Identifying Youth at Risk for Difficulties Following a Traumatic Event: Pre-event Factors are Associated with Acute Symptomatology

Authors


  • This research was supported by funding from SAMHSA (U79 SM54318). The authors would like to thank Arthur Roy for his contributions to this project.

Correspondence concerning this article should be addressed to Megan Goslin, Yale University Child Study Center, Trauma Section 100 York Street, Suite 2H, New Haven, CT 06511. E-mail: megan.goslin@yale.edu

Abstract

This study examined factors related to children's acute symptoms following a potentially traumatic event (PTE) to more clearly identify domains that should be included in screenings of youth exposed to a PTE. In particular, the authors examined whether trauma category (i.e., sexual abuse/disclosure of abuse, intentionally perpetrated traumas other than sexual abuse, and unintentional traumas) was related to symptoms after controlling for other relevant factors. Participants were 112 youth presenting for clinical evaluation within a month of a PTE and their nonoffending caregivers. Using data from baseline assessments collected as part of a randomized controlled trial of a secondary prevention program, the following factors were tested in 3 hierarchical regression models: index PTE category, history of traumatic exposure, preindex event functioning, and parenting behaviors. Prior trauma exposure, preindex event functioning, and hostile parenting were uniquely related to children's symptoms in the acute posttraumatic period after controlling for time since the event and child age, but trauma category was not. Implications for identifying and referring children at high risk for poor outcomes in the early aftermath of a PTE are discussed. An exclusive focus on the event is insufficient and more comprehensive understanding of the child and family is required.

Traditional and Simplified Chinese Abstracts by AsianSTSS

標題:如何發掘創傷事件後有困擾的高危青少年:事件前因素與急性症狀學的關係。

撮要:本研究檢視潛在創傷事件(PTE)後兒童急性症狀的相關因素,以期辨識PTE後必要的青少年篩查領域;亦研究控制其他相關因素後,創傷種類(即性侵犯/侵犯的揭露,其他蓄意的和非蓄意的傷害)與症狀的關係。樣本是在PTE發生後一個月內進行臨床診斷的112名青少年,及他們的照顧者(非引致傷害者)。我們利用一個二級預防計劃的隨機對照試驗的基準評核數據來設計三層回歸模型,而下列因素則用此模型來測試,包括:PTE指標類別,創傷經歷史,指標事件前的功能,和親子行為。在對照事件後時差和兒童年紀後,曾有創傷經歷,指標事件前的功能,和敵意親子行為都與兒童創傷後的急性症狀各有獨特關連;而創傷類別則未有相似發現。我們也探討在PTE後的早期階段,如何能發掘及轉介高危兒童接受治療。聚焦事件本身並不足夠,而我們必須對兒童及其家庭有更深入瞭解。

标题:如何发掘创伤事件后有困扰的高危青少年:事件前因素与急性症状学的关系。

撮要:本研究检视潜在创伤事件(PTE)后儿童急性症状的相关因素,以期辨识PTE后必要的青少年筛查领域;亦研究控制其他相关因素后,创伤种类(即性侵犯/侵犯的揭露,其他蓄意的和非蓄意的伤害)与症状的关系。样本是在PTE发生后一个月内进行临床诊断的112名青少年,及他们的照顾者(非引致伤害者)。我们利用一个二级预防计划的随机对照试验的基准评核数据来设计三层回归模型,而下列因素则用此模型来测试,包括:PTE指标类别,创伤经历史,指针事件前的功能,和亲子行为。在对照事件后时差和儿童年纪后,曾有创伤经历,指针事件前的功能,和敌意亲子行为都与儿童创伤后的急性症状各有独特关连;而创伤类别则未有相似发现。我们也探讨在PTE后的早期阶段,如何能发掘及转介高危儿童接受治疗。聚焦事件本身并不足够,而我们必须对儿童及其家庭有更深入了解。

Ancillary