British Journal of Clinical Psychology最新文献_第10页

The development and validation of the Death Anxiety Beliefs and Behaviours Scale 死亡焦虑信念与行为量表的编制与验证

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2022-08-08 DOI: 10.1111/bjc.12387

Rachel E. Menzies, Louise Sharpe, Ilan Dar-Nimrod

Objectives

Research spanning the fields of clinical, social and health psychology suggests that death anxiety is an important construct. However, no comprehensive, psychometrically adequate measure of the construct exists. The current studies outline the development of a new measure of death anxiety, the Death Anxiety Beliefs and Behaviours Scale (DABBS), which is the first measure to specifically assess unhelpful beliefs and behaviours that may underlie fears of death.

Methods

In Study 1, items were piloted in a large community sample (N = 505). In Studies 2A and 2B, exploratory and confirmatory factor analyses were performed using a treatment-seeking (N = 200) and non-treatment-seeking sample (N = 200). These analyses resulted in the final 18-item scale.

Results

The DABBS demonstrated good construct validity, criterion validity, internal consistency and test–retest reliability. In Study 3, the DABBS effectively distinguished participants with clinically significant death anxiety and distress from those without, demonstrating excellent discriminant validity.

Conclusions

The present data indicate that the DABBS is a valid and reliable measure of affect, beliefs and behaviours relating to death anxiety, in a community sample of adults and among those seeking mental health treatment. Given the increasing recognition of the importance of death anxiety, the DABBS offers a useful research and clinical tool.

目的临床、社会和健康心理学领域的研究表明，死亡焦虑是一种重要的建构。然而，没有全面的，心理测量学上适当的结构测量存在。目前的研究概述了一种新的死亡焦虑测量方法的发展，死亡焦虑信念和行为量表(DABBS)，这是第一个专门评估可能导致死亡恐惧的无益信念和行为的测量方法。方法在研究1中，在一个大的社区样本(N = 505)中进行项目试点。在研究2A和2B中，采用寻求治疗(N = 200)和非寻求治疗的样本(N = 200)进行探索性和验证性因素分析。这些分析产生了最终的18项量表。结果DABBS具有良好的结构效度、效标效度、内部一致性和重测信度。在研究3中，DABBS有效地区分了有临床意义的死亡焦虑和痛苦的参与者和没有临床意义的参与者，显示出极好的区分效度。结论:目前的数据表明，在社区成人样本和寻求心理健康治疗的人群中，DABBS是与死亡焦虑相关的情感、信念和行为的有效和可靠的测量方法。鉴于人们越来越认识到死亡焦虑的重要性，DABBS提供了一个有用的研究和临床工具。

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引用次数: 5

Trauma and aggression: Evaluating the influence of primed hostility and survivor sex 创伤和攻击:评估启动敌意和幸存者性的影响

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2022-08-08 DOI: 10.1111/bjc.12386

Adam J. Ripley, Joshua D. Clapp, Benjamin M. Wilkowski

Objectives

The relation between posttrauma symptoms and aggression is an area of growing interest in the larger clinical literature. The current project looked to examine the impact of primed hostility on aggressive responding in men and women with and without a history of prior trauma.

Design

Experimental aggression paradigm assessed in a 2 (Group) × 2 (Sex) × 2 (Prime) mixed factorial ANOVA.

Methods

Trauma-naïve participants (N = 52) and survivors reporting active symptoms (N = 43) were exposed to hostile and neutral lexical primes in what was presented as a reaction time task played against an unseen ‘opponent’. In actuality, ‘wins’ and ‘losses’ during the task were assigned by an automated system. The intensity of an aversive sound blast delivered by participants to the supposed opponent in trials the participant ‘won’ served as an index of behavioural aggression.

Results

Repeated-measures ANOVA identified a between-by-within interaction of exposure group and lexical prime (p = .010; $� � � �_{η}^{�} � �$ = .070), with trauma-exposed participants (p = .002, Δ = .30), but not controls (p = .159, Δ = .11), demonstrating elevations in aggression subsequent to hostile priming. A sex by prime interaction (p = .001; $� � � �_{η}^{�} � �$ = .117) similarly indicated elevated aggression following hostile priming in men (p = .007, Δ = .58) as compared to women (p = .062, Δ = .10).

Conclusions

Results offer preliminary support for the association of situationally primed hostility and biological sex with aggressive responding in survivors reporting active symptoms.

