild or moderate IDD (vs. severe/profound), male sex (vs. female) were associated with greater externalizing symptoms. There was a quadratic relationship between age and externalizing symptoms.

CONCLUSION

The project advances knowledge on trauma and polyvictimization patterns and their association with IDD severity and externalizing symptoms in this population. Trauma-informed services should be tailored to the specific needs of these children.

摘要

背景与目的

本研究旨在调查智力发育障碍(IDD)伴发精神健康问题儿童和青少年中潜在创伤性事件(PTEs)和多受害的发生率,以及 PTE 类型之间的相互关系。还考察了多受害(经历三种或更多种 PTEs)与外化症状之间的关联,同时控制 IDD 严重程度、性别和年龄。

方法

本研究使用了 2012 年至 2020 年期间由加拿大安大略省临床心理健康服务机构的经过培训的评估人员(例如护士、社会工作者、心理学家)收集的档案数据。样本包括 502 名儿童和青少年(年龄范围:4-18 岁),他们使用 interRAI 儿童和青少年心理健康和发育障碍(ChYMH-DD)工具进行评估。通过使用这种标准化评估,经过培训的临床医生报告了儿童的人口统计学信息、创伤性生活事件以及外化症状(主动和反应性攻击)和其他身体和心理健康指标。

结果

64.74%的儿童经历过至少一种类型的 PTE,而 33.06%的儿童经历过终生多受害。大多数 PTE 类型呈正相关,与身体、情感虐待、目睹家庭暴力和父母成瘾之间的关联最强。在多变量模型中,经历三种或更多种 PTEs(与无 PTEs 相比)、轻度或中度 IDD(与重度/极重度 IDD 相比)、男性性别(与女性相比)与更多的外化症状相关。年龄与外化症状之间存在二次关系。

结论

该项目增进了对该人群中创伤和多受害模式及其与 IDD 严重程度和外化症状之间关联的认识。应该根据这些儿童的特定需求定制以创伤为中心的服务。

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