BACKGROUND & AIMS: :Screening programs can reduce the burden of disease, however, they can be associated with raised levels of anxiety. The risk of endometrial and ovarian cancer is increased in hereditary nonpolyposis colorectal cancer (HNPCC). There is no prospective evidence to support screening for gynecological disease in HNPCC, however, current recommendations include the use of ultrasound and endometrial biopsy. This study assesses the impact of screening for gynecological cancer on self-reported symptoms of anxiety, depression, and perceptions of health. Women from HNPCC families attending gynecological screening (n = 26) completed the Hospital Anxiety and Depression Scale and the ShortForm36v2 questionnaires prior to screening with transvaginal ultrasound, outpatient/office hysteroscopy, endometrial biopsy, and ovarian tumor marker assessment (CA125). The same questionnaires were completed at 3 and 6 months following screening (15/26). Women in HNPCC families attending for gynecological screening did not have excess symptoms of anxiety or depression at baseline in subjective comparison to other populations. The process of screening and false positive screening results had no significant impact on symptoms of anxiety and depression or perceptions of health. We conclude that within the limitations of analysis in this small study group, screening for gynecological disease in HNPCC does not appear to be associated with any psychological morbidity.

背景与目标： : 筛查计划可以减轻疾病负担，但是，它们可能与焦虑水平升高有关。遗传性非息肉病性结直肠癌 (HNPCC) 发生子宫内膜癌和卵巢癌的风险增加。目前尚无前瞻性证据支持在HNPCC中筛查妇科疾病，但是，目前的建议包括使用超声和子宫内膜活检。这项研究评估了筛查妇科癌症对自我报告的焦虑，抑郁和健康观念的影响。来自HNPCC家庭的女性 (n = 26) 在接受经阴道超声，门诊/办公室宫腔镜检查，子宫内膜活检和卵巢肿瘤标志物评估 (CA125) 进行筛查之前，完成了医院焦虑和抑郁量表和ShortForm36v2问卷。在筛选后的3个月和6个月 (15/26) 完成相同的问卷。与其他人群相比，参加妇科筛查的HNPCC家庭中的女性在基线时没有过度的焦虑或抑郁症状。筛查过程和假阳性筛查结果对焦虑抑郁症状或健康感知无显著影响。我们得出的结论是，在这个小型研究组的分析局限性内，在HNPCC中筛查妇科疾病似乎与任何心理疾病无关。

BACKGROUND & AIMS: PURPOSE:Psychological distress may decrease adherence to medical treatments and lead to poorer health outcomes of chronic diseases. The aim of this study was to evaluate the relationship between psychological distress and multimorbidity among patients seen in family practice after controlling for potential confounding variables and taking into account the severity of diseases. METHODS:We evaluated 238 patients to construct quintiles of increasing multimorbidity based on the Cumulative Illness Rating Scale (CIRS), which is a comprehensive multimorbidity index that takes into account disease severity. Patients completed a psychiatric symptom questionnaire as a measurement of their psychological distress. In the first model of logistic regression analyses, we used the counted number of chronic diseases as the independent variable. In subsequent models, we used the quintiles of CIRS. RESULTS:After adjusting for confounding factors, multimorbidity measured by a simple count of chronic diseases was not related to psychological distress (OR, 1.12; 95% CI, 0.97-1.29; P = .188), whereas multimorbidity measured by the CIRS remained significantly associated (OR, 1.67; 95% CI, 1.19-2.37; P = .002). The estimate risk of psychological distress by quintile of CIRS was as follows: Q1/2 = 1.0; Q3 = OR, 1.72; 95% CI, 0.53-5.86; Q4 = OR, 2.99; 95% CI, 1.01-9.74; Q5 = OR, 4.67; 95% CI, 1.61-15.16. CONCLUSIONS:Psychological distress increased with multimorbidity when we accounted for disease severity. Clinicians should be aware of the possible presence of psychological distress, which can further complicate the comprehensive management of these complex patients.

背景与目标：

BACKGROUND & AIMS: Our experience with the first family in the Netherlands for whom predictive DNA-testing for Hereditary Breast and Ovarian Cancer (HBOC) became an option is described. This serves to illustrate the complex emotional impact on a family as a whole, and upon the members separately, of becoming aware that breast and ovarian cancer is hereditary, and the implications of undergoing predictive testing. All family members received genetic counseling and were offered pre- and post-test psychological follow-up. We observed two important roles within the family. One member became "the messenger of the news" informing the relatives of the hereditary character of cancer in the family. Another was "the first utilizer" of the new options; namely, the predictive DNA-test and preventive surgery. This first utilizer became the example to the rest of the family. Decisions made about preventive treatment (prophylactic ovariectomy and/or mastectomy) were based on the experiences within the family, whether one identified with an affected family member with breast or with ovarian cancer. The actions and reactions perceived were illustrative of what kind of support provisions should be provided in addition to the genetic and oncological counseling for HBOC. Moreover HBOC should be considered both as an individual and a family problem and be treated as such in genetic counseling.