目的创伤后症状与攻击行为之间的关系是临床文献中一个越来越受关注的领域。目前的项目旨在研究在有或没有创伤史的男性和女性中，启动敌意对攻击性反应的影响。设计采用2(组)× 2(性别)× 2 (Prime)混合因子方差分析评估实验攻击范式。方法Trauma-naïve参与者(N = 52)和报告活跃症状的幸存者(N = 43)暴露于敌对和中性词汇启动，这是一个与看不见的“对手”进行的反应时间任务。实际上，任务中的“赢”和“输”是由一个自动化系统分配的。在实验中，参与者向假想的对手发出的厌恶声音的强度被参与者“赢”了，这是行为攻击的一个指标。结果重复测量方差分析发现暴露组与词汇启动之间存在相互作用(p = 0.010;η p 2 = 0.070)，与创伤暴露的参与者(p = 0.002， Δ = 0.30)，但没有对照组(p = 0.159， Δ = 0.11)，表明攻击性在敌意启动后升高。A性别由启动相互作用(p = .001;η p 2 = .117)同样表明，与女性(p = .062， Δ = .10)相比，男性在敌意启动后的攻击性升高(p = .007， Δ = .58)。结果初步支持情境启动敌意和生理性别与报告活跃症状的幸存者的攻击反应之间的关联。

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引用次数: 0

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2022-08-01 DOI: 10.1111/bjc.12383

Sarah Anvar, Benjamin A. Swerdlow, David Jobes, Kiara R. Timpano, Abby Adler Mandel, Evan Kleiman, Thomas Joiner, Sheri L. Johnson

Objectives

Suicidal ideation is a pervasive and painful experience that varies considerably in its phenomenology. Here, we consider how one key risk variable might inform our understanding of variation in suicidal ideation: emotion-related impulsivity, the trait-like tendency towards unconstrained speech, behaviour, and cognition in the face of intense emotions. We hypothesized that emotion-related impulsivity would be tied to specific features, including severity, perceived lack of controllability, more rapidly fluctuating course, higher scores on a measure of acute suicidal affective disturbance, and more emotional and cognitive disturbance as antecedents.

Methods

We recruited two samples of adults (Ns = 421, 221) through Amazon Mechanical Turk (MTurk), with oversampling of those with suicidal ideation. Both samples completed psychometrically sound self-report measures online to assess emotion- and non-emotion-related dimensions of impulsivity and characteristics of suicidal ideation.

Results

One form of emotion-related impulsivity related to the severity, uncontrollability, dynamic course, and affective and cognitive precursors of ideation.

Conclusions

Despite limitations of the cross-sectional design and self-report measures, the current findings highlight the importance of specificity in considering key dimensions of impulsivity and suicidal ideation.

目的：自杀意念是一种普遍而痛苦的体验，其现象学差异很大。在这里，我们考虑了一个关键的风险变量如何影响我们对自杀意念变化的理解：情绪相关的冲动，面对强烈情绪时不受约束的言语、行为和认知的特质倾向。我们假设，与情绪相关的冲动与特定特征有关，包括严重程度、感知缺乏控制性、波动更快、急性自杀情感障碍评分更高，以及更多的情绪和认知障碍作为前因。方法：我们通过Amazon Mechanical Turk（MTurk）招募了两个成年人样本（Ns=42121），并对有自杀意念的人进行了过采样。两个样本都在网上完成了心理测量学上健全的自我报告测量，以评估冲动的情绪和非情绪相关维度以及自杀意念的特征。结果：一种形式的情绪相关冲动与意念的严重性、不可控性、动态过程以及情感和认知前兆有关。结论：尽管横断面设计和自我报告措施存在局限性，但目前的研究结果强调了在考虑冲动和自杀意念的关键维度时特异性的重要性。

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引用次数: 0

Engagement with services in Black African and Caribbean people with psychosis: The role of social networks, illness perceptions, internalized stigma, and perceived discrimination 非洲和加勒比黑人精神病患者的服务参与:社会网络、疾病认知、内化污名和感知歧视的作用

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2022-07-30 DOI: 10.1111/bjc.12385

Amy Degnan, Katherine Berry, Matthew Vaughan, Nick Crossley, Dawn Edge

Objectives

Research and policies in the United Kingdom have repeatedly highlighted the need to reduce ethnic disparities and improve engagement with mental health services among Black African and Caribbean people with psychosis. The aim of this study was to examine the role of social network characteristics and psychological factors in engagement with services in Black people with psychosis.

