Guilt is associated with acute stress symptoms in children after road traffic accidents.
Guilt is associated with acute stress symptoms in children after road traffic accidents.
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DOI：
10.3402/ejpt.v6.29074
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发表时间：
2015
影响因子：
5
通讯作者：
Landolt MA
中科院分区：
文献类型：
--
作者：
Haag AC;Zehnder D;Landolt MA
虽然先前的研究一直发现意外伤害儿童的急性应激障碍（ASD）发生率相当高，但有关ASD决定因素的知识仍然不完整。内疚是儿童在创伤事件后的一种常见反应，已被证明有助于创伤后应激障碍。然而，它与ASD的关系从未被研究过。这项研究评估了道路交通事故（RTA）后儿童和青少年ASD的患病率。此外，创伤后内疚和ASD之间的关联进行了调查，依靠目前的认知理论创伤后应激和控制女性性别，年龄，社会经济地位（SES），损伤严重程度，住院治疗，创伤前精神病理学，和产妇创伤后应激症状（PTSS）。101名儿童和青少年（7-16岁）在RTA后约10天通过临床访谈进行评估。通过问卷调查对母亲进行了评估。根据DSM-IV，3名参与者（3.0%）符合完全ASD的诊断标准，17名（16.8%）符合亚综合征ASD的诊断标准。在多元回归模型中，内疚被认为是ASD严重程度的重要预测因素。女性、门诊治疗和母亲PTSS也可预测ASD的严重程度。儿童年龄、SES、损伤严重程度和创伤前儿童精神病理学与ASD严重程度无关。未来的研究应该更详细地研究创伤前后内疚感和急性应激症状之间的联系。此外，在事故后的急性期内疚评估可能是临床关注的相关目标。
Although previous research has consistently found considerable rates of acute stress disorder (ASD) in children with accidental injuries, knowledge about determinants of ASD remains incomplete. Guilt is a common reaction among children after a traumatic event and has been shown to contribute to posttraumatic stress disorder. However, its relationship to ASD has never been examined. This study assessed the prevalence of ASD in children and adolescents following road traffic accidents (RTAs). Moreover, the association between peritraumatic guilt and ASD was investigated relying on current cognitive theories of posttraumatic stress and controlling for female sex, age, socioeconomic status (SES), injury severity, inpatient treatment, pretrauma psychopathology, and maternal posttraumatic stress symptoms (PTSS). One hundred and one children and adolescents (aged 7–16 years) were assessed by means of a clinical interview approximately 10 days after an RTA. Mothers were assessed by questionnaires. Three participants (3.0%) met diagnostic criteria for full ASD according to DSM-IV, and 17 (16.8%) for subsyndromal ASD. In a multivariate regression model, guilt was found to be a significant predictor of ASD severity. Female sex, outpatient treatment, and maternal PTSS also predicted ASD severity. Child age, SES, injury severity, and pretraumatic child psychopathology were not related to ASD severity. Future research should examine the association between peritraumatic guilt and acute stress symptoms in more detail. Moreover, guilt appraisals in the acute phase after an accident might be a relevant target for clinical attention.