背景与目标： 描述了我们在荷兰第一个家庭的经验，对于该家庭，遗传性乳腺癌和卵巢癌 (HBOC) 的预测性DNA测试成为一种选择。这可以说明对整个家庭以及对成员的复杂情感影响，使他们意识到乳腺癌和卵巢癌是遗传性的，以及进行预测性测试的含义。所有家庭成员都接受了遗传咨询，并接受了测试前和测试后的心理随访。我们观察到家庭中的两个重要角色。一名成员成为 “新闻的使者”，向亲戚通报了家族中癌症的遗传特征。另一个是新选择的 “第一个利用者”; 即预测性DNA测试和预防性手术。第一个利用者成为了家庭其他成员的榜样。关于预防性治疗 (预防性卵巢切除术和/或乳房切除术) 的决定基于家庭中的经验，无论是患有乳腺癌还是卵巢癌的受影响家庭成员。所感知的行动和反应说明了除了HBOC的遗传和肿瘤咨询外，还应提供什么样的支持规定。此外，HBOC应被视为个人和家庭问题，并在遗传咨询中被视为此类问题。

BACKGROUND & AIMS: :Pharmacotherapies for the behavioural and psychological symptoms of dementia are limited; novel agents for the symptoms are still needed. Herein, we report the case of an 80-year-old male patient with Alzheimer's disease whose severe agitation, insomnia and sexual delusions were successfully treated with a traditional natural Japanese (Kampo) medicine, keishi-ka-ryukotsu-borei-to. We found that administrating keishi-ka-ryukotsu-borei-to increased his serum luteinizing hormone level, which could be inversely associated with his behavioural and psychological symptoms. This report suggests that keishi-ka-ryukotsu-borei-to is a possible alternative treatment for the behavioural and psychological symptoms of dementia, especially sexual delusions.

背景与目标： : 针对痴呆症的行为和心理症状的药物疗法有限; 仍然需要针对这些症状的新型药物。在此，我们报告了一名80岁的男性阿尔茨海默氏病患者，其严重的躁动，失眠和性妄想已成功地用传统的天然日本 (Kampo) 药物keishi-ka-ryukotsu-borei-too治疗。我们发现，服用keishi-ka-ryukotsu-borei-会增加他的血清黄体生成激素水平，这可能与他的行为和心理症状成反比。该报告表明，keishi-ka-ryukotsu-borei-too可能是治疗痴呆症的行为和心理症状，尤其是性妄想的替代疗法。

BACKGROUND & AIMS: :The aim of this study was to assess the efficacy and safety of tandospirone, a 5-HT1A partial agonist, for treatment of behavioural and psychological symptoms of dementia (BPSD). Thirteen outpatients with DSM-IV diagnosis of Alzheimer's type or vascular dementia were enrolled in this study. Their BPSD and cognitive functions were evaluated with the Neuropsychiatric Inventory (NPI) and Mini-Mental State Examination, respectively, for an 8-wk period of treatment. The maximum benefit of tandospirone was achieved at a mean dose of 19.6 mg/d. There were significant improvements in the NPI subscores for delusion, agitation, depression, anxiety, and irritability at 2 or 4 wk after the start of administration of tandospirone. No patients experienced severe adverse effects. The results suggest that tandospirone was effective at improving BPSD symptoms and well-tolerated in elderly demented patients.

背景与目标： : 这项研究的目的是评估5-HT1A部分激动剂坦度螺酮治疗痴呆症 (BPSD) 的行为和心理症状的疗效和安全性。本研究招募了13例dsm-iv诊断为阿尔茨海默氏型或血管性痴呆的门诊患者。在8周的治疗时间内，分别通过神经精神病学量表 (NPI) 和迷你精神状态检查评估了他们的BPSD和认知功能。在19.6 mg/d的平均剂量下实现了坦度螺酮的最大益处。在开始服用坦度螺酮后的2或4周，对妄想，躁动，抑郁，焦虑和易怒的NPI子评分有显着改善。没有患者出现严重的不良反应。结果表明，坦度螺酮可有效改善老年痴呆患者的BPSD症状，并且耐受性良好。

BACKGROUND & AIMS: :We examined whether constructs outlined in self-determination theory (Deci & Ryan, 2002), namely, autonomy-supportive and controlling motivational climates and autonomous and controlled motivation, were related to attitudes toward performance-enhancing drugs (PEDs) in sport and drug-taking susceptibility. We also investigated moral disengagement as a potential mediator. We surveyed a sample of 224 competitive athletes (59% female; M age = 20.3 years; M = 10.2 years of experience participating in their sport), including 81 elite athletes. Using structural equation modeling analyses, our hypothesis proposing positive relationships with controlling climates, controlled motivation, and PEDs attitudes and susceptibility was largely supported, whereas our hypothesis proposing negative relationships among autonomous climate, autonomous motivation, and PEDs attitudes and susceptibility was not supported. Moral disengagement was a strong predictor of positive attitudes toward PEDs, which, in turn, was a strong predictor of PEDs susceptibility. These findings are discussed from both motivational and moral disengagement viewpoints.