Methods

A cross-sectional study was conducted with 51 Black African and Caribbean adults with non-affective psychosis and currently receiving care from mental health services in England. Measures were completed to examine relationships between social networks, illness perceptions, perceived racial or ethnic discrimination in services, internalized stigma, and current engagement with services from service user and staff perspectives.

Results

Social network composition (ethnic homogeneity) moderately correlated with better service user and staff reported engagement. Greater perceived personal control over problems was associated with better staff reported engagement. Lower perceived ethnic or racial discrimination in services, and specific illness perceptions (higher perceived treatment control, greater self-identification with psychosis symptoms, more concern and greater emotional response related to problems) were associated with better service user reported engagement. Internalized stigma was not associated with service engagement. Multivariate regression analyses suggested that a more ethnically homogenous social network was the strongest predictor of better service user and staff reported engagement.

Conclusions

Psychosocial interventions that target social networks, perceived ethnic and racial discrimination in services, and illness perceptions may facilitate better engagement and improve outcomes. Further longitudinal studies are required to examine causal mechanisms.

联合王国的研究和政策一再强调有必要减少种族差异，改善非洲和加勒比黑人精神病患者接受心理健康服务的情况。本研究的目的是研究社会网络特征和心理因素在黑人精神病患者参与服务中的作用。方法对51名非情感性精神病的非洲和加勒比黑人成年人进行横断面研究，这些成年人目前正在英国的精神卫生服务机构接受治疗。完成了从服务用户和工作人员的角度检查社会网络、疾病认知、服务中感知的种族或民族歧视、内化的耻辱以及目前与服务的接触之间关系的措施。结果社会网络构成(种族同质性)与服务用户和员工的参与度有中等相关性。对问题的个人控制程度越高，员工的敬业度就越高。服务中较低的族裔或种族歧视感知和特定疾病感知(较高的治疗控制感知、对精神病症状的更大自我认同、对问题的更多关注和更大的情绪反应)与较好的服务用户参与度报告相关。内化污名与服务参与无关。多变量回归分析表明，种族同质的社交网络是更好的服务用户和员工参与度的最强预测因子。针对社会网络、服务中存在的民族和种族歧视以及疾病认知的社会心理干预可能促进更好的参与并改善结果。需要进一步的纵向研究来检验因果机制。

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引用次数: 0

Treatment experiences of male and female youths with eating disorders 男女青年饮食失调的治疗体会

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2022-07-25 DOI: 10.1111/bjc.12384

Jennifer S. Coelho, Janet Suen, Sheila Marshall, Haya Zaid-Alkailani, Josie Geller, Pei-Yoong Lam

Objectives

The current study was conducted to further understand the experiences of youths with an eating disorder with accessing services and receiving treatment. Participants' perceptions of the role of gender in eating disorder treatment was also assessed.

Design

A prospective mixed methods design was used, with the current report focusing on qualitative interviews.

Methods

Youths who were receiving services in a specialized paediatric eating disorder program completed a semi-structured interview in combination with a visual lifeline upon their discharge. A process of interpretative induction was employed to derive high-level concepts from the interviews.

Results

A total of 28 youths (15 males and 13 females) completed an interview. Four high-level concepts were identified: (1) unwanted/non-collaborative support, (2) conflicting views, (3) dynamics in relationships (with sub-concepts relating to peers and health professionals), and (4) changing mindset. Although many participants viewed treatment as universal, a subset of participants noted that treatment was tailored towards females.

Conclusions

Youths shared several challenges that they encountered in their journey to accessing specialized eating disorders treatment, including disagreement with their parents/caregivers and health professionals about treatment plans. Interactions with peers and health professionals represented both a facilitator (e.g., feeling supported and inspired by peers) and a challenge (e.g., negative interactions with professionals). Some youths shared concerns about the female-centric nature of treatment. The results of this study highlight the importance of collaborative care for paediatric eating disorders, and consideration for gender inclusivity in eating disorders treatment.

