ABSTRACT

Objective

Theoretical and conceptual models of posttraumatic stress disorder (PTSD) symptom progression in youth have identified social functioning as having a central influence. Yet a dearth of research has examined the bidirectional temporal associations between PTSD symptoms and social functioning.

Method

This study is the first to investigate these temporal dynamics in a sample of adolescents in trauma-informed residential treatment (N= 453; M age = 15.77 [range = 12.12–18.95], SD = 1.55; 57.2% female). The UCLA PTSD Reaction Index for DSM-5 was analyzed as a measure of youth-reported PTSD symptoms and the Interpersonal Problems subscale of the Children’s Depression Inventory, 2nd edition was analyzed as a measure of youth-reported social functioning issues. The Social Problems subscale from the Child Behavior Checklist was analyzed as a measure of clinician-reported social functioning difficulties. Measures were completed at baseline and then approximately every three months for the duration of treatment. Multivariate lagged analyses were used to examine the temporal, bidirectional associations between PTSD symptoms and social functioning.

Results

Results indicated that while controlling for length of stay, trauma exposure, age, and gender, reductions in PTSD symptoms predicted subsequent reductions in social functioning problems across both measures (prs = .12-.16), and that improvement in interpersonal relationships predicted subsequent decreases in PTSD symptoms (pr = .12).

Conclusions

Taken together, these findings highlight the importance of healthy social relationships for decreasing adolescent’s psychological distress. Treatments that include components that target social functioning in addition to symptom reduction may maximally benefit youth with trauma-related psychopathology.

中文翻译：

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住院护理青少年 PTSD 症状与社会功能之间的时间关系

摘要

客观的

青少年创伤后应激障碍 (PTSD) 症状进展的理论和概念模型已确定社会功能具有核心影响。然而，缺乏研究来检验创伤后应激障碍症状与社会功能之间的双向时间关联。

方法

本研究首次调查了接受创伤知情住院治疗的青少年样本中的这些时间动态（N = 453；M年龄 = 15.77 [范围 = 12.12–18.95]，SD = 1.55；57.2% 女性）。对 DSM-5 的加州大学洛杉矶分校 PTSD 反应指数进行分析，作为青少年报告的 PTSD 症状的衡量标准，对儿童抑郁量表第二版的人际关系问题分量表进行分析，作为青少年报告的社会功能问题的衡量标准。对儿童行为检查表中的社会问题分量表进行分析，作为临床医生报告的社会功能困难的衡量标准。测量在基线时完成，然后在治疗期间大约每三个月完成一次。多变量滞后分析用于检查 PTSD 症状与社会功能之间的时间、双向关联。

结果

结果表明，在控制住院时间、创伤暴露、年龄和性别的同时，PTSD 症状的减少预示着随后这两项指标中社会功能问题的减少 ( prs  = .12-.16)，而人际关系的改善预示着随后的社会功能问题的减少。 PTSD 症状减少 ( pr  = .12)。

结论

总而言之，这些发现强调了健康的社会关系对于减少青少年心理困扰的重要性。除了减轻症状之外，还包括针对社会功能的治疗可能会最大程度地使患有创伤相关精神病理学的青少年受益。