Childhood trauma

童年创伤
  • 文章类型: Journal Article
    背景:儿童虐待在全球范围内造成了巨大的心理健康负担。不同的儿童虐待措施是不等同的,可能会捕捉到有意义的差异。特别是,虐待的前瞻性和回顾性措施可识别不同的个体群体,并与精神病理学差异相关。然而,这些差异背后的原因尚未全面绘制。
    方法:在这篇综述中,我们借鉴了多学科研究,并提出了一个综合框架来解释虐待测量分歧。
    结果:我们确定了三个相互关联的域。首先,与测量和数据收集方法相关的方法论问题。第二,记忆在影响虐待回顾性报道中的作用。最后,个人可能不得不披露的动机,扣留,或者捏造关于虐待的信息。
    结论:对虐待测量分歧的更多理解可能指向概念化和评估虐待的新方法。此外,它可能有助于揭示虐待相关精神病理学的潜在机制和新干预措施的目标。
    BACKGROUND: Childhood maltreatment contributes to a large mental health burden worldwide. Different measures of childhood maltreatment are not equivalent and may capture meaningful differences. In particular, prospective and retrospective measures of maltreatment identify different groups of individuals and are differentially associated with psychopathology. However, the reasons behind these discrepancies have not yet been comprehensively mapped.
    METHODS: In this review, we draw on multi-disciplinary research and present an integrated framework to explain maltreatment measurement disagreement.
    RESULTS: We identified three interrelated domains. First, methodological issues related to measurement and data collection methods. Second, the role of memory in influencing retrospective reports of maltreatment. Finally, the motivations individuals may have to disclose, withhold, or fabricate information about maltreatment.
    CONCLUSIONS: A greater understanding of maltreatment measurement disagreement may point to new ways to conceptualise and assess maltreatment. Furthermore, it may help uncover mechanisms underlying maltreatment-related psychopathology and targets for novel interventions.
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  • 文章类型: Journal Article
    目的:精神合并症提示不同诊断的症状重叠;诊断网络方法对于研究精神病理学是有价值的。儿童创伤是精神疾病的常见诊断危险因素,但是,儿童创伤和精神病理学之间的复杂关系很少使用大型横断面诊断样本进行研究。
    方法:这项研究招募了869名诊断不同的患者,包括418例精神分裂症,215双相情感障碍,和236个重度抑郁症。参与者完成了精神病学访谈和自我报告问卷。我们构建了基于维度和项目级别的最小绝对收缩和选择算子(LASSO)网络,以探索童年创伤之间的关系,精神病理学,和疾病的持续时间。此外,我们构建了有向无环图(DAG),以初步阐明这些变量之间潜在的关联方向.对不同诊断组和性别分层组进行网络比较测试(NCT)。
    结果:经诊断的LASSO网络显示,不同类型的儿童创伤对不同的精神病理学维度产生不同的影响。情绪虐待与抑郁症状有关,身体虐待到兴奋症状,性虐待到积极和混乱的症状,情绪忽视抑郁症状和消极症状的动机和快乐(MAP)缺陷因子,和身体忽视MAP因素。DAG的发现通常与LASSO网络一致。NCT显示了可比的网络。
    结论:我们的研究结果表明,儿童创伤与不同诊断组的精神病理学发展显著相关。情感途径模型表明,对于有童年创伤史的人,需要早期识别和量身定制的干预措施。
    OBJECTIVE: Psychiatric comorbidities suggest that symptoms overlap across different diagnoses; the transdiagnostic network approach is valuable for studying psychopathology. Childhood trauma is a common transdiagnostic risk factor for psychiatric disorders, but the complex relationship between childhood trauma and psychopathology has seldom been investigated using a large cross-sectional transdiagnostic sample.
    METHODS: This study recruited 869 patients with different diagnoses, including 418 schizophrenia, 215 bipolar disorder, and 236 major depressive disorder. Participants completed psychiatric interviews and self-report questionnaires. We constructed dimension- and item-level Least Absolute Shrinkage and Selection Operator-based (LASSO) networks to explore the relationship between childhood trauma, psychopathology, and duration of illness. Moreover, we constructed directed acyclic graphs (DAGs) to tentatively clarify the potential directions of associations among these variables. Network Comparison Tests (NCTs) were conducted for different diagnostic groups and gender-stratified groups.