目的本研究旨在进一步了解患有饮食失调的青少年在获得服务和接受治疗方面的经历。参与者对性别在饮食失调治疗中的作用的看法也被评估。设计采用前瞻性混合方法设计，目前的报告侧重于定性访谈。方法接受儿童饮食失调专科项目服务的青少年在出院时完成半结构化访谈并结合视觉生命线。采用解释性归纳法从访谈中推导出高层次的概念。结果共有28名青少年(男15名，女13名)完成了访谈。确定了四个高级概念:(1)不想要的/非合作支持，(2)冲突的观点，(3)关系中的动态(与同伴和卫生专业人员相关的子概念)，以及(4)心态的变化。虽然许多参与者认为治疗是普遍的，但一部分参与者指出，治疗是为女性量身定制的。青少年分享了他们在寻求专业饮食失调治疗的过程中遇到的几个挑战，包括与父母/照顾者和卫生专业人员在治疗计划上的分歧。与同伴和卫生专业人员的互动既是一种促进因素(例如，感到受到同伴的支持和鼓舞)，也是一种挑战(例如，与专业人员的消极互动)。一些年轻人对以女性为中心的治疗表示担忧。这项研究的结果强调了合作护理儿科饮食失调的重要性，以及在饮食失调治疗中考虑性别包容性。

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引用次数: 0

Associations between symptoms of prolonged grief disorder and depression and suicidal ideation 长期悲伤障碍和抑郁症状与自杀意念之间的关系

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2022-07-22 DOI: 10.1111/bjc.12381

Marcin Sekowski, Holly G. Prigerson

Objectives

We examined associations between the severity of symptoms of prolonged grief disorder (PGD) and depression and recent suicidal ideation among bereaved family members.

Methods

Individuals who survived the death of a family member 1–8 year earlier (N = 225) were surveyed using self-report measures in the cross-sectional study. Regression analyses were conducted to test the multivariable effects of PGD and depression symptom severity—including their interactive effect—on recent suicidal ideation among the full sample and subsample of suicidal ideators (n = 38).

Results

The severity of PGD symptoms was positively associated with frequency of recent suicidal ideation in the full sample and subsample of suicidal ideators. Depressive symptoms were positively related to suicidal ideation in the full sample; however, they were significant only in the presence of PGD symptoms in the subsample of suicidal ideators.

Conclusions

Severity of PGD and depression symptoms are positively associated with suicidal ideation among bereaved individuals, highlighting the need to attend to both PGD and depressive symptoms in understanding risk for suicidal ideation among bereaved individuals.

目的:我们研究了在失去亲人的家庭成员中，延长悲伤障碍(PGD)和抑郁症状的严重程度与近期自杀意念之间的关系。方法在横断面研究中，采用自我报告方法对1-8年前家庭成员死亡的幸存者(N = 225)进行调查。采用回归分析来检验PGD和抑郁症状严重程度对自杀意念者全样本和子样本近期自杀意念的多变量影响——包括它们的相互作用(n = 38)。结果在自杀意念者的全样本和亚样本中，PGD症状的严重程度与近期自杀意念的频率呈正相关。在整个样本中，抑郁症状与自杀意念呈正相关;然而，只有在自杀意念者的子样本中出现PGD症状时，它们才有意义。结论PGD和抑郁症状的严重程度与丧亲个体的自杀意念呈正相关，强调在了解丧亲个体自杀意念风险时需要同时关注PGD和抑郁症状。

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引用次数: 2

Reappraisal, social support, and parental burnout 重新评估，社会支持和父母倦怠

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2022-07-18 DOI: 10.1111/bjc.12380

Gao-Xian Lin, Amit Goldenberg, Gizem Arikan, Anna Brytek-Matera, Kamila Czepczor-Bernat, Denisse Manrique-Millones, Moïra Mikolajczak, Hannah Overbye, Isabelle Roskam, Dorota Szczygieł, A. Meltem Ustundag-Budak, James J. Gross

Objectives

Parental burnout is a prevalent condition that affects parents' functioning and health. While various protective factors have been examined, little is known about their interplay. In the current study, we examined the joint effect of two protective factors against parental burnout (one external—social support and one internal—cognitive reappraisal). We were specifically interested in whether the presence of one factor could compensate for the lack of the other.

Methods

To address this question, 1835 participants were drawn from five countries: United States, Poland, Peru, Turkey and Belgium.

Results

Results suggested that both social support and cognitive reappraisal were associated with lower parental burnout. An interaction was also found between the resource factors, such that the presence of cognitive reappraisal compensated for the absence of social support.

Conclusions

These findings point to ways in which parental burnout could be reduced, especially in situations where social support is not easily available.

