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Traumatic Stress Symptomatology After Child Maltreatment and Single Traumatic Events: Different Profiles

Authors

  • Caroline S. Jonkman,

    Corresponding author
    1. Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    • De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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  • Eva Verlinden,

    1. Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    2. De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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  • Eva A. Bolle,

    1. De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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  • Frits Boer,

    1. Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    2. De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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  • Ramón J. L. Lindauer

    1. Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    2. De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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  • We want to thank the staff from the Trauma Center and Therapeutic Foster Care from De Bascule. We also would like to thank the children that participated in this study. We acknowledge the assistance of Brent C. Opmeer from the Division of Clinical Methods and Public Health, Academic Medical Center, University of Amsterdam, Amsterdam.

Correspondence concerning this article should be addressed to Caroline Jonkman, Department of Child and Adolescent Psychiatry, Academic Medical Center-University of Amsterdam De Bascule, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands. E-mail: caroline.jonkman@gmail.com

Abstract

The sequelae of child maltreatment tend to extend current posttraumatic stress disorder (PTSD) symptoms. This study examined this assumption, hypothesizing that (a) PTSD and trauma-related symptoms are more severe after single trauma than after child maltreatment; (b) symptoms unrelated to trauma are more severe after child maltreatment than after single trauma; and (c) a comorbid association of clinical PTSD with trauma-related symptoms is more prevalent after single trauma, whereas a comorbid association of clinical PTSD with trauma unrelated symptoms is more prevalent after child maltreatment. The Trauma Symptom Checklist for Children (TSCC) assessed PTSD and trauma-related symptoms in 256 children (83 children exposed to single trauma, 173 to child maltreatment). The Strengths and Difficulties Questionnaire (SDQ) assessed trauma-unrelated symptoms. Single-trauma children reported significantly more severe PTSD and trauma-related symptoms. Significantly more severe trauma unrelated symptoms were reported after child maltreatment. A significant relation was found between clinical PTSD and more severe trauma-related symptoms in both samples. Likelihood of children meeting PTSD symptoms after trauma seems to decrease when traumatization becomes more complex. Findings support our assumption that symptomatology of maltreated children extends current PTSD symptoms.

Traditional and Simplified Chinese Abstracts by AsianSTSS

標題:孩童面對家長離世的HPA軸功能與心理及環境因素的關鍵:初步研究結果

撮要:本文檢視孩童喪親後HPA軸功能(包括皮質醇睡醒反應;CAR) 與心理困擾、應對、和另一尚存家長的悲傷反應之間的關係。樣本包括38名孩童(20名女童曾在過去6個月有家長離世)和28名尚存的孩童家長(23名女性),他們會接受自我答問工具和半結構面談,而面談包括討論孩童對喪親的想法及感受,面談後連續三日,受訪者會提供3個在家唾液樣本(睡醒時,30分鐘後和黃昏時)。結果顯示孩童第1天CAR減退與更多焦慮症狀(r= -.45) 、 抑鬱症狀(r= -.40) 、 創傷後壓力症狀(r= -.45) 、不適應哀悼症狀(r= -.43) 和迴避性應對水平(r= -.53)有顯著關連。家長的更高不適應哀悼水平(r= -.47) 亦與孩童第1天CAR減退有關連。這些數據突出了減弱的CAR可能是累積穩態負荷和(又或)情緒上刺激的事件(與死者相關的討論),及在家庭中相關的後續處理(或缺少處理)而導致的。這些可能對喪親兒童(已經歷高度心理困擾、迴避應對和家長的不適應哀悼)來說已是特別壓力。

标题:孩童面对家长离世的HPA轴功能与心理及环境因素的关键:初步研究结果

撮要:本文检视孩童丧亲后HPA轴功能(包括皮质醇睡醒反应;CAR) 与心理困扰、应对、和另一尚存家长的悲伤反应之间的关系。样本包括38名孩童(20名女童曾在过去6个月有家长离世)和28名尚存的孩童家长(23名女性),他们会接受自我答问工具和半结构面谈,而面谈包括讨论孩童对丧亲的想法及感受,面谈后连续三日,受访者会提供3个在家唾液样本(睡醒时,30分钟后和黄昏时)。结果显示孩童第1天CAR减退与更多焦虑症状(r= -.45) 、 抑郁症状(r= -.40) 、 创伤后压力症状(r= -.45) 、不适应哀悼症状(r= -.43) 和回避性应对水平(r= -.53)有显著关连。家长的更高不适应哀悼水平(r= -.47) 亦与孩童第1天CAR减退有关连。这些数据突出了减弱的CAR可能是累积稳态负荷和(又或)情绪上刺激的事件(与死者相关的讨论),及在家庭中相关的后续处理(或缺少处理)而导致的。这些可能对丧亲儿童(已经历高度心理困扰、回避应对和家长的不适应哀悼)来说已是特别压力。

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