背景与目标： : 我们研究了自我决定理论 (Deci & Ryan，2002) 中概述的结构，即自主支持和控制动机气候以及自主和控制动机，是否与运动和药物对提高表现药物 (ped) 的态度有关吸毒易感性。我们还调查了道德脱离作为潜在调解人的情况。我们调查了224名竞技运动员 (59% 名女性; M年龄 = 20.3岁; M = 10.2年参加运动的经验) 的样本，其中包括81名精英运动员。使用结构方程模型分析，我们的假设提出了与控制气候，受控动机以及PEDs态度和敏感性之间的正相关关系，而我们的假设提出了自主气候，自主动机以及PEDs态度和敏感性之间的负相关关系，则没有得到支持。道德脱离是对ped积极态度的有力预测因素，而这反过来又是ped易感性的有力预测因素。从动机和道德脱离的角度讨论了这些发现。

BACKGROUND & AIMS: :This Special Issue of Clinical Psychology: Science and Practice provides a series of articles detailing efforts to consider the concepts of emotion and emotion regulation in relation to clinical assessment and psychopathology intervention efforts across the lifespan. In our commentary, we review some common themes and challenges presented in these articles to move forward the discussion of emotion's role in psychological therapy. We discuss efforts to conceptualize the role of context in defining emotion concepts and maximizing the relevancy of such concepts to treatment. We review the importance of imbuing efforts to develop emotion-focused treatments with emphases on positive, as well as negative, emotions and flexibility in the expression of these emotions. We also highlight the relevance of a lifespan developmental approach to the accurate use of emotion and emotion regulation concepts within treatment. Finally, we discuss the application of these issues to our own treatment development and evaluation efforts regarding a unified approach to the treatment of emotional disorders in adults and adolescents.

背景与目标： : 本期《临床心理学: 科学与实践》特刊提供了一系列文章，详细介绍了在整个生命周期中考虑与临床评估和精神病理学干预工作相关的情绪和情绪调节概念的努力。在我们的评论中，我们回顾了这些文章中提出的一些常见主题和挑战，以推进对情感在心理治疗中的作用的讨论。我们讨论了将上下文在定义情感概念中的作用概念化并最大程度地提高这些概念与治疗的相关性的努力。我们回顾了努力开发以情绪为中心的治疗方法的重要性，重点是积极，消极的情绪和这些情绪表达的灵活性。我们还强调了寿命发展方法与在治疗中准确使用情绪和情绪调节概念的相关性。最后，我们讨论了这些问题在我们自己的治疗开发和评估工作中的应用，以统一的方法治疗成人和青少年的情绪障碍。

BACKGROUND & AIMS: :This study was aimed at determining the effects of dancing on the health status of older persons. A pool of 111 community-dwelling subjects were allocated to either an intervention group (IG), which included 23 sessions of dance over 12 weeks, or a control group (CG). All participants were assessed at baseline and 12 weeks. Physical outcome measures included the 6-min timed walking test (6MWT), trunk flexibility, body composition, lower limb endurance and strength, balance, the timed up-and-go test (TUG), resting heart rate and blood pressure. Quality of life was assessed by the Medical Outcomes Survey Short Form (SF-36) questionnaire. The IG's views toward dancing were also evaluated at 12 weeks. Significant difference was observed between the groups in six outcome measures: mean change in resting heart rate, 6MWT, TUG, lower limb endurance and the 'general health' and 'bodily pain' domains of SF-36. The majority of the dance group felt the intervention improved their health status. These findings demonstrate that dancing has physical and psychological benefits, and should be promoted as a form of leisure activity for senior citizens.