    RESULTS: The transdiagnostic LASSO networks showed that different types of childhood trauma exerted distinct impacts on various psychopathological dimensions. Emotional abuse was linked to depressive symptoms, physical abuse to excited symptoms, sexual abuse to positive and disorganized symptoms, emotional neglect to depressive symptoms and motivation and pleasure (MAP) deficits factor of negative symptoms, and physical neglect to MAP factor. The DAG findings generally concurred with the LASSO network. The NCT showed comparable networks.
    CONCLUSIONS: Our findings suggest that childhood trauma is significantly associated with the development of psychopathology across different diagnostic groups. The affective pathway model suggests that early identification and tailored interventions would be needed for people with a history of childhood trauma.
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  • 文章类型: Journal Article
    背景:儿童创伤与成人抑郁症密切相关,但神经生物学机制仍不清楚。先前的研究表明,抑郁症与大型大脑网络之间存在关联,例如腹侧注意力网络(VAN)和体感运动网络(SMN)。这项研究假设这些网络内部和之间的功能连接(FC)介导了儿童创伤与成人抑郁症之间的联系。
    方法:儿童创伤问卷(CTQ)评估发育经历,和汉密尔顿抑郁量表(HAMD-17)衡量抑郁症状。静息状态功能磁共振成像(fMRI)分析了VAN和SMN内部和之间的FC。
    结果:抑郁组表现出更高的HAMD和CTQ评分,以及VAN内以及VAN和SMN之间的FC升高(P<0.05)。HAMD总分与VAN内FC呈正相关(P<0.05,r=0.35),VAN与SMN呈正相关(P<0.05,r=0.34),以及CTQ总分(P<0.05,r=0.27)。CTQ总分与VAN内FC呈正相关(P<0.05,r=0.31),VAN与SMN呈正相关(P<0.05,r=0.29)。在调解模式中,FC内和之间的VAN和SMN显著介导了儿童期创伤和抑郁。
    结论:横截面设计限制了因果推断。不同创伤类型的样本量相对较小,敦促在推广调查结果时保持谨慎。
    结论:该研究强调了抑郁症严重程度之间的关联,VAN功能障碍,异常的VAN-SMNFC,童年的创伤。这些发现有助于理解童年创伤和抑郁症的神经生物学机制。
    BACKGROUND: Childhood trauma is closely tied to adult depression, but the neurobiological mechanisms remain unclear. Previous studies suggested associations between depression and large-scale brain networks such as the Ventral Attention Network (VAN) and Somatosensory Motor Network (SMN). This study hypothesized that functional connectivity (FC) within and between these networks mediates the link between childhood trauma and adult depression.
    METHODS: The Childhood Trauma Questionnaire (CTQ) assessed developmental experiences, and the Hamilton Rating Scale for Depression (HAMD-17) gauged depressive symptoms. Resting-state functional magnetic resonance imaging (fMRI) analyzed FC within and between the VAN and SMN.
    RESULTS: Depression group exhibited significantly higher HAMD and CTQ scores, as well as elevated FC within the VAN and between the VAN and SMN (P < 0.05). Positive correlations were found between HAMD total score and FC within the VAN (P < 0.05, r = 0.35) and between the VAN and SMN (P < 0.05, r = 0.34), as well as with CTQ total score (P < 0.05, r = 0.27). Positive correlations were also observed between CTQ total score and FC within the VAN (P < 0.05, r = 0.31) and between the VAN and SMN (P < 0.05, r = 0.29). In the mediation model, FC within and between the VAN and SMN significantly mediated childhood trauma and depression.
    CONCLUSIONS: The cross-sectional design limits causal inference. The sample size for different trauma types is relatively small, urging caution in generalizing findings.
    CONCLUSIONS: The study underscores the association between depression severity, VAN dysfunction, abnormal VAN-SMN FC, and childhood trauma. These findings contribute to understanding the neurobiological mechanisms underlying childhood trauma and depression.
