Traumatic events and posttraumatic stress in childhood
Traumatic events and posttraumatic stress in childhood
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DOI：
10.1001/archpsyc.64.5.577
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发表时间：
2007-05-01
影响因子：
--
通讯作者：
Costello, E. Jane
中科院分区：
文献类型：
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作者：
Copeland, William E.;Keeler, Gordon;Costello, E. Jane
背景：创伤性事件是常见的，与儿童期的精神障碍有关。对儿童不同类型创伤暴露的创伤后应激障碍（PTSD）风险知之甚少。目的：探讨儿童潜在创伤和创伤后应激障碍（PTS）的发展流行病学特征。对1420名年龄分别为9岁、11岁和13岁的儿童的代表性人群样本进行了每年一次的随访，直至16岁。每年从儿童和父母报告评估创伤事件和PTS，直至16岁。危险因素和DSM-IV疾病也assessed.Results：超过三分之二的儿童报告至少有1个创伤性事件的16岁，13.4%的儿童发展一些PTS症状。在经历第一次事件的个体中观察到很少的PTS症状或精神障碍，并且任何影响都是短暂的。不到0.5%的儿童符合DSM-IV创伤后应激障碍的标准。暴力或性创伤与最高的症状发生率有关。PTS的症状可以通过先前暴露于多重创伤、焦虑症和家庭逆境来预测。终身共同发生的其他精神疾病与创伤性事件和PTS症状是高的，与焦虑和抑郁disorders.Conclusions率最高：在一般人群中的儿童，潜在的创伤性事件是相当常见的，并不经常导致PTS症状，除了经过多次创伤或焦虑的历史。第一次终生创伤暴露后的预后通常是有利的。除了创伤后应激障碍，创伤性事件与许多形式的精神病理学有关，与焦虑和抑郁障碍的联系最紧密。
Context: Traumatic events are common and are related to psychiatric impairment in childhood. Little is known about the risk for posttraumatic stress disorder (PTSD) across different types of trauma exposure in children.Objective: To examine the developmental epidemiology of potential trauma and posttraumatic stress (PTS) in a longitudinal community sample of children.Methods: A representative population sample of 1420 children aged 9, 11, and 13 years at intake were followed up annually through 16 years of age.Main Outcome Measure: Traumatic events and PTS were assessed from child and parent reports annually to 16 years of age. Risk factors and DSM-IV disorders were also assessed.Results: More than two thirds of children reported at least 1 traumatic event by 16 years of age, with 13.4% of those children developing some PTS symptoms. Few PTS symptoms or psychiatric disorders were observed for individuals experiencing their first event, and any effects were short-lived. Less than 0.5% of children met the criteria for full-blown DSM-IV PTSD. Violent or sexual trauma were associated with the highest rates of symptoms. The PTS symptoms were predicted by previous exposure to multiple traumas, anxiety disorders, and family adversity. Lifetime co-occurrence of other psychiatric disorders with traumatic events and PTS symptoms was high, with the highest rates for anxiety and depressive disorders.Conclusions: In the general population of children, potentially traumatic events are fairly common and do not often result in PTS symptoms, except after multiple traumas or a history of anxiety. The prognosis after the first lifetime trauma exposure was generally favorable. Apart from PTSD, traumatic events are related to many forms of psychopathology, with the strongest links being with anxiety and depressive disorders.