Department of Psychology, University of Georgia, Athens, GA, USA.
Department of Neuropsychology and Rehabilitation Services, Children's Healthcare of Atlanta, Atlanta, GA, USA.
BMC Pediatr. 2024 Jun 18;24(1):397. doi: 10.1186/s12887-024-04878-w.
Accidental and assault gunshot wounds (GSWs) are the second leading cause of injury in the United States for youth ages 1- to 17-years-old, resulting in significant negative effects on pediatric patients' mental health functioning. Despite the critical implications of GSWs, there has yet to be a systematic review synthesizing trends in mental health outcomes for pediatric patients; a gap the present review fills. Additionally, this review identifies evidence-based psychological interventions shown to be effective in the treatment of subclinical symptoms of psychological disorders in the general population.
A comprehensive search was conducted using five databases: American Psychological Association (APA) PsycInfo, APA PsycArticles, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resource Information Center (ERIC), and Medical Literature Analysis and Retrieval Systems Online (MEDLINE). Twenty-two articles met inclusion criteria.
Findings suggest pediatric GSW patients are at a significantly elevated risk for mental health disorders when compared to other- (e.g., motor vehicle collision) and non-injured youth. Disorders include post-traumatic stress, disruptive behavior, anxiety, depression, and substance use. Hospital-based violence intervention programs, cultivating supportive relationships with adults in one's community, and trauma-focused outpatient services were identified as effective interventions for treating subclinical psychological symptoms.
Depicted in the proposed conceptual model, the present study delineates a direct association between pediatric GSWs and subsequent onset of mental health disorders. This relation is buffered by evidence-based psychological interventions targeting subclinical symptoms. Results suggest brief psychological interventions can help treat mental health challenges, minimizing risk for significant long-term concerns. Cultural adaptations to enhance the utility and accessibility of interventions for all patients are recommended.
意外伤害和袭击性枪伤（GSW）是美国 1 至 17 岁青少年受伤的第二大主要原因，对儿科患者的心理健康功能产生重大负面影响。尽管 GSW 具有重要意义，但尚未有系统评价综合分析儿科患者心理健康结果的趋势；本综述填补了这一空白。此外，本综述确定了基于证据的心理干预措施，这些措施已被证明对一般人群中亚临床心理障碍症状的治疗有效。
使用五个数据库进行了全面搜索：美国心理协会（APA）心理信息、APA 心理文章、护理学和联合健康文献累积索引（CINAHL）、教育资源信息中心（ERIC）和医学文献分析和检索系统在线（MEDLINE）。有 22 篇文章符合纳入标准。
研究结果表明，与其他伤害（例如，机动车碰撞）和未受伤的青少年相比，儿科 GSW 患者患心理健康障碍的风险显著升高。这些障碍包括创伤后应激障碍、破坏性行为、焦虑、抑郁和物质使用障碍。医院为基础的暴力干预计划、与社区中成年人建立支持性关系以及创伤焦点门诊服务被确定为治疗亚临床心理症状的有效干预措施。
本研究提出的概念模型描绘了儿科 GSW 与随后发生的心理健康障碍之间的直接关联。这种关系受到针对亚临床症状的基于证据的心理干预措施的缓冲。研究结果表明，简短的心理干预可以帮助治疗心理健康问题，最大限度地减少长期关注的风险。建议进行文化适应，以提高所有患者干预措施的实用性和可及性。