父母倦怠是一种影响父母功能和健康的普遍状况。虽然研究了各种保护因素，但对它们之间的相互作用知之甚少。在本研究中，我们考察了两种保护因素(外部-社会支持和内部-认知重评)对父母倦怠的共同作用。我们特别感兴趣的是，一个因素的存在是否可以弥补另一个因素的缺失。为了解决这个问题，从五个国家:美国、波兰、秘鲁、土耳其和比利时抽取了1835名参与者。结果社会支持和认知重评均可降低父母倦怠。在资源因素之间也发现了一种相互作用，例如认知重新评价的存在弥补了社会支持的缺失。这些发现指出了减少父母倦怠的方法，特别是在不易获得社会支持的情况下。

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引用次数: 9

The association between maternal perinatal mental health and perfectionism: A systematic review and meta-analysis 母亲围产期心理健康与完美主义的关系:系统回顾和荟萃分析

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2022-06-28 DOI: 10.1111/bjc.12378

Clare Evans, Jana Kreppner, Peter J. Lawrence

Background

Perfectionism is an important feature of adult psychopathology. In the absence of a prior review of the role of perfectionism in perinatal psychopathology, we aimed to ascertain whether perfectionism was associated with symptoms of maternal perinatal depression and anxiety.

Method

We followed PRISMA guidance (PROSPERO: 42019143369), estimated weighted effect sizes and tested possible moderators: timing (pre or post- natal), scales used to measure constructs, infant gender, temperament and age; and rated study quality.

Results

Fourteen studies met eligibility criteria. Perfectionism as a whole, and the perfectionistic concerns dimension, were moderately correlated with common maternal perinatal mental health difficulties r = .32 (95% Confidence Interval = 0.23 to 0.42). In sub-group analyses, perfectionistic concerns were associated with depression (r = .35, 95% CI = 0.26–0.43). We found no evidence of significant moderation of associations.

Limitations

Included studies had methodological and conceptual limitations. All studies examined depression and two examined anxieties; all examined perfectionistic concerns and four examined perfectionist strivings.

Conclusions

Perfectionism, namely perfectionistic concerns, is potentially associated with common maternal perinatal mental health problems. While further research is warranted, identification of perfectionism in the perinatal period may help focus resources for intervention, reducing the prevalence of perinatal mental health difficulties.

完美主义是成人精神病理学的一个重要特征。在缺乏对完美主义在围产期精神病理中的作用的先前审查的情况下，我们旨在确定完美主义是否与母亲围产期抑郁和焦虑症状有关。方法:我们遵循PRISMA指南(PROSPERO: 42019143369)，估计加权效应大小并测试可能的调节因素:时间(产前或产后)、用于测量结构的量表、婴儿性别、气质和年龄;并评价学习质量。结果14项研究符合入选标准。完美主义整体和完美主义关注维度与常见的孕产妇围产期心理健康困难存在中度相关(r = .32)(95%置信区间= 0.23 ~ 0.42)。在亚组分析中，完美主义担忧与抑郁相关(r =。35, 95% ci = 0.26-0.43)。我们没有发现显著的关联缓和的证据。纳入的研究存在方法学和概念上的局限性。所有的研究都是关于抑郁的，两项研究是关于焦虑的;所有人都研究了完美主义的担忧，四人研究了完美主义的努力。结论完美主义，即完美主义关注，可能与常见的孕产妇围产期心理健康问题有关。虽然需要进一步的研究，但围产期完美主义的识别可能有助于集中资源进行干预，减少围产期心理健康问题的患病率。

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引用次数: 2

Schematic beliefs, negative affect and paranoia in at-risk youth 高危青少年的图式信念、消极情绪和偏执

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2022-06-28 DOI: 10.1111/bjc.12373

Lucie Crowter, Robin Banerjee, Clio Berry, David Fowler

Objectives

Attenuated symptoms of psychosis are a core feature of At-Risk Mental States. However, subthreshold levels of paranoia are also common among nonpsychosis populations. At present, little is known about whether the processes underpinning the experience of paranoid ideation in high-risk youth differ as a consequence of meeting At-Risk Mental States (ARMS) for psychosis criteria.

Methods

This study utilized path analysis techniques to examine the relationships between schematic beliefs, negative affect and the experience of paranoia for two groups: a group meeting criteria for ARMS (n = 133) and a group presenting with emerging complex mental health difficulties who did not meet the criteria for ARMS (n = 137).

Results

While the ARMS group displayed significantly greater maladaptive schematic beliefs and more severe symptomatology, the associations between schematic beliefs, symptoms of negative affect and paranoia did not differ as a consequence of ARMS status.