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  • 文章类型: Journal Article
    早期的逆境增加了健康问题的风险。支持保护性和响应性护理的干预措施提供了一种有希望的方法来减轻逆境引起的压力敏感生物标志物的变化。这项研究测试了是否参与基于证据的二元心理社会干预,儿童父母心理治疗(CPP),与较低的表观遗传年龄加速有关,加速生物衰老的创伤敏感生物标志物,与后来的健康损害有关,在有创伤史的儿童样本中。在这个准实验中,重复措施研究,我们在接受CPP治疗的低收入儿童样本(n=45;年龄范围=2-6岁;76%拉丁裔)中检查了基线和干预后的表观遗传年龄加速,倾向匹配的社区比较样本(n=110;年龄范围=3-6岁;40%拉丁裔)。基线表观遗传年龄加速度在各组之间是相等的。然而,后处理,治疗组的表观遗传年龄加速度低于匹配的社区样本。研究结果强调了双重心理社会干预改善创伤暴露儿童加速生物衰老的潜力。
    Early-life adversity increases the risk of health problems. Interventions supporting protective and responsive caregiving offer a promising approach to attenuating adversity-induced changes in stress-sensitive biomarkers. This study tested whether participation in an evidence-based dyadic psychosocial intervention, child-parent psychotherapy (CPP), was related to lower epigenetic age acceleration, a trauma-sensitive biomarker of accelerated biological aging that is associated with later health impairment, in a sample of children with trauma histories. Within this quasi-experimental, repeated-measures study, we examined epigenetic age acceleration at baseline and postintervention in a low-income sample of children receiving CPP treatment (n = 45; age range = 2-6 years; 76% Latino) compared with a weighted, propensity-matched community-comparison sample (n = 110; age range = 3-6 years; 40% Latino). Baseline epigenetic age acceleration was equivalent across groups. However, posttreatment, epigenetic age acceleration in the treatment group was lower than in the matched community sample. Findings highlight the potential for a dyadic psychosocial intervention to ameliorate accelerated biological aging in trauma-exposed children.
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  • 文章类型: Journal Article
    背景:非自杀性自我伤害(NSSI)是全球青少年人群中的一个严重问题。儿童创伤和欺凌已被确定为NSSI的危险因素。我们探索了童年创伤之间的关系,欺凌受害和NSSI行为的严重程度,并测试欺凌受害在调节儿童创伤与NSSI行为之间的关联中的作用。
    方法:共招募123名青少年。他们被诊断出患有抑郁症或双相情感障碍的抑郁发作,并在去年经历了NSSI。他们使用儿童期创伤问卷中文版(CTQ-C)进行评估,修订后的Olweus欺凌受害问卷(OBVQ-R),和青少年自我伤害问卷(ASHQ)。
    结果:女性的性虐待和关系欺凌的患病率明显高于男孩。年轻年龄组(10-14岁)的个体表现出更高的情感忽视发生率,言语欺凌,关系欺凌,和完全的欺凌,他们的NSSI评分也高于老年组(15-19岁).独生子女的性虐待发生率高于非独生子女。单亲家庭在情感虐待方面得分更高,情感上的忽视,身体上的忽视和身体上的欺凌比双亲家庭。儿童期创伤的各维度与欺凌的各维度均呈显著正相关,在童年创伤和NSSI之间,在欺凌和NSSI之间。童年创伤不仅可以直接影响NSSI的严重程度,而且可以通过欺凌受害间接加重NSSI的严重程度。欺凌受害对情感虐待的中介作用,身体虐待,情感忽视和身体忽视占14%,21%,20%,13%和20%,分别。
    结论:童年创伤与欺凌呈显著正相关,在童年创伤和NSSI之间,在欺凌和NSSI之间。童年创伤不仅可以直接影响NSSI的严重程度,而且可以通过欺凌受害间接加重NSSI的严重程度。欺凌受害在儿童创伤和NSSI之间起部分中介作用。
    BACKGROUND: Nonsuicidal self-injury (NSSI) is a serious problem in the adolescent population worldwide. Childhood trauma and bullying have been identified as risk factors for NSSI. We explored the relationships among Childhood trauma, Bullying victimization and the severity of NSSI behaviours, and test the effect of Bullying victimization in mediating the association between Childhood trauma and the NSSI behaviours.
