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创伤后认知与儿童和青少年内化症状的纵向关系。

Longitudinal relationship between posttraumatic cognitions and internalising symptoms in children and adolescents.

机构信息

Mental Health Research and Treatment Center (FBZ), Department of Clinical Child and Adolescent Psychology, Ruhr University Bochum, Bochum, Germany.

Department of Psychology, Division of Child and Adolescent Health Psychology, University of Zurich, Zurich, Switzerland.

出版信息

Eur J Psychotraumatol. 2024;15(1):2398357. doi: 10.1080/20008066.2024.2398357. Epub 2024 Oct 1.

Abstract

Little is known about the naturalistic course of posttraumatic cognitions (PTCs) after exposure to a potentially traumatic event (PTE) in children and adolescents. Moreover, previous studies on the longitudinal associations of PTCs with internalising symptoms yielded mixed results. To explore the naturalistic courses and longitudinal associations of dysfunctional PTCs and functional PTCs with posttraumatic stress symptoms (PTSS), depression, and anxiety. A total of 115 children and adolescents, aged 7-15 years, were assessed within 1 month, 3 months, and 6 months after exposure to an acute accidental PTE. Repeated measures analyses of variance were conducted to capture the naturalistic courses of PTCs and internalising symptoms. Cross-lagged panel analyses were applied to explore the longitudinal relationship between dysfunctional and functional PTCs, along with their longitudinal associations with PTSS, depression, and anxiety. Dysfunctional PTCs and internalising symptoms decreased, whereas functional PTCs increased over time. Dysfunctional and functional PTCs were moderately inversely related, but no significant cross-lagged paths emerged among them. Dysfunctional PTCs were moderately to strongly associated with internalising symptoms, while functional PTCs were weakly to moderately inversely associated with internalising symptoms. Initial PTSS predicted later dysfunctional PTCs (β = .31, < .05), but not vice versa. Dysfunctional PTCs, functional PTCs, and internalising symptoms were entangled over time. Our findings support the cognitive scar model with initial PTSS predicting later dysfunctional PTCs. Future research complementing between-subject with within-subject analyses could offer additional insights into the longitudinal relationship between dysfunctional PTCs, functional PTCs, and psychological symptoms.

摘要

儿童和青少年在经历创伤后,其创伤后认知(PTC)的自然病程知之甚少。此外,先前关于 PTC 与内化症状的纵向关联的研究结果喜忧参半。本研究旨在探讨功能失调性 PTC 和功能性 PTC 与创伤后应激症状(PTSS)、抑郁和焦虑的自然病程和纵向关联。共有 115 名 7-15 岁的儿童和青少年在经历急性意外创伤后 1 个月、3 个月和 6 个月进行评估。采用重复测量方差分析来捕捉 PTC 和内化症状的自然病程。交叉滞后面板分析用于探索功能失调性和功能性 PTC 之间的纵向关系,以及它们与 PTSS、抑郁和焦虑的纵向关联。结果发现,功能失调性 PTC 和内化症状随时间减少,而功能性 PTC 随时间增加。功能失调性和功能性 PTC 之间存在中度负相关,但没有出现显著的交叉滞后路径。功能失调性 PTC 与内化症状呈中度到高度相关,而功能性 PTC 与内化症状呈弱到中度负相关。初始 PTSS 预测后期功能失调性 PTC(β=0.31,<.05),但反之则不然。功能失调性 PTC、功能性 PTC 和内化症状随时间交织在一起。本研究结果支持认知创伤模型,即初始 PTSS 预测后期功能失调性 PTC。未来的研究可以通过补充组内和组间分析,进一步深入了解功能失调性 PTC、功能性 PTC 和心理症状之间的纵向关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1297/11445896/8e67ae9cfc98/ZEPT_A_2398357_F0001_OB.jpg

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