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首页> 外文期刊>Journal of the American Academy of Child and Adolescent Psychiatry >Posttraumatic stress disorder in infants and young children exposed to war-related trauma.
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Posttraumatic stress disorder in infants and young children exposed to war-related trauma.

机译：遭受战争相关创伤的婴幼儿创伤后应激障碍。

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OBJECTIVE: Although millions of the world's children are growing up amidst armed conflict, little research has described the specific symptom manifestations and relational behavior in young children exposed to wartime trauma or assessed factors that chart pathways of risk and resilience. METHOD: Participants included 232 Israeli children 1.5 to 5 years of age, 148 living near the Gaza Strip and exposed to daily war-related trauma and 84 controls. Children's symptoms were diagnosed, maternal and child attachment-related behaviors observed during the evocation of traumatic memories, and maternal psychological symptoms and social support were self-reported. RESULTS: PTSD was diagnosed in 37.8% of war-exposed children (n = 56). Children with PTSD exhibited multiple posttraumatic symptoms and substantial developmental regression. Symptoms observed in more than 60% of diagnosed children included nonverbal representation of trauma in play; frequent crying, night waking, and mood shifts; and social withdrawal and object focus. Mothers of children with PTSD reported the highest depression, anxiety, and posttraumatic symptoms and the lowest social support, and displayed the least sensitivity during trauma evocation. Attachment behavior of children in the Exposed-No-PTSD group was characterized by use of secure-base behavior, whereas children with PTSD showed increased behavioral avoidance. Mother's, but not child's, degree of trauma exposure and maternal PTSD correlated with child avoidance. CONCLUSIONS: Large proportions of young children exposed to repeated wartime trauma exhibit a severe posttraumatic profile that places their future adaptation at significant risk. Although more resilient children actively seek maternal support, avoidance signals high risk. Maternal well-being, sensitive behavior, and support networks serve as resilience factors and should be the focus of interventions for families of war-exposed infants and children.
机译：目的：尽管世界上有数百万儿童在武装冲突中成长，但很少有研究描述遭受战时创伤的幼儿的特定症状表现和相关行为，或评估风险和适应力途径的评估因素。方法：参与者包括232名1.5至5岁的以色列儿童，148名生活在加沙地带附近，每天遭受与战争有关的创伤的以色列儿童和84名控制人员。诊断出儿童的症状，并在唤起创伤记忆时观察到与母婴相关的行为，并自我报告了母婴的心理症状和社会支持。结果：37.8％的战争暴露儿童（n = 56）被诊断为PTSD。患有创伤后应激障碍的儿童表现出多种创伤后症状和实质性的发育退化。在超过60％的被诊断儿童中观察到的症状包括游戏中创伤的非语言表达;经常哭，夜醒和情绪变化;以及社会退缩和关注对象。患有创伤后应激障碍的儿童的母亲所报告的抑郁，焦虑和创伤后症状最高，而社会支持也最低，并且在创伤诱发期间表现出的敏感性最低。暴露无PTSD组儿童的依恋行为以使用安全基础行为为特征，而患有PTSD的儿童表现出较高的行为回避率。母亲的创伤暴露程度和母亲的PTSD与孩子的回避程度有关，而与孩子无关。结论：遭受战时反复伤害的大部分幼儿表现出严重的创伤后特征，这使他们未来的适应面临重大风险。尽管更有韧性的孩子积极寻求母亲的支持，但回避意味着高风险。孕产妇的健康，敏感的行为和支持网络是恢复力的因素，应成为受战争影响的婴幼儿家庭干预的重点。

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