ABSTRACT

Background: Child maltreatment (CM), particularly in institutional contexts, can affect the development of post-traumatic stress disorder (PTSD). Research suggests that factors during CM (e.g. severity, variety, duration) and in the aftermath of CM (e.g. stressful life events, and social acknowledgement, i.e. the degree to which an individual feels validated and supported following a traumatic event) can explain some of the heterogeneity in PTSD development. However, there is a lack of research on long-term correlates of CM and mitigating factors, with only a few studies having been conducted with older survivors of institutional upbringing. Such research is relevant, given the long-term associations between CM and the older age status of many survivors.

Objective: The current study examined the link between CM and PTSD in older individuals with a history of institutional upbringing (risk group; RG) and a matched control group (CG). Differences in stressful life events and social acknowledgement were also investigated.

Method: Participants were n = 116 RG (M_age = 70.25 years, 41% female) and n = 122 CG (M_age = 70.71 years, 51% female). Data was assessed using self-report questionnaires and a clinical interview.

Results: The RG reported higher levels of exposure to CM. Lifetime PTSD showed a bigger association with the level of exposure to CM, compared to having an institutional upbringing. Participants with higher CM levels reported more stressful life events. High levels of social acknowledgement mediated the relationship between CM and PTSD in the CG.

Conclusions: Exposure to CM had a stronger association with PTSD than a history of institutional upbringing. In the CG, the survivors’ perception of social acknowledgement ameliorated lifetime PTSD to a small extent. A critical issue for policy makers should be to enhance safeguarding measures against CM exposure, not only in institutional contexts, but also more generally, given the link to PTSD.

摘要

背景：儿童虐待 (CM)，特别是在机构环境中，会影响创伤后应激障碍 (PTSD) 的发展。研究表明，CM 期间的因素（例如严重程度、多样性、持续时间）和 CM 之后的因素（例如压力性生活事件和社会认可，即个人在创伤事件后感到被认可和支持的程度）可以解释一些PTSD 发展的异质性。然而，缺乏对 CM 和缓解因素的长期相关性的研究，只有少数研究是针对机构抚养的老年幸存者进行的。鉴于 CM 与许多幸存者的老年状态之间存在长期关联，此类研究具有相关性。

目标：当前的研究检查了具有机构教养史的老年人（风险组；RG）和匹配的对照组（CG）中 CM 和 PTSD 之间的联系。还调查了压力性生活事件和社会承认的差异。

方法：参与者为n = 116 RG（M_年龄 = 70.25 岁，41% 女性）和n = 122 CG（M_年龄 = 70.71 岁，51% 女性）。使用自我报告问卷和临床访谈评估数据。

结果：RG 报告了更高水平的 CM 暴露。与接受机构教育相比，终生 PTSD 与接触 CM 的程度有更大的关联。CM 水平较高的参与者报告了更多压力性生活事件。高水平的社会承认在 CG 中调节了 CM 和 PTSD 之间的关系。

结论：接触 CM 与 PTSD 的关联比机构教养史的关联更强。在 CG 中，幸存者对社会承认的感知在一定程度上改善了终生 PTSD。政策制定者的一个关键问题应该是加强针对 CM 暴露的保护措施，不仅在制度环境中，而且更普遍地考虑到与 PTSD 的联系。