A Longitudinal Examination of the Relationship between Trauma-Related Cognitive Factors and Internalising and Externalising Psychopathology in Physically Injured Children.
A Longitudinal Examination of the Relationship between Trauma-Related Cognitive Factors and Internalising and Externalising Psychopathology in Physically Injured Children.
复制标题
DOI：
10.1007/s10802-018-0477-8
复制
发表时间：
2019-04
影响因子：
3.6
通讯作者：
Halligan SL
中科院分区：
文献类型：
--
作者：
Hiller RM;Creswell C;Meiser-Stedman R;Lobo S;Cowdrey F;Lyttle MD;Ehlers A;Halligan SL
创伤后应激障碍(PTSD)的认知模型强调创伤后适应不良评估、创伤记忆质量和应对策略，如沉思或思维抑制，是维持创伤后应激障碍症状的关键过程。儿童在创伤后也会出现焦虑、抑郁和外在症状，但几乎没有关于创伤后认知过程与这些困难的潜在相关性的实证调查。在这里，我们研究了：a)急性适应不良认知过程(特别是适应不良评估、记忆质量和认知应对)是否与创伤后1个月的创伤后应激障碍、内化和外化症状相关(T1)；以及b)这些认知过程的变化预测了6个月后的后续评估中的症状变化(T2)。根据儿童的急性创伤经历，我们从急诊科招募了132名6-13岁的儿童及其父母。儿童自我报告他们的不良适应评估、创伤记忆和认知应对策略，以及创伤后应激障碍、焦虑和抑郁的症状。家长还对孩子的内化和外化症状进行了评分。我们发现，每个认知过程都与T1时的创伤后应激障碍和非创伤后应激障碍内化症状密切相关，并在每个预测的症状变化中变化到T2。适应不良评价和认知应对是儿童创伤后内化的唯一预测因子。即使控制了共同出现的创伤后应激障碍症状，效果也部分保留。很少有证据表明创伤特有的认知过程与外在症状有关。研究结果表明，创伤后应激障碍认知模型的某些方面适用于更广泛的创伤后精神病理学，并对我们如何理解和针对性地进行儿童创伤后心理适应具有启示意义。本文的在线版本(10.1007/s10802-0180477-8)包含补充材料，可供授权用户使用。
Cognitive models of posttraumatic stress disorder (PTSD) highlight maladaptive posttrauma appraisals, trauma memory qualities, and coping strategies, such as rumination or thought suppression, as key processes that maintain PTSD symptoms. Anxiety, depression and externalising symptoms can also present in children in the aftermath of trauma, yet there has been little empirical investigation of the potential relevance of posttrauma cognitive processes for such difficulties. Here, we examined whether: a) acute maladaptive cognitive processes (specifically, maladaptive appraisals, memory qualities, and cognitive coping) were associated with symptoms of PTSD, internalising, and externalising at 1-month posttrauma (T1); and b) changes in these cognitive processes predicted symptom change at a follow-up assessment 6 months later (T2). We recruited 132 6–13 year old children and their parents from emergency departments following the child’s experience of an acute trauma. Children self-reported on their maladaptive appraisals, trauma-memory and cognitive coping strategies, along with symptoms of PTSD, anxiety and depression. Parents also rated children’s internalising and externalising symptoms. We found each cognitive process to be robustly associated with PTSD and non-PTSD internalising symptoms at T1, and change in each predicted change in symptoms to T2. Maladaptive appraisals and cognitive coping were unique predictors of children’s posttrauma internalising. Effects were partially retained even controlling for co-occurring PTSD symptoms. There was less evidence that trauma-specific cognitive processes were associated with externalising symptoms. Findings suggest aspects of cognitive models of PTSD are applicable to broader posttrauma psychopathology, and have implications for how we understand and target children’s posttrauma psychological adjustment. The online version of this article (10.1007/s10802-018-0477-8) contains supplementary material, which is available to authorized users.
登录
查看更多内容
影响因子：
6.9
作者：
Ellis, Danielle M.;Hudson, Jennifer L.
通讯作者：
Hudson, Jennifer L.
影响因子：
2.1
作者：
Hackmann, A;Holmes, E
通讯作者：
Holmes, E
DOI：
10.1016/j.jbtep.2017.04.004
发表时间：
2017-12-01
影响因子：
1.8
作者：
McKinnon, Anna;Brewer, Neil;Nixon, Reginald D. V.
通讯作者：
Nixon, Reginald D. V.
影响因子：
3.6
作者：
Le Brocque, Robyne M.;Hendrikz, Joan;Kenardy, Justin A.
通讯作者：
Kenardy, Justin A.
DOI：
10.1097/01.chi.0000237703.97518.12
发表时间：
2006-12-01
影响因子：
13.3
作者：
Kassam-Adams, Nancy;Garcia-Espana, J. Felipe;Winston, Flaura
通讯作者：
Winston, Flaura