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探讨儿童早期母亲创伤后应激障碍的复杂多维关系及其对学龄儿童的影响。

On the complex and dimensional relationship of maternal posttraumatic stress disorder during early childhood and child outcomes at school-age.

机构信息

Child and Adolescent Psychiatry Service, Lausanne University Hospital, Lausanne, Switzerland.

Institute of Psychology, University of Bern, Bern, Switzerland.

出版信息

Eur Psychiatry. 2023 Feb 3;66(1):e20. doi: 10.1192/j.eurpsy.2023.8.

Abstract

BACKGROUND

Several studies have shown associations between maternal interpersonal violence-related posttraumatic stress disorder (PTSD), child mental health problems, and impaired socioemotional development. However, the existing literature lacks evidence linking constellations of risk factors such as maternal interpersonal-violence-related PTSD, psychopathology, and interactive behavior with toddlers and outcome measures at school-age.

METHODS

This study involved a prospective, longitudinal investigation of 62 mothers and examined the relationship between maternal variables measured when children were in early childhood (mean age 27 months), and child outcomes when children were school-age (age mean = 83.2 months) while retaining a focus on the context of maternal PTSD. To identify and weigh associated dimensions comparatively, we employed sparse canonical correlation analysis (sCCA) aimed at associating dimensions of a dataset of 20 maternal variables in early childhood with that of more than 20 child outcome variables (i.e., child psychopathology, life-events, and socioemotional skills) at school-age.

RESULTS

Phase 1 variables with the highest weights were those of maternal psychopathology: PTSD, depressive and dissociative symptoms, and self-report of parental stress. The highest weighted Phase 2 child outcome measures were those of child psychopathology: PTSD, anxiety, and depressive symptoms as well as peer bullying and victimization.

CONCLUSIONS

sCCA revealed that trauma-related concepts in mothers were significantly and reliably associated with child psychopathology and other indicators of risk for intergenerational transmission of violence and victimization. The results highlight the dimensional and multifaceted nature-both for mothers as well as children-of the intergenerational transmission of violence and associated psychopathology.

摘要

背景

多项研究表明,母亲人际暴力相关创伤后应激障碍(PTSD)、儿童心理健康问题和社会情感发育受损之间存在关联。然而,现有文献缺乏证据表明,母亲人际暴力相关 PTSD、精神病理学和互动行为等风险因素的组合与幼儿期和学龄期的儿童结局测量值之间存在联系。

方法

本研究对 62 名母亲进行了前瞻性、纵向调查,考察了儿童处于幼儿期(平均年龄 27 个月)时的母亲变量与儿童处于学龄期(平均年龄 83.2 个月)时的儿童结局之间的关系,同时关注母亲 PTSD 的背景。为了识别和比较相关维度,我们采用稀疏典型相关分析(sCCA),旨在将幼儿期 20 个母亲变量数据集的维度与学龄期 20 多个儿童结局变量(即儿童精神病理学、生活事件和社会情感技能)的维度相关联。

结果

第一阶段权重最高的变量是母亲精神病理学:PTSD、抑郁和分离症状以及父母压力的自我报告。第二阶段权重最高的儿童结局测量值是儿童精神病理学:PTSD、焦虑和抑郁症状以及同伴欺凌和受害。

结论

sCCA 显示,母亲的创伤相关概念与儿童精神病理学以及代际暴力和受害风险的其他指标显著且可靠地相关。结果强调了代际暴力和相关精神病理学在母亲和儿童身上的维度和多面性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b1b/9970153/ce8de6d26dc4/S0924933823000081_fig1.jpg

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