Carolina Population Center, University of North Carolina, Chapel Hill, USA.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA.
BMC Psychol. 2024 Aug 25;12(1):454. doi: 10.1186/s40359-024-01944-x.
The burden of childhood trauma (violence, injury/illness, loss) in low-resource settings is high, although the effect of trauma on children's mental and cognitive health is under-researched. Child gender may moderate the association between trauma and outcomes; boys are more likely to experience trauma, but girls are more likely to show distress following trauma.
We draw on data from the Bachpan cohort (n = 888), a sample of mother-child dyads in rural Pakistan, to investigate these associations among 6-year-old children in a South Asian, low-resource setting. Mothers reported on children's lifetime exposure to 15 possible traumas and their current mental health. In addition, children were assessed for their verbal skills, working memory, and inhibitory control. We estimated trauma prevalence and used generalized estimating equations to test the association between number of traumatic events and child mental health and cognitive skills in the overall sample and by gender.
90.5% of children experienced at least one trauma. The most common traumas were death of a loved one (47%) and hearing about war/terrorism on the TV/radio (48%). On average, boys experienced more traumas (M = 3.00) than girls (M = 2.67). Specifically, boys were more likely than girls to experience an injury or hospitalization (30% vs. 21%, p < .05) and to hear about war/terrorism on the TV/radio (52% vs. 43%, p < .05). Trauma was associated with increased mental health difficulties and increased anxiety scores. There was little evidence that trauma exposure was associated with child cognitive skills. The strength of association between trauma and outcomes was similar for boys and girls.
Findings show that childhood trauma exposure is common in this setting and associated with worse mental health problems among young boys and girls. Results suggest that trauma-informed interventions are important for supporting child mental health in South Asia.
在资源匮乏的环境中，儿童创伤（暴力、伤害/疾病、丧失）负担很高，尽管创伤对儿童心理和认知健康的影响还研究不足。儿童性别可能会调节创伤与结果之间的关系；男孩更有可能经历创伤，但女孩在经历创伤后更有可能感到痛苦。
我们利用来自巴基斯坦农村 Bachpan 队列（n=888）的数据，该队列是南亚资源匮乏环境中 6 岁儿童的母婴对子样本，来研究这些关联。母亲报告了孩子一生中经历的 15 种可能的创伤及其当前的心理健康状况。此外，还对儿童的语言技能、工作记忆和抑制控制能力进行了评估。我们估计了创伤的发生率，并使用广义估计方程来检验在整个样本和按性别划分的情况下，创伤事件数量与儿童心理健康和认知技能之间的关联。
90.5%的儿童经历过至少一次创伤。最常见的创伤是亲人死亡（47%）和在电视/广播上听到战争/恐怖主义（48%）。平均而言，男孩经历的创伤（M=3.00）多于女孩（M=2.67）。具体而言，男孩比女孩更有可能经历受伤或住院治疗（30%比 21%，p<.05），也更有可能在电视/广播上听到战争/恐怖主义（52%比 43%，p<.05）。创伤与心理健康问题增加和焦虑评分增加有关。几乎没有证据表明创伤暴露与儿童认知技能有关。创伤与结果之间的关联强度在男孩和女孩之间相似。
研究结果表明，在这种环境中，儿童创伤暴露很常见，并且与年轻男孩和女孩的心理健康问题更严重有关。结果表明，在南亚，创伤知情干预对于支持儿童心理健康非常重要。
