Williams Kimberley C, Nto Nto J, van Vuren Esmé Jansen, Sallie Farhanah N, Molebatsi Keneilwe, Kroneberg Kayla S, Roomaney Aqeedah A, Salie Muneeb, Womersley Jacqueline S
Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
Eur J Psychotraumatol. 2024;15(1):2432160. doi: 10.1080/20008066.2024.2432160. Epub 2024 Dec 9.
Posttraumatic stress disorder (PTSD) is a debilitating mental health condition that can develop after experiencing or witnessing a traumatic event. While considerable research has investigated PTSD in adults, little is known about the biological, psychological, and social factors that contribute to its onset, development, and persistence in youth. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify longitudinal studies examining factors associated with PTSD status and symptom severity in children and adolescents. Literature searches were conducted in PubMed, Scopus, and Web of Science, yielding 24 eligible studies after screening. The included studies identified various biological factors associated with paediatric PTSD, including dysregulation of the hypothalamic-pituitary-adrenal axis, brain structural alterations, and physiological markers such as heart rate. Psychological factors, including depression, trauma appraisals, coping styles, and cognitive deficits predicted PTSD symptom development. Social factors included parental PTSD, family environment, and cultural influences. Many studies highlighted the importance of the interplay between these biological, psychological, and social factors in the manifestation of PTSD in youth. This review synthesises evidence that PTSD development in youth is influenced by a complex array of neurobiological vulnerabilities, psychological processes, and environmental factors. Longitudinal, multi-dimensional studies are needed to further elucidate personalised risk profiles and trajectories, which can inform targeted prevention and intervention strategies for PTSD in youth.
创伤后应激障碍（PTSD）是一种使人衰弱的心理健康状况，可能在经历或目睹创伤性事件后出现。虽然已有大量研究调查了成人的创伤后应激障碍，但对于导致其在青少年中发病、发展和持续存在的生物学、心理学和社会因素却知之甚少。本系统评价遵循系统评价和Meta分析的首选报告项目（PRISMA）指南，以确定考察儿童和青少年创伤后应激障碍状态及症状严重程度相关因素的纵向研究。在PubMed、Scopus和科学网中进行文献检索，筛选后得到24项符合条件的研究。纳入的研究确定了与儿童创伤后应激障碍相关的各种生物学因素，包括下丘脑 - 垂体 - 肾上腺轴功能失调、脑结构改变以及心率等生理指标。心理因素，包括抑郁、创伤评估、应对方式和认知缺陷，可预测创伤后应激障碍症状的发展。社会因素包括父母的创伤后应激障碍、家庭环境和文化影响。许多研究强调了这些生物学、心理学和社会因素之间的相互作用在青少年创伤后应激障碍表现中的重要性。本综述综合了证据，表明青少年创伤后应激障碍的发展受到一系列复杂的神经生物学易感性、心理过程和环境因素的影响。需要进行纵向、多维度的研究，以进一步阐明个性化的风险概况和轨迹，从而为青少年创伤后应激障碍的针对性预防和干预策略提供依据。
