Memarzia Jessica, Lofthouse Katie, Dalgleish Tim, Boyle Adrian, McKinnon Anna, Dixon Clare, Smith Patrick, Meiser-Stedman Richard
Department of Clinical Psychology & Psychological Therapies, Norwich Medical School, University of East Anglia, NR4 7TJ, Norwich, UK.
Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.
Psychol Med. 2024 Oct 7;54(12):1-10. doi: 10.1017/S0033291724001648.
This study examined the power of theory-derived models to account for the development of PTSD, Complex PTSD (CPTSD), depression, and anxiety in children and adolescents who had experienced a single-event trauma.
Children ( = 234, aged 8-17 years) recruited from local Emergency Departments were assessed at two and nine weeks post-trauma. Data obtained from self-report questionnaires completed by the child, telephone interviews with parents, and hospital data were used to develop four predictive models of risk factors for PTSD, CPTSD, depression, and Generalized Anxiety Disorder (GAD). ICD-11 proposed diagnostic criteria were used to generate measures for CPTSD and PTSD to assess for risk factors and identify the sample prevalence of these disorders.
At nine weeks post-trauma, 64% did not meet criteria for any disorder, 23.5% met criteria for PTSD, and 5.2% met criteria for CPTSD. 23.9% and 10.7% had developed clinically significant symptoms of depression and GAD, respectively. A cognitive model was the most powerful predictive model, a psychosocial model was weak, and subjective markers of event severity were more powerful than objective measures.
Youth exposed to single-incident trauma may develop different forms of psychopathology, and PTSD and CPTSD are frequently experienced alongside other conditions. The cognitive model of PTSD shows utility in identifying predictors of PTSD, CPTSD, depression, and GAD, particularly the role of trauma-related negative appraisals. This supports the application of cognitive interventions which focus upon re-appraising trauma-related beliefs in youth.
本研究检验了理论衍生模型对经历单次创伤事件的儿童和青少年中创伤后应激障碍（PTSD）、复杂性创伤后应激障碍（CPTSD）、抑郁症和焦虑症发展情况的解释力。
从当地急诊科招募的儿童（n = 234，年龄8 - 17岁）在创伤后两周和九周进行评估。从儿童填写的自我报告问卷、与家长的电话访谈以及医院数据中获取的数据，用于建立PTSD、CPTSD、抑郁症和广泛性焦虑障碍（GAD）风险因素的四个预测模型。使用国际疾病分类第11版（ICD - 11）提出的诊断标准来生成CPTSD和PTSD的测量方法，以评估风险因素并确定这些障碍的样本患病率。
在创伤后九周，64%的儿童未达到任何障碍的标准，23.5%符合PTSD标准，5.2%符合CPTSD标准。分别有23.9%和10.7%出现了具有临床意义的抑郁和GAD症状。认知模型是最强大的预测模型，心理社会模型较弱，事件严重程度的主观指标比客观测量更具影响力。
经历单次创伤事件的青少年可能会出现不同形式的精神病理学问题，PTSD和CPTSD常与其他情况同时出现。PTSD的认知模型在识别PTSD、CPTSD、抑郁症和GAD的预测因素方面显示出效用，特别是创伤相关负面评价的作用。这支持了在青少年中应用专注于重新评估与创伤相关信念的认知干预措施。
