50 How can informal support impact child PTSD symptoms following a psychological trauma?
50 How can informal support impact child PTSD symptoms following a psychological trauma?
复制标题
50 非正式支持如何影响心理创伤后儿童的 PTSD 症状？
DOI：
10.1136/emermed-2017-207308.50
复制
发表时间：
2017
影响因子：
3.1
通讯作者：
Halligan S
中科院分区：
文献类型：
--
作者：
Halligan S
背景估计有20%的儿童在发生潜在的创伤事件（例如，严重受伤、道路交通事故、袭击）会因此而患上创伤后应激障碍。PTSD的发展可能对儿童的发展轨迹产生重大影响，包括他们的情感，社会和教育健康。尽管如此，只有一小部分人能够获得心理健康服务，大多数人依靠非正式的支持来源。尤其是父母，往往是主要的支持来源。然而，目前还不清楚什么类型的父母的反应可能是有效的，和父母自己的报告经历的最佳方法的不确定性。为了解决这个知识的差距，我们研究了能力的具体方面的父母在儿童创伤后的反应，以促进或阻碍儿童的心理recovery.MethodWe进行了纵向研究的132个亲子对，招募以下儿童的创伤和随后出席的经验，在四个区域急诊科之一。在创伤后1个月内的初步评估中，我们使用问卷调查和直接观察来研究父母在事件发生后如何评价和回应他们的孩子。儿童报告问卷被用来评估PTSD症状的严重程度，在1个月后，并在6个月后的随访。儿童还报告了自己的评价的创伤和他们的应对行为，这被认为是父母的支持和后来的儿童symptoms.ResultsControlling相关的协变量和最初的PTSD症状之间的潜在中介，家长负面评价的创伤和鼓励回避应对儿童与较高的儿童报告的PTSD症状在6个月的后续。有一些证据表明，儿童自己的创伤相关的评价和应对方式介导这些effects.ConclusionFindings表明，儿童的社会支持可以影响他们的创伤后心理结果。即使在控制了孩子的最初症状之后，父母的养育与6个月的PTSD有关，这表明创伤后时期的父母反应积极影响孩子的长期适应能力，而不仅仅是对孩子最初痛苦的反应。结果表明，帮助父母提供更少的负面评价的创伤/他们的孩子的反应，并鼓励更多的适应性应对方式，可以有效地改善儿童的心理结果。由于急诊科为受创伤影响的家庭提供初级保健和支持，他们可以在向父母提供这些建议方面发挥重要作用。
BackgroundAn estimated 20% of children who present to hospital emergency departments following potentially traumatic events (e.g., serious injuries, road traffic accidents, assaults) will develop post-traumatic stress disorder as a consequence. The development of PTSD can have a substantial impact on a child’s developmental trajectory, including their emotional, social and educational wellbeing. Despite this, only a small proportion will access mental health services, with the majority relying on informal sources of support. Parents, in particular, are often the primary source of support. However, it remains unclear what types of parental responses may be effective, and parents themselves report experiencing uncertainty about the best approach. To address this gap in knowledge, we examined the capacity for specific aspects of parental responding in the aftermath of child trauma to facilitate or hinder children’s psychological recovery.MethodWe conducted a longitudinal study of 132 parent-child pairs, recruited following the child’s experience of trauma and subsequent attendance at one of four regional emergency departments. At an initial assessment, within 1 month post-trauma, we examined how parents appraised and responded to their child following the event, using both questionnaires and direct observations. Child-report questionnaires were used to assess PTSD symptom severity at 1 month, and at a follow up 6 months later. Children also reported on their own appraisals of the trauma and their coping behaviours, which were considered as potential mediators between parental support and later child symptoms.ResultsControlling for relevant covariates and initial PTSD symptoms, parent negative appraisals of the trauma and encouragement of avoidant coping in children were associated with higher child-reported PTSD symptoms at 6 month follow-up. There was some evidence that children’s own trauma related appraisals and coping styles mediated these effects.ConclusionFindings indicate that children’s social support can influence their post-trauma psychological outcomes. That parenting was associated with 6 month PTSD, even after controlling for the child’s initial symptoms, suggests that parenting responses in the posttrauma period actively influence the child’s poorer longer-term adjustment, rather than simply being a response to the child’s initial distress. The results suggest that helping parents to provide fewer negative appraisals about the trauma/their child’s response, and to encourage more adaptive coping styles, could be effective in improving child psychological outcomes. As emergency departments provide primary care and support for families affected by trauma, they could play an important role in making this advice available to parents.