    METHODS: A total of 123 adolescents were recruited. They were diagnosed with depression or depressive episodes of bipolar disorder and had experienced NSSI in the last year. They were assessed using the Chinese version of the Childhood Trauma Questionnaire (CTQ-C), the Revised Olweus Bullying Victimization Questionnaire (OBVQ-R), and the Adolescent Self-Harm Questionnaire (ASHQ).
    RESULTS: Females presented a significantly greater prevalence of sexual abuse and relationship bullying than boys. Individuals in the younger age group (10-14 years) presented a greater incidence of emotional neglect, verbal bullying, relationship bullying, and total bullying, and their NSSI score was also higher than that of those in the older age group (15-19 years). Only children show a greater prevalence of sexual abuse than nononly children. Single-parent families scored higher on emotional abuse, emotional neglect, physical neglect and physical bullying than two-parent families. There was a significant positive correlation between each dimension of childhood trauma and all the dimensions of bullying, between childhood trauma and NSSI, and between bullying and NSSI. Childhood trauma can not only directly affect the severity of NSSI but also indirectly aggravate the severity of NSSI through bullying victimization. The mediating effects of bullying victimization on emotional abuse, physical abuse, emotional neglect and physical neglect were 14%, 21%, 20%, 13% and 20%, respectively.
    CONCLUSIONS: There was a significant positive correlation between childhood trauma and bullying, between childhood trauma and NSSI, and between bullying and NSSI. Childhood trauma can not only directly affect the severity of NSSI but also indirectly aggravate the severity of NSSI through bullying victimization. Bullying victimization played the partial mediating effects between Childhood trauma and NSSI.
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  • 文章类型: Journal Article
    目标:产后抑郁症(PPD)影响10-15%的产后妇女,在有创伤史的妇女中风险增加。目的探讨贝都因人和犹太妇女不良生活事件与产后抑郁症状的关系。
    方法:在2021年11月至2022年3月期间,在以色列南部地区的一家三级医院对单胎分娩的妇女进行了横断面研究。符合条件的女性填写了两份问卷,以确定儿童创伤(CT)和其他潜在创伤事件(PTE)的暴露情况。包括童年创伤问卷(CTQ),和终身事件清单调查表(LEC)。为了测量PPD的风险,我们使用了爱丁堡产后抑郁量表(EPDS)。CT之间的关联,PTE,并分析PPD风险,构建多变量逻辑回归模型以控制潜在的混杂因素.
    结果:共包括201名妇女,120名贝都因人(59.7%)和81名犹太人(40.2%)。在整个研究人群中,CT和PTE均与PPD风险独立相关(校正OR=2.13,95%CI1.02-4.44,p=0.043,校正OR=3.42,95%,CI1.46-8.00,p=0.004)。而在贝都因妇女中,PTE与PPD风险独立相关(校正后OR=4.83,95%CI1.66-14.05,p=0.004),在犹太妇女中未发现显著关联.
    结论:在贝都因人和犹太妇女中,CT和PTE均与PPD风险增加相关。只有PTE,而不是CT,在贝都因妇女中与PPD有关。了解PPD的危险因素,以及少数群体之间的差异,可以促进PPD的预防工作。
    OBJECTIVE: Postpartum depression (PPD) affects 10-15% of postpartum women with increased risk among women with trauma history. The purpose of this study was to investigate the relationship between adverse life events and postpartum depressive symptoms among Bedouin and Jewish women.
    METHODS: A cross-sectional study was performed in a tertiary hospital in the southern district of Israel on women with singleton deliveries between November 2021 and March 2022. Eligible women completed two questionnaires to determine exposure to childhood trauma (CT) and other potentially traumatic events (PTE), including the Childhood Trauma Questionnaire (CTQ), and Lifetime Events Checklist questionnaire (LEC). To measure risk for PPD we used the Edinburgh Postnatal Depression Scale (EPDS). The associations between CT, PTE, and risk for PPD were analyzed and multivariable logistic regression models were constructed to control for potential confounders.
