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寄养青少年的潜在创伤性事件及创伤后应激症状

Potentially traumatising events and post-traumatic stress symptoms of adolescents in out-of-home care.

作者信息

Hummel Carolin, Schepp Steffen, Rassenhofer Miriam, Witt Andreas, Fegert Jörg, Pfeiffer Elisa

机构信息

Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ulm University, Ulm, Germany.

German Center for Mental Health (DZPG), partner site Ulm, Ulm, Germany.

出版信息

Eur J Psychotraumatol. 2025 Dec;16(1):2486902. doi: 10.1080/20008066.2025.2486902. Epub 2025 May 28.

Abstract

Children and adolescents in out-of-home care are particularly vulnerable to potentially traumatising events (PTEs) and trauma-related mental health disorders. In Germany, there is limited evidence on trauma exposure and posttraumatic stress symptoms (PTSS) among youth in child welfare facilities. Better understanding their psychopathology could support the development of tailored trauma-focused interventions. This study investigates PTEs and PTSS (DSM-5 criteria) in adolescents living in residential care. It also examines risk factors for PTSS and compares self-reports with proxy-reports from institutional staff. A total of = 126 adolescents (mean age = 14.98 years, = 1.62, = 11-19) from 17 residential care facilities in southern Germany and their institutional caregivers completed questionnaires assessing demographics, PTEs, and PTSS. Participants reported an average of = 4.51 PTEs ( = 3.08, = 0-12). High rates of online victimisation were found, with 19.8% reporting cyberbullying and 22.2% reporting being coerced online into sexual acts - the latter showing a strong correlation with PTSS ( = 0.33). Adolescents scored an average of = 21.24 ( = 11.01, = 2-50) on the CATS-2, with scores above the clinical cut-off (≥21) indicating high symptom burden. Significant predictors of PTSS included the number of PTEs ( = .55, < .001), female gender ( = .27, < .01), and interpersonal trauma ( = .55, < .001). Correlations between self- and staff-reports were low ( = .06-.19), with staff reporting fewer symptoms. The findings underline the high vulnerability of youth in care to trauma and stress-related symptoms and support the need for trauma-sensitive care. The prominence of online victimisation highlights the need for routine clinical screening. Low agreement between self- and caregiver reports reinforces the importance of directly assessing adolescents' experiences.

摘要

接受院外照料的儿童和青少年特别容易受到潜在创伤性事件(PTEs)以及与创伤相关的心理健康障碍的影响。在德国,关于儿童福利机构中青年的创伤暴露和创伤后应激症状(PTSS)的证据有限。更好地了解他们的精神病理学情况有助于制定针对性的创伤聚焦干预措施。本研究调查了居住在寄养机构中的青少年的PTEs和PTSS(依据《精神疾病诊断与统计手册》第5版标准)。研究还考察了PTSS的风险因素,并将青少年的自我报告与机构工作人员的代理报告进行比较。来自德国南部17家寄养机构的总共126名青少年(平均年龄 = 14.98岁,标准差 = 1.б2,年龄范围 = 11 - 19岁)及其机构照料者完成了评估人口统计学、PTEs和PTSS的问卷。参与者报告平均经历了4.51次PTEs(标准差 = 3.08,范围 = 0 - 12)。研究发现网络受害率很高,19.8%的人报告遭受网络欺凌,22.2%的人报告在网上被迫进行性行为——后者与PTSS显示出强烈相关性(相关系数 = 0.33)。青少年在儿童青少年创伤症状量表 - 2(CATS - 2)上的平均得分为21.24(标准差 = 11.01,范围 = 2 - 50),得分高于临床临界值(≥21)表明症状负担较重。PTSS的显著预测因素包括PTEs的数量(β = 0.55,p < 0.001)、女性性别(β = 0.27,p < 0.01)以及人际创伤(β = 0.55,p < 0.001)。青少年自我报告与工作人员报告之间的相关性较低(相关系数 = 0.06 - 0.19),工作人员报告的症状较少。研究结果强调了受照料青少年对创伤和与压力相关症状的高度易感性,并支持提供对创伤敏感的照料的必要性。网络受害的突出情况凸显了进行常规临床筛查的必要性。青少年自我报告与照料者报告之间的低一致性强化了直接评估青少年经历的重要性。

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