儿童青少年创伤后应激症状与成长的关系研究: 基于变量与群体异质性视角
文献类型：学位论文
| 作者 | 方若娇 |
| 答辩日期 | 2023-06 |
| 文献子类 | 博士 |
| 授予单位 | 中国科学院大学 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 王力 |
| 关键词 | 创伤 创伤后应激障碍 创伤后成长 儿童 青少年 |
| 学位名称 | 理学博士 |
| 学位专业 | 健康心理学 |
| 其他题名 | The Relationship Between Posttraumatic Stress Symptoms and Growth Among Children and Adolescents: Based on Variables and Population Heterogeneity |
| 中文摘要 | Background: Traumatic events have a profound impact on individuals, there are different theoretical hypotheses about the relationship between posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG), the most common and specific responses following traumatic events. Within the population of children and adolescents, who are particularly susceptible to the influences of traumatic events, all those hypotheses are supported by different empirical evidence, yet the associated findings remain inconclusive. Methods: Current research systematically examined the relationship between PTSD and PTG among children and adolescents based on two different perspectives, variables and people heterogeneity, and investigated the sources of heterogeneity in their relationship. The research encompassed: (1) Meta-analysis of the robust relationship between cross-sectional PTSD and PTG, (2) Cross-lagged analysis was used to calculate influence of PTSD and PTG on each other's level, (3) Latent growth modeling was used to analysis the influence of PTSD and PTG on each other's development rate, (4) Latent profile analysis was used to calculate the combined of PTSD and PTG, (5) Latent transition analysis was used to assess the transformation between combined groups of PTSD and PTG, (6) Latent growth mixture modeling was used to analysis the development of PTSD and PTG, (7) Multi-process growth mixture modeling was used to analysis the combined trajectories of PTSD and PTG. The meta-analysis followed the PRISMA standards and searched multiple databases such as Scopus, Web of Science and PubMed. The empirical studies use data from the survey of 699 children and adolescents(mean age 12.2, SD=2.3, range:8-17)who experienced the "8·12" Tianjin Port explosion incident, at 4 months, 8 months and 13 months after the explosion. Results: The meta-analysis, which synthesized findings from 28 articles (involving 18,816 participants) in existing literature, revealed a positive cross-sectional correlation between PTSD and PTG (r=0.129, 95% CI: 0.063; 0.195). In empirical studies, PTSD and PTG were positively correlated at all three different time points. Cross-lagged panel analysis demonstrated that earlier levels of PTSD could predict later levels of PTG, but not vice versa. Latent growth modeling indicated that initial levels of PTSD could predict the rate of change in PTG, whereas the reverse was not supported. Latent profile analysis revealed three population heterogeneity patterns: "Growth Group," "High Symptom Group," and "Psychological Resilience Group." Latent transition analysis suggested that individuals may transition between these groups over time. Latent growth mixture modeling identified two population heterogeneity trajectories of PTSD: "Symptom Escalation Group" and "Resilience Recovery Group." Conversely, in the PTG development trajectory, three population heterogeneity trajectories emerged: "Stable Group," "Low Growth Decline Group," and "Continued High Growth Group," with initial severity levels of PTSD symptoms predicting the PTG trajectories, while the reverse was not supported. Multi-process growth mixture modeling uncovered three population heterogeneity groups in the combined developmental model of both constructs: "Symptom Feature Group," "Resilience Feature Group," and "Growth Feature Group," each demonstrating differences in developmental levels and rates of change, the intensity of trauma exposure can predict the classification of some heterogeneous groups. |
| 英文摘要 | 背景:创伤性事件会对个体造成重大影响，而作为创伤性事件发生后最常见和最特异性的反应，创伤后应激障碍(PTSD)与创伤后成长(PTG)二者之间的关系存在着不同的理论假设。在儿童青少年这一更易受到创伤事件影响的群体中，各种假设均有实证证据支持，相关结论莫衷一是。 方法:本研究分别基于变量视角与群体异质性视角探讨了儿童青少年中PTSD与PTG的关系以及二者关系异质性的来源。具体研究包括:(1) PTSD及PTG横断面稳健关系的元分析，(2)通过交叉滞后分析探讨二者对彼此水平的影响，(3) 通过潜在增长模型分析二者对彼此发展速率的影响，(4) 通过潜在剖面分析探索二者合并的异质性，(5) 通过潜在转化分析探索二者异质性合并组别间的转化，（6)通过潜在混合增长模型分析二者各自异质性的发展轨迹，(7)通过多进程增长混合模型分析二者合并发展的异质性组别。其中，元分析遵循PRISMA标准对Scopus, Web of Science, PubMed等不同数据库进行了检索梳理，各项实证研究则基于对699名经历“8 "12”天津港爆炸事故的儿童青少年(平均年龄12.3岁，标准差2.3，范围8-17岁)，在爆炸后4个月、8个月和13个月等三个时间点的调查数据。 结果:元分析通过对28篇(涉及18816名被试)已有文献的分析发现PTSD与PTG在横断面上总体呈正相关(r = 0.129, 95% CI: 0.063; 0.195 )。实证研究中，在三个时间上PTSD与PTG二者均呈正相关。交叉滞后分析发现较早时间点的PTSD水平可能预测较晚时间点的PTG水平;反之则不然。潜在增长模型分析发现PTSD初始水平可能预测PTG的变化速率;反之则不然。潜在剖面分析发现二者的合并可能存在“成长组”、“高症状组”和“心理韧性组”3类群体异质性模式。潜在转化分析发现个体可能随着时间推移在不同模式间转化。潜在增长混合模型分析发现PTSD可能存在“症状升高组”和“韧性恢复组”2类群体异质性发展轨迹;PTG可能存在“稳定组”、“低成长衰退组”和“持续高成长组”3 类群体异质发展轨迹;初始的PTSD症状严重水平可能预测PTG的发展轨迹，反之则不然。多进程增长混合模型分析发现二者合并发展存在“症状特征组”、“韧性特征组”和“成长特征组”3类群体异质模式，各种模式在二者的发展水平和变化速率上都存在差异，创伤暴露水平可以预测部分异质性组别的归类。结论:变量视角下，本研究验证了PTSD与PTG的共存关系与二者总体的正向关联，支持了PTG是对PTSD的应对这一理论观点;个体差异视角下，本研究发现了PTSD与PTG的关系及合并发展模式存在群体异质性，创伤暴露严重程度等因素可能对这些异质性表现具有预测作用。这有助于我们对人类创伤应激反应的理解，并可能为创伤后的实践工作提供指导。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/46604]  |
| 专题 | 心理研究所_健康与遗传心理学研究室 |
| 推荐引用方式 GB/T 7714 | 方若娇. 儿童青少年创伤后应激症状与成长的关系研究: 基于变量与群体异质性视角[D]. 中国科学院心理研究所. 中国科学院大学. 2023. |
入库方式： OAI收割
来源：心理研究所
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