    RESULTS: A total of 201 women were included, 120 Bedouin (59.7%) and 81 Jewish (40.2%). In the entire study population, both CT and PTE were independently associated with risk for PPD (adjusted OR = 2.13, 95% CI 1.02-4.44, p = 0.043 and adjusted OR = 3.42, 95%, CI 1.46-8.00, p = 0.004, respectively). While among Bedouin women, PTE was independently associated with PPD risk (adjusted OR = 4.83, 95% CI 1.66-14.05, p = 0.004), no significant association was found among Jewish women.
    CONCLUSIONS: Both CT and PTE were associated with increased PPD risk in Bedouin and Jewish women. Only PTE, and not CT, was associated with PPD among Bedouin women. Understanding risk factors for PPD, and differences among minority groups, could promote prevention efforts for PPD.
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  • 文章类型: Journal Article
    患有与童年创伤相关的重度抑郁(MDD)发作的青少年对治疗的反应较差,自杀风险较高。潜在的病因尚不清楚。脑源性神经营养因子(BDNF)可通过下调哺乳动物雷帕霉素靶蛋白(mTOR)信号通路改善抑郁症状,参与神经发育过程中的不良环境刺激。BDNF和mTOR在与儿童创伤相关的重度抑郁发作的青少年中没有同时报道。
    儿童创伤问卷简表(CTQ-SF),采用儿童抑郁量表(CDI)和儿童抑郁量表修订(CDRS-R)对招募的青少年重度抑郁发作进行评估。采用ELISA法检测31例青少年抑郁症伴儿童创伤和18例健康对照组的血清BDNF和p-mTOR水平。
    血清BDNF水平显着降低(p<0.001);p-mTOR的血清水平在首次出现严重抑郁发作并伴有儿童创伤的青少年中很高(p=0.003)。在31名患有严重抑郁发作的青少年中,17人自杀或自伤。与健康对照组相比,自杀或自伤患者血清BDNF水平低于无自杀或自伤患者(p<0.001);p-mTOR水平高于无自杀或自伤患者(p=0.01)。在没有自杀或自伤的患者中,仅血清p-mTOR明显高于健康组(p=0.028)。BDNF与CDRS-R呈负相关(r=-0.427,p=0.006),p-mTOR与CDI呈正相关(r=0.364,p=0.048)。根据接收机工作特性曲线(ROC),血清BDNF和p-mTOR水平联合检测具有较好的诊断价值。
    神经营养和信号通路,涉及BDNF和p-mTOR,可能在有童年创伤史的青少年MDD中发挥作用,尤其是有自杀和自伤倾向的患者。
    UNASSIGNED: Adolescents with major depressive (MDD) episodes associated with childhood trauma have a poorer response to treatment and a higher risk of suicide. The underlying etiology is unclear. Brain-derived neurotrophic factor (BDNF) could improve depressive symptoms by down-regulating mammalian target of rapamycin (mTOR) signaling pathways, which was involved in adverse environmental stimuli during neurodevelopment. BDNF and mTOR have not been reported simultaneously in adolescents with major depressive episodes associated with childhood trauma.
    UNASSIGNED: Childhood Trauma Questionnaire-Short Form (CTQ-SF), Children\'s Depression Inventory (CDI) and Children\'s Depression Rating Scale-Revised (CDRS-R) were used to evaluate the recruited adolescents with major depression episodes. Serum BDNF and p-mTOR levels were measured by ELISA in 31 adolescents with major depression episodes with childhood trauma and 18 matched healthy control.
    UNASSIGNED: The serum levels of BDNF were significantly lower (p<0.001); and the serum levels of p-mTOR were high (p=0.003) in the adolescents with the first episode of major depressive episode accompanied by childhood trauma. Of the 31 adolescents with major depressive episodes, 17 had suicide or self-injury. Compared with the healthy control group, the serum levels of BDNF in patients with suicide or self-injury were lower than those without suicide or self-injury(p<0.001); the serum levels of p-mTOR were higher than those without suicide or self-injury (p=0.01). While in patients without suicide or self-injury, only serum p-mTOR was significantly higher than that in healthy group (p=0.028). BDNF was negatively correlated with CDRS-R (r=-0.427, p=0.006), p-mTOR was positively correlated with CDI (r=0.364, p=0.048). According to Receiver Operating Characteristic Curve (ROC), the combination of serum BDNF and p-mTOR levels have better diagnostic value.
