Schiff Miriam, Auslander Wendy F, Gerke Donald R
The Hebrew University of Jerusalem, Jerusalem, Israel.
Washington University in St. Louis, St. Louis, USA.
J Child Adolesc Trauma. 2023 May 8;16(3):759-771. doi: 10.1007/s40653-023-00545-x. eCollection 2023 Sep.
Child maltreatment is common in the US and has been shown to be associated with physical and psychological health problems in adolescence and adulthood. Based on the allostatic load theory, this study examined the association between different types of child maltreatment (emotional, physical, and sexual abuse, and physical neglect) and self-rated health, and the mediating roles of post-traumatic stress and depression in these relationships. Participants were 249 girls involved in the child welfare system, ages 12-19 years, the majority of whom were African American. A one item self-reported general health measure, the Child Trauma Questionnaire-Short Form (CTQ-SF), Child PTSD Symptom Scale (CPSS) and the Child Depression Inventory (CDI) measured self-reported health, child maltreatment, and posttraumatic and depression symptoms, respectively. Higher levels of emotional, physical, and sexual abuse, and physical neglect were significantly associated with poorer ratings of health. PTSD and depression were significant mediators between histories of childhood emotional, physical, and sexual abuse and physical health. In conclusion, results indicate that the pathways from child abuse to physical health problems in adolescents are through psychological distress. Trauma focused interventions to reduce symptoms of PTSD and depression among this vulnerable group of adolescents are essential to improve health.
儿童虐待在美国很常见，并且已被证明与青少年期及成年期的身心健康问题有关。基于应激负荷理论，本研究考察了不同类型的儿童虐待（情感虐待、身体虐待、性虐待及身体忽视）与自评健康之间的关联，以及创伤后应激障碍和抑郁在这些关系中的中介作用。研究参与者为249名年龄在12至19岁、参与儿童福利系统的女孩，其中大多数是非裔美国人。一项自评总体健康指标、儿童创伤问卷简表（CTQ-SF）、儿童创伤后应激障碍症状量表（CPSS）以及儿童抑郁量表（CDI）分别用于测量自评健康、儿童虐待情况以及创伤后应激症状和抑郁症状。情感虐待、身体虐待、性虐待及身体忽视程度较高均与较差的健康自评显著相关。创伤后应激障碍和抑郁在童年期情感虐待、身体虐待、性虐待史与身体健康之间起着显著的中介作用。总之，研究结果表明，青少年中从儿童虐待到身体健康问题的途径是通过心理困扰。针对这一脆弱青少年群体开展以创伤为重点的干预措施以减轻创伤后应激障碍和抑郁症状，对于改善健康至关重要。
