Rockhold Madeline N, Kautz-Turnbull Carson, Handley Elizabeth D, Petrenko Christie L M
Mt. Hope Family Center, University of Rochester, Rochester, New York, USA.
Alcohol Clin Exp Res (Hoboken). 2023 Sep;47(9):1722-1735. doi: 10.1111/acer.15144. Epub 2023 Jul 18.
Individuals with fetal alcohol spectrum disorders (FASD) experience heightened rates of childhood trauma and adversity. Research has examined the negative impact adverse childhood experiences have on developmental outcomes. This study aims to take the field a step further by examining the details of traumatic events, including duration, perpetrator, whether the event significantly impacted the child, and trauma subtype. Subtype is examined using threat/deprivation dimensions and their relation to child behavior and the caregiver-child relationship.
A sample of 84 children aged 4-12 with FASD, all in out-of-home placements, and their families took part in an emotion coaching intervention study. At baseline, caregivers completed questionnaires assessing child trauma, child emotion regulation and behavior, caregiver emotion socialization, and caregiver-child relationships. We used analysis of covariance to examine the differing impacts of threat, deprivation, and a combination of the two on behavioral outcomes, while controlling for age. We also used Pearson's r correlations, controlling for age, to examine whether the duration of threat or deprivation exposure was related to child outcomes.
Descriptive statistics showed that 87.5% of individuals experienced three or more subtypes of trauma. The average duration of all subtypes was 1.62 years, with a mean onset of 3.94 years. Biological parents were the most common perpetrator. There were significantly worse behavioral and caregiver-child relationship outcomes for children experiencing a combination of threat and deprivation trauma. A r correlations, controlling for age, demonstrated longer duration of deprivation was associated with greater cognitive difficulties.
We found unique patterns of behavior in children with FASD when analyzing the impact of traumatic experiences through a threat/deprivation framework. The combination of both threat and deprivation experiences leads to worse outcomes overall. Additionally, vital details surrounding the traumatic experiences point to crucial areas for intervention, including caregiver-child relationships.
患有胎儿酒精谱系障碍（FASD）的个体童年期遭受创伤和逆境的几率更高。已有研究探讨了童年不良经历对发育结果的负面影响。本研究旨在通过考察创伤事件的细节，包括持续时间、肇事者、事件是否对儿童产生重大影响以及创伤亚型，使该领域的研究更进一步。使用威胁/剥夺维度及其与儿童行为和照顾者 - 儿童关系的关联来考察亚型。
84名年龄在4至12岁、均处于家庭外安置状态的患有FASD的儿童及其家庭参与了一项情感辅导干预研究。在基线时，照顾者完成了评估儿童创伤、儿童情绪调节与行为、照顾者情绪社会化以及照顾者 - 儿童关系的问卷。我们使用协方差分析来考察威胁、剥夺以及两者结合对行为结果的不同影响，同时控制年龄因素。我们还使用Pearson相关系数，控制年龄因素，来考察威胁或剥夺暴露的持续时间是否与儿童结果相关。
描述性统计显示，87.5%的个体经历了三种或更多亚型的创伤。所有亚型的平均持续时间为1.62年，平均发病年龄为3.94岁。亲生父母是最常见的肇事者。经历威胁和剥夺创伤组合的儿童在行为和照顾者 - 儿童关系方面的结果明显更差。控制年龄因素的相关分析表明，剥夺持续时间越长，认知困难越大。
当通过威胁/剥夺框架分析创伤经历的影响时，我们在患有FASD的儿童中发现了独特的行为模式。威胁和剥夺经历的结合总体上会导致更差的结果。此外，创伤经历周围的重要细节指出了关键的干预领域，包括照顾者 - 儿童关系。