    UNASSIGNED: Neurotrophic and signaling pathways, involving BDNF and p-mTOR, may play a role in adolescent MDD with a history of childhood trauma, especially patients with suicide and self-injury tendencies.
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  • 文章类型: Journal Article
    强迫症(OCD)的特征是侵入性思想和重复性,强迫行为,儿童创伤被认为是其病理生理学的一个促成因素。这项研究旨在描述强迫症患者的脑功能异常,并探讨这些异常与儿童创伤之间的关系。深入了解强迫症的神经基础。48名未经药物治疗的强迫症患者和42名健康对照(HC)接受了静息状态功能磁共振成像和临床评估,包括耶鲁-布朗强迫症量表(Y-BOCS)和儿童创伤问卷简表(CTQ-SF)。与HC相比,强迫症患者表现出右小脑低频波动(ALFF)振幅显著降低,右侧小脑和右侧上枕叶的区域同质性(ReHo)降低(FWE校正p<0.05),与Y-BOCS评分呈负相关(p<0.05)。此外,小脑ALFF与CTQ情绪虐待分量表呈负相关(r=-0.514,p<0.01)。中介分析表明,小脑ALFF介导了CTQ情绪虐待与Y-BOCS之间的关系(良好的模型拟合:R2=0.231,MSE=14.311,F=5.721,p<0.01;直接效应,c\'=0.153,间接效应,a*b=0.191)。研究结果表明,强迫症患者的自发性和区域性小脑活动异常,提示儿童创伤通过小脑神经重塑影响强迫症症状,突出了其对临床治疗选择的重要性。
    Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive, compulsive behaviors, with childhood trauma recognized as a contributing factor to its pathophysiology. This study aimed to delineate brain functional aberrations in OCD patients and explore the association between these abnormalities and childhood trauma, to gain insights into the neural underpinnings of OCD. Forty-eight drug-naive OCD patients and forty-two healthy controls (HC) underwent resting-state functional magnetic resonance imaging and clinical assessments, including the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Childhood Trauma Questionnaire-Short Form (CTQ-SF). Compared to HCs, OCD patients exhibited significantly decreased amplitude of low-frequency fluctuations (ALFF) in the right cerebellum, decreased regional homogeneity (ReHo) in the right cerebellum and right superior occipital lobes (FWE-corrected p < 0.05), which negatively correlated with Y-BOCS scores (p < 0.05). Furthermore, cerebellar ALFF negatively correlated with the CTQ emotional abuse subscale (r = - 0.514, p < 0.01). Mediation analysis revealed that cerebellar ALFF mediated the relationship between CTQ-emotional abuse and Y-BOCS (good model fit: R2 = 0.231, MSE = 14.311, F = 5.721, p < 0.01; direct effect, c\' = 0.153, indirect effect, a*b = 0.191). Findings indicated abnormal spontaneous and regional cerebellar activity in OCD, suggesting childhood trauma impacts OCD symptoms through cerebellar neural remodeling, highlighting its importance for clinical treatment selection.