背景与目标： : 这项研究旨在确定跳舞对老年人健康状况的影响。将111个社区居住的受试者分配给干预组 (IG) 或对照组 (CG)，干预组 (IG) 包括12周的23次舞蹈。所有参与者均在基线和12周进行评估.身体结果指标包括6分钟定时步行测试 (6MWT)，躯干柔韧性，身体成分，下肢耐力和力量，平衡，定时上行测试 (TUG)，静息心率和血压。生活质量通过医疗结果调查 (SF-36) 问卷进行评估。IG对舞蹈的看法也在12周时进行了评估。在六个结果指标中，两组之间观察到显着差异: 静息心率，6MWT，TUG，下肢耐力以及SF-36的 “总体健康” 和 “身体疼痛” 领域的平均变化。大多数舞蹈团认为干预措施改善了他们的健康状况。这些发现表明，舞蹈具有身体和心理上的益处，应作为老年人休闲活动的一种形式加以推广。

BACKGROUND & AIMS: BACKGROUND:Cognitive Behaviour Therapy (CBT) is the front-line psychological intervention for step 3 within UK psychological therapy services. Counselling is recommended only when other interventions have failed and its effectiveness has been questioned. METHOD:A secondary data analysis was conducted of data collected from 33,243 patients across 103 Improving Access to Psychological Therapies (IAPT) services as part of the second round of the National Audit of Psychological Therapies (NAPT). Initial analysis considered levels of pre-post therapy effect sizes (ESs) and reliable improvement (RI) and reliable and clinically significant improvement (RCSI). Multilevel modelling was used to model predictors of outcome, namely patient pre-post change on PHQ-9 scores at last therapy session. RESULTS:Counselling received more referrals from patients experiencing moderate to severe depression than CBT. For patients scoring above the clinical cut-off on the PHQ-9 at intake, the pre-post ES (95% CI) for CBT was 1.59 (1.58, 1.62) with 46.6% making RCSI criteria and for counselling the pre-post ES was 1.55 (1.52, 1.59) with 44.3% of patients meeting RCSI criteria. Multilevel modelling revealed a significant site effect of 1.8%, while therapy type was not a predictor of outcome. A significant interaction was found between the number of sessions attended and therapy type, with patients attending fewer sessions on average for counselling [M = 7.5 (5.54) sessions and a median (IQR) of 6 (3-10)] than CBT [M = 8.9 (6.34) sessions and a median (IQR) of 7 (4-12)]. Only where patients had 18 or 20 sessions was CBT significantly more effective than counselling, with recovery rates (95% CIs) of 62.2% (57.1, 66.9) and 62.4% (56.5, 68.0) respectively, compared with 44.4% (32.7, 56.6) and 42.6% (30.0, 55.9) for counselling. Counselling was significantly more effective at two sessions with a recovery rate of 34.9% (31.9, 37.9) compared with 22.2% (20.5, 24.0) for CBT. CONCLUSIONS:Outcomes for counselling and CBT in the treatment of depression were comparable. Research efforts should focus on factors other than therapy type that may influence outcomes, namely the inherent variability between services, and adopt multilevel modelling as the given analytic approach in order to capture the naturally nested nature of the implementation and delivery of psychological therapies. It is of concern that half of all patients, regardless of type of intervention, did not show reliable improvement.

背景与目标：

BACKGROUND & AIMS: :Individuals with chronic pain are at an elevated risk of suicide, yet psychosocial factors that might be involved in increasing or decreasing vulnerability for suicidal ideation and behaviour have received little attention. Extant literature on the topic of suicide in individuals with chronic pain incorporates only a few of the wide array of known vulnerability and protective factors. This Review focuses on transdiagnostic psychological processes, (ie, those of relevance for both chronic pain and suicide). We reviewed a selection of published literature on chronic pain and suicide, concentrating on previously unexplored and underexplored lines of research, including future orientation, mental imagery, and psychological flexibility. A greater degree of crosspollination between the fields of chronic pain and suicide research is required to progress our understanding of why some people with chronic pain become suicidal and others do not.

背景与目标： : 患有慢性疼痛的人自杀的风险较高，但是可能与增加或减少自杀观念和行为的脆弱性有关的社会心理因素很少受到关注。关于慢性疼痛患者自杀的现有文献仅纳入了各种已知的脆弱性和保护因素中的少数。本文的重点是跨诊断心理过程 (即与慢性疼痛和自杀相关的过程)。我们回顾了一些有关慢性疼痛和自杀的已发表文献，重点是以前尚未探索和尚未探索的研究领域，包括未来取向，心理意象和心理灵活性。需要在慢性疼痛和自杀研究领域之间进行更大程度的交叉研究，以加深我们对为什么某些患有慢性疼痛的人自杀而另一些人没有自杀的理解。

BACKGROUND & AIMS: AIM:The prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) in the general population has been estimated to be 5.9%, 3.3% and 4.4% respectively. The aim of this study was to determine whether psychological problems are more prevalent following colorectal surgery. METHOD:Patients who had undergone colorectal resection in a 2-year period across four centres were asked to complete validated screening questionnaires for anxiety, depression and PTSD (GAD-7, PHQ-9, PCL-5) 12-48 months after surgery. Risk factors were identified using multiple linear regression analysis. RESULTS:After excluding those who had died or received palliative diagnoses, questionnaires were sent to 1150 patients. 371 responded (32