附着和复杂的创伤:评估治疗住院护理儿童的结果
Steve Farnfield1, Caryn Onions2
1School of Psychology, Formerly University of Roehampton, Portsmouth, UK.
Clinical child psychology and psychiatry
|November 18, 2025
概括
这项对患有复杂创伤的儿童的研究发现,未解决的创伤显著阻碍了发展,而特定的不良童年经历 (ACE),如围产期忽视,会影响进步. 附着模式和调节策略需要量身定制的治疗方法.
科学领域:
- 儿童心理学 儿童心理学
- 发展心理学 发展心理学
- 创伤研究 创伤研究
背景情况:
- 严重虐待儿童的复杂创伤带来了重大的发展挑战.
- 了解依恋,创伤和情感调节的相互作用对于有效的干预至关重要.
- 现有的评估可能无法完全捕捉这个人群中复杂创伤的细微差别.
研究的目的:
- 描述严重虐待儿童的复杂创伤.
- 为了评估两年来依恋,创伤,影响调节和教育成就的变化.
- 确定影响这些儿童改善或恶化的因素.
主要方法:
- 一项为期两年的重复测量研究,涉及治疗性寄宿学校的45名儿童.
- 利用基于Crittenden的动态成熟模型 (DMM) 的儿童依恋和游戏评估 (CAPA) 来评估依恋,创伤和影响调节.
- 基于依恋风险矩阵,未解决的损失/创伤和生理兴奋状态的分析进展.
主要成果:
- 51%的孩子表现出改善,而33%的情况恶化.
- 学业成绩普遍有所提高,但未解决创伤的孩子在学业上没有显著的进步.
- 特定的不良童年经历 (ACE),特别是围产期疏忽,比ACE积累更有影响力.
- 类型A+的DMM附着物比类型C+更容易发生失调.
结论:
- 未解决的创伤和损失对儿童的发展是有害的,即使不安全的依恋作为缓冲.
- 针对不同的依恋模式 (例如,DMM类型A+与C+) 需要量身定制的治疗方法.
- 与标准问卷相比,CAPA提供了更详细的分析,用于制定复杂创伤的个性化治疗计划.
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