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  • 文章类型: Journal Article
    这项定性的描述性研究探讨了学校护士暴露于其护理者的创伤报告的经历。在新泽西州执业的学校护士的在线访谈,美国,被逐字记录和转录。研究发现,学校护士在不同程度上暴露于他人的创伤报告中,在城市环境中服务的人比在郊区环境中服务的人报告更多的暴露故事。报告包括许多,社区和个人层面的分层创伤,包括学生与贫困相关的逆境和心理困扰。定性内容分析揭示了四个类别:作为安全港的卫生办公室,在学校模式下工作的挑战,我们听到的事情:创伤报告,创伤的涟漪效应。基于学校的挑战包括缺乏合作,对学校护士角色的误解,和工作量问题,如竞争的需求和有限的时间和资源。学校护士报告说,他们专注于个人的直接需求,并在之后处理经验。他们承认他们只能做这么多,并分享了应对和韧性的故事。额外的教育,资源,和支持解决学生的创伤可以加强学校护理服务的提供,并支持学校护士的福祉,学生,和工作人员。需要对更大,更多样化的学校护士样本进行进一步的研究,包括对学校护士健康和韧性策略的关注。
    This qualitative descriptive study explored school nurses\' experiences of exposure to reports of trauma from those in their care. Online interviews of school nurses practicing in NJ, USA, were recorded and transcribed verbatim. The study found that school nurses were exposed to reports of others\' trauma to varying degrees, with those serving in urban settings reporting more stories of exposure than those in suburban settings. Reports included numerous, layered traumas at the community and individual levels, including students\' poverty-related adversity and psychological distress. Qualitative content analysis revealed four categories: Health Office as Safe Haven, Challenges Working Within the School Model, Things That We Hear: Reports of Trauma, and The Ripple Effect of Trauma. School-based challenges included a lack of collaboration, misunderstanding of the school nurse\'s role, and workload issues such as competing demands and limited time and resources. School nurses reported focusing on the individual\'s immediate needs and processing the experience afterward. They acknowledged they can only do so much, and shared stories of coping and resilience. Additional education, resources, and support in addressing student trauma can enhance the provision of school nursing services and support the well-being of school nurses, students, and staff. Further research is warranted with a larger and more diverse sample of school nurses, including attention to school nurse wellness and resilience strategies.
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  • 文章类型: Journal Article
    这项研究旨在探讨儿童创伤(CT)的潜在差异,心理理论(ToM),社会认知的重要组成部分,双相情感障碍(BD)患者和健康对照者的述情障碍。该研究包括50名符合研究标准并在我们诊所接受随访的BD患者以及50名健康对照。两组的年龄相匹配,性别,和教育地位。社会人口统计问卷,童年创伤问卷(CTQ),多伦多述情障碍量表(TAS),DokuzEylul心理理论指数(DEZIKO),汉密尔顿抑郁量表(HDRS),对所有参与者应用年轻躁狂症评定量表(YMRS)。CTQ-Total,TAS总计,与健康组相比,BD组的DEZIKO总分明显更高(p<.001)。TAS总分与CTQ身体忽视之间存在显著正相关(r=0.472,p=0.001),BD组CTQ情绪疏忽(r=0.449,p=0.001)和CTQ总分(r=0.5,p<.001)。DEZIKO失礼评分和CTQ身体忽视评分之间存在统计学上显著的负相关(r=-0.437,p=.002)。BD患者有更多的不良童年经历,尽管处于缓解期,但ToM能力较低,与健康对照组相比,性情障碍人格特征更为明显。我们还确定了ToM之间的关系,述情障碍,以及BD的不良童年经历。
    This study aimed to investigate the potential differences in childhood trauma (CT), theory of mind (ToM), a significant component of social cognition, and alexithymia in bipolar disorder (BD) patients and healthy controls. The study included 50 BD patients who met the study criteria and were under follow-up at our clinic along with 50 healthy controls. The two groups were matched for age, gender, and educational status. A sociodemographic questionnaire, Childhood Trauma Questionnaire (CTQ), Toronto Alexithymia Scale (TAS), Dokuz Eylul Theory of Mind Index (DEZIKO), Hamilton Depression Rating Scale (HDRS), and Young Mania Rating Scale (YMRS) were applied to all participants. The CTQ-Total, TAS total, and DEZIKO total scores were significantly higher in the BD group compared to the healthy group (p < .001). A significant positive correlation was identified between the TAS total score and CTQ physical neglect (r = 0.472, p = .001), CTQ emotional neglect (r = 0.449, p = .001) and CTQ total scores (r = 0.5, p < .001) in the BD group. A statistically significant negative correlation was identified between the DEZIKO faux pas score and the CTQ physical neglect score (r = -0.437, p = .002). BD patients had more adverse childhood experiences, lower ToM abilities despite being in remission, and more pronounced alexithymic personality features compared to healthy controls. We also identified a relationship between ToM, alexithymia, and adverse childhood experiences in BD.
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