Evaluating traumatic event scoring schemas for their predictive value to concurrent diagnostic profiles: Texas Childhood Trauma Research Network.
Evaluating traumatic event scoring schemas for their predictive value to concurrent diagnostic profiles: Texas Childhood Trauma Research Network.
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评估创伤事件评分模式对并发诊断特征的预测价值：德克萨斯儿童创伤研究网络。
DOI：
10.1016/j.jad.2023.10.092
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发表时间：
2024
影响因子：
6.6
通讯作者：
Wagner,Karen
中科院分区：
文献类型：
--
作者：
Aksan,Nazan;Guzick,AndrewG;Taylor,Leslie;Richmond,Robyn;Liberzon,Israel;Cross,Jeremyra;Garza,Cynthia;Rousseau,Justin;Shahidullah,JeffreyD;Clark,ShaunnaL;Rathouz,PaulJ;Dodd,CodyG;Cisler,Josh;Newport,DJeffrey;Wagner,Karen
背景要前瞻性地绘制儿童创伤后风险和复原力的路径图，研究需要解决先前工作的三个局限性：1)在社会服务/治疗环境之外招募人员；2)包括广泛的创伤类型；3)建立一个广泛的临床诊断和创伤暴露的纵向测量框架。德克萨斯州-儿童创伤研究网络(TX-CTRN)是一个多站点合作，旨在解决这些限制。在这份仅限基线的报告中，我们检查了创伤的领域，并评估了各种创伤事件评分模式对临床诊断的并发预测有效性。方法广泛招募8-20岁儿童(N=1289)，包括创伤中心、急诊科、儿科和初级保健诊所以及其他社区环境。结果因素分析支持创伤领域的五因素解决方案，包括非故意/急性、故意/人际关系、欺凌、家庭内与社区见证的人际伤害。创伤负担评分模式的预测优势被检验。符合DSM-5创伤后应激障碍(PTSD)标准-A的创伤的特定领域计数是区分无诊断的青少年、合并抑郁症、自杀、滥用药物和创伤后应激障碍的最佳总体模式。局限性没有对疏忽的评估。结论研究结果与早期关于故意人际创伤相对重要性的研究基本一致，表明欺凌可能是创伤应激的一个重要来源，独立地增加了几种诊断的预测，应在临床实践中考虑。
BackgroundTo prospectively chart pathways of risk and resiliency following childhood trauma studies need to address three limitations of prior work: 1) recruit beyond social service/ treatment settings; 2) include broad spectrum of trauma types and 3) cast a broad longitudinal measurement framework of both clinical diagnoses and traumatic exposures. The Texas-Childhood Trauma Research Network (TX-CTRN) is a multi-site collaboration that addresses these limitations. In this baseline-only report, we examined domains of trauma and evaluated the concurrent predictive validity of various traumatic event scoring schemas for clinical diagnoses.MethodsBroad-base recruitment of 8–20 year-olds (N= 1289) included trauma centers, emergency departments, pediatric and primary care clinics, and other community settings. Assessments were comprehensive and based on clinical interviews by trained research interviewers.ResultsFactor analyses supported a five-factor solution of trauma domains including unintentional/acute, intentional/interpersonal, bullying, in-home versus community witnessed interpersonal harms. Trauma burden scoring schemas were examined for their predictive superiority. Domain-specific counts of traumas that met DSM-5 post-traumatic-stress disorder (PTSD) Criterion-A was the best overall schema in distinguishing among youth with no diagnosis, comorbidities, those with depression, suicidality, substance misuse, and PTSD.LimitationsThere were no assessments of neglect.ConclusionsFindings largely aligned with earlier studies on the relative importance of intentional interpersonal traumas and showed bullying may be an important source of traumatic stress that independently adds to prediction of several diagnoses and should be considered in clinical practice.
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