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儿童父母癌症后创伤后应激:与个体和家庭因素的关联。

Child Posttraumatic Stress after Parental Cancer: Associations with Individual and Family Factors.

机构信息

Department of Clinical Psychology, Utrecht University, The Netherlands.

Ingeborg Douwes Centrum, Centre for Psycho-oncology, The Netherlands.

出版信息

J Pediatr Psychol. 2022 Sep 15;47(9):1031-1043. doi: 10.1093/jpepsy/jsac041.

Abstract

OBJECTIVE

This study aimed to examine the severity of posttraumatic stress disorder (PTSD) symptoms in children of parents with cancer and to identify individual and family factors associated with these symptoms.

METHODS

The sample consisted of 175 children (52% girls, aged M = 11.98, SD = 3.20, range = 6-20 years) from 92 families, of which 90 parents with a current or past cancer diagnosis and 71 healthy co-parents also completed questionnaires. Children reported on PTSD symptoms, trauma-related cognitions, emotion regulation difficulties, general family functioning, and family communication. Both parents reported on their own PTSD symptoms. Associations were investigated using multilevel regression.

RESULTS

Twenty-seven percentage of the children showed clinically relevant PTSD symptoms. Intraclass correlations indicated that children from the same family showed little overlap in these symptoms. Multilevel analyses showed that child trauma-related cognitions and emotion regulation difficulties were related to higher levels of PTSD symptoms at the individual level. General family functioning was only related to child PTSD symptoms at the family level. Child PTSD severity was unrelated to parental PTSD symptoms and family communication at the family level when taking into account the other factors.

CONCLUSIONS

The current study highlights the psychological impact of parental cancer on children. Individual factors contributed more strongly to child PTSD symptoms than family factors. Trauma-related cognitions and emotion regulation difficulties might be targeted through specific psychoeducation for children and parents, family-oriented support and interventions, and evidence-based treatments for child PTSD.

摘要

目的

本研究旨在调查父母患有癌症的儿童创伤后应激障碍(PTSD)症状的严重程度,并确定与这些症状相关的个体和家庭因素。

方法

样本包括来自 92 个家庭的 175 名儿童(52%为女孩,年龄 M=11.98,SD=3.20,范围为 6-20 岁),其中 90 名父母患有当前或既往癌症诊断,71 名健康的共同父母也完成了问卷调查。儿童报告 PTSD 症状、创伤相关认知、情绪调节困难、一般家庭功能和家庭沟通情况。父母双方均报告了自己的 PTSD 症状。使用多层回归分析了关联。

结果

27%的儿童表现出临床相关的 PTSD 症状。类内相关系数表明,来自同一家庭的儿童在这些症状上几乎没有重叠。多水平分析表明,儿童的创伤相关认知和情绪调节困难与个体水平上更高的 PTSD 症状有关。一般家庭功能仅与家庭水平上的儿童 PTSD 症状有关。考虑到其他因素,儿童 PTSD 严重程度与父母 PTSD 症状和家庭沟通在家庭水平上无关。

结论

本研究强调了父母癌症对儿童的心理影响。个体因素对儿童 PTSD 症状的影响比家庭因素更为强烈。创伤相关认知和情绪调节困难可能通过针对儿童和父母的特定心理教育、面向家庭的支持和干预措施以及儿童 PTSD 的循证治疗来加以解决。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf67/9487652/8dc7897a9a89/jsac041f1.jpg

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