Latent classes of DSM-5 acute stress disorder symptoms in children after single-incident trauma: findings from an international data archive
Latent classes of DSM-5 acute stress disorder symptoms in children after single-incident trauma: findings from an international data archive
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DOI：
10.1080/20008198.2020.1717156
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发表时间：
2020-01-01
影响因子：
5
通讯作者：
Krause-Utz, Annegret
中科院分区：
文献类型：
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作者：
Lenferink, Lonneke I. M.;Egberts, Marthe R.;Krause-Utz, Annegret
背景：在潜在创伤性事件(PTE)后，儿童通常表现出急性应激障碍(ASD)的症状，这可能演变为创伤后应激障碍(PTS)。越来越多的文献使用潜在分类分析(LCA)来理清PTS症状学基础上的复杂结构，根据PTS表现区分同质亚组。到目前为止，人们对创伤暴露儿童ASD反应的亚群或类别知之甚少。目的：我们的研究旨在确定暴露于单次PTE的儿童ASD症状的潜在类别，并确定类别成员(性别、年龄、文化背景、父母教育、创伤类型和创伤病史)的预测因素。方法：2287名儿童和青少年(5-18岁)的样本来自急性儿童创伤和康复(PACT/R)数据档案的前瞻性研究，该数据档案是一个国际档案，包括来自美国、英国、澳大利亚和瑞士的研究。LCA用于根据ASD症状确定不同的亚组。使用三步法检验了班级成员的预测因素。结果：我们的LCA得到了三个级别的解决方案：低(42%)、中(43%)和高(15%)ASD症状严重程度，根据损害和认可的ASD症状的数量而不同。与低症状组相比，中等或高度严重组的儿童更有可能是女性，年龄更小，父母没有完成中学教育，以及暴露在道路交通事故或人际暴力中(与意外伤害相比)。结论：基于一组独特的国际数据，这些发现提供了关于单发创伤后有ASD风险的儿童的新信息。根据潜在症状对儿童进行分类有助于确定暴露于PTE后需要预防和干预的目标群体。
Background: After a potentially traumatic event (PTE), children often show symptoms of acute stress disorder (ASD), which may evolve into posttraumatic stress (PTS) disorder. A growing body of literature has employed latent class analysis (LCA) to disentangle the complex structure underlying PTS symptomatology, distinguishing between homogeneous subgroups based on PTS presentations. So far, little is known about subgroups or classes of ASD reactions in trauma-exposed children. Objective: Our study aimed to identify latent classes of ASD symptoms in children exposed to a single-incident PTE and to identify predictors of class membership (gender, age, cultural background, parental education, trauma type, and trauma history). Method: A sample of 2287 children and adolescents (5-18 years) was derived from the Prospective studies of Acute Child Trauma and Recovery (PACT/R) Data Archive, an international archive including studies from the USA, UK, Australia, and Switzerland. LCA was used to determine distinct subgroups based on ASD symptoms. Predictors of class membership were examined using a three-step approach. Results: Our LCA yielded a three-class solution: low (42%), intermediate (43%) and high (15%) ASD symptom severity that differed in terms of impairment and number of endorsed ASD symptoms. Compared to the low symptoms class, children in the intermediate or high severity class were more likely to be of female gender, be younger of age, have parents who had not completed secondary education, and be exposed to a road traffic accident or interpersonal violence (vs. an unintentional injury). Conclusions: These findings provide new information on children at risk for ASD after single-incident trauma, based on a unique set of international data. Classifying children based on latent symptom profiles helps to identify target groups for prevention and intervention after exposure to a PTE.