Conclusions

While meeting the ARMS criteria is associated with experiencing more maladaptive cognitions and more negative symptomatology among at-risk youth, the associations between these cognitive beliefs and symptoms may be similar for youth who do not meet ARMS. These findings have implications for broadening the scope of at-risk/high-risk and for developing effective interventions for young people presenting with emerging difficulties.

目的精神病症状减轻是高危精神状态的核心特征。然而，阈下偏执狂水平在非精神病人群中也很常见。目前，对于高危青少年偏执观念的形成过程是否因符合高危精神状态(ARMS)的精神病标准而有所不同，我们知之甚少。方法采用通径分析方法对符合ARMS标准的两组(n = 133)和未符合ARMS标准的新出现的复杂心理健康困难组(n = 137)进行图式信念、消极情绪和偏执体验之间的关系研究。结果虽然ARMS组表现出更大的适应不良图式信念和更严重的症状，但图式信念、消极情绪症状和偏执之间的关联并不因ARMS状态而不同。结论:虽然符合ARMS标准与高危青少年出现更多的适应不良认知和更多的负性症状相关，但这些认知信念与症状之间的关联可能与不符合ARMS标准的青少年相似。这些发现对扩大风险/高风险范围以及为出现新困难的年轻人制定有效干预措施具有重要意义。

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引用次数: 0

Differences in the diagnosis and treatment decisions for children in care compared to their peers: An experimental study on post-traumatic stress disorder 与同龄人相比，护理儿童的诊断和治疗决定的差异:创伤后应激障碍的实验研究

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology

Pub Date : 2022-06-14 DOI: 10.1111/bjc.12379

Rosie McGuire, Sarah L. Halligan, Richard Meiser-Stedman, Lucy Durbin, Rachel M. Hiller

Objectives

Despite evidence of high rates of diagnosable mental health difficulties in children in care, there remains ongoing debate around the appropriateness of traditional diagnoses and treatments. The aim of this study was to quantitatively explore whether mental health diagnosis and treatment decision-making differed when a young person was identified as being in care, specifically focused on post-traumatic stress disorder (PTSD). PTSD is a trauma-specific mental health disorder with rates substantially higher in children in care versus their peers.

Methods

Participants were 270 UK mental health professionals who completed an online survey. Participants were randomized to receive one of two vignettes, which were identical in their description of a teenage boy experiencing PTSD symptoms, except in one he was in foster care and in the other he lived with his mother. Participants were asked to select a primary diagnosis, treatment approach, and potential secondary diagnosis.

Results

Professionals were twice as likely to choose a primary diagnosis of PTSD and a National Institute for Clinical Excellence (NICE)-recommended PTSD treatment when randomized to the mother vignette versus the foster carer vignette. Selecting PTSD as the primary diagnosis made clinicians three times more likely to select a NICE-recommended treatment for PTSD. Developmental trauma was the most common ‘diagnosis’ for both groups, although this led to different treatment decisions.

Conclusions

In the context of PTSD, we found children in care face diagnosis and treatment decision-making biases. Practice implications are discussed.

尽管有证据表明，在接受护理的儿童中，可诊断的精神健康困难比例很高，但围绕传统诊断和治疗的适当性仍存在争议。本研究的目的是定量探讨当一个年轻人被确定为创伤后应激障碍(PTSD)的护理时，心理健康诊断和治疗决策是否会有所不同。创伤后应激障碍是一种创伤特异性心理健康障碍，在接受护理的儿童中，其发病率明显高于同龄人。方法参与者是270名英国心理健康专业人员，他们完成了一项在线调查。参与者被随机分成两组，其中一组描述的是一个经历创伤后应激障碍症状的十几岁男孩，除了一组是寄养儿童，另一组是和母亲住在一起。参与者被要求选择初步诊断、治疗方法和潜在的二次诊断。结果:当被随机分为母亲组和寄养组时，专业人员选择PTSD的初步诊断和国家临床卓越研究所(NICE)推荐的PTSD治疗的可能性是前者的两倍。选择创伤后应激障碍作为主要诊断使临床医生选择nice推荐的创伤后应激障碍治疗方法的可能性增加三倍。发展性创伤是两组中最常见的“诊断”，尽管这导致了不同的治疗决定。结论在PTSD背景下，我们发现儿童在护理中面临诊断和治疗决策偏差。讨论了实践意义。

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引用次数: 5