Famularo R, Fenton T, Kinscherff R, Ayoub C, Barnum R
Boston Juvenile Court Clinic, MA 02108.
Child Abuse Negl. 1994 Jan;18(1):27-36. doi: 10.1016/0145-2134(94)90093-0.
The purpose of this study was to examine the rates of posttraumatic stress disorder (PTSD) among a sample of severely maltreated children and their mothers, and to investigate the age of onset of documented maltreatment in these children. The sample consisted of 109 pairs of women and their children who were before a juvenile/family court due to maltreatment of sufficient severity to warrant removal of the child from parental custody. Children were examined using the PTSD Section of the Diagnostic Interview for Children and Adolescents, Revised 6th Version (DICA-6-R). The PTSD Module of the Structured Clinical Interview for DSM-III-R (SCID) was administered to all mothers. Clinical psychiatric interviews were also administered to all children and mothers. From the sample of 109 cases, 15.6% of the mothers met SCID criteria for a current presentation of PTSD, while 36.7% had a past history of PTSD. Of the 109 evaluated children, 35.8% met current DICA criteria for PTSD. Posttraumatic stress disorder is significantly overrepresented in the children of mothers diagnosed with PTSD (p = .001). The average age of maltreatment onset was 46.4 months among the children diagnosed as PTSD, and was 61.3 months in the group of seriously maltreated children who did not develop PTSD (p = .038). The onset of maltreatment is significantly earlier among children whose mothers meet PTSD criteria than among other maltreated children (p = .025). Intergenerational transmission of violence and developmental effects of traumatic experiences upon the young child are discussed.
本研究的目的是调查受严重虐待儿童及其母亲样本中创伤后应激障碍(PTSD)的发生率,并探究这些儿童中记录在案的虐待行为的发病年龄。样本包括109对妇女及其子女,他们因虐待行为严重到足以使儿童被剥夺父母监护权而面临少年/家庭法庭审判。使用《儿童与青少年诊断访谈修订第6版》(DICA - 6 - R)中的PTSD部分对儿童进行检查。对所有母亲进行《精神疾病诊断与统计手册第III - R版》(DSM - III - R)结构化临床访谈的PTSD模块评估。还对所有儿童和母亲进行了临床精神病学访谈。在109个病例样本中,15.6%的母亲符合SCID当前PTSD表现的标准,而36.7%有PTSD病史。在109名接受评估的儿童中,35.8%符合当前DICA的PTSD标准。被诊断患有PTSD的母亲的子女中,创伤后应激障碍的比例明显过高(p = 0.001)。被诊断为PTSD的儿童中,虐待行为发病的平均年龄为46.4个月,在未患PTSD的严重受虐儿童组中为61.3个月(p = 0.038)。母亲符合PTSD标准的儿童中,虐待行为的发病明显早于其他受虐儿童(p = 0.025)。本文讨论了暴力的代际传递以及创伤经历对幼儿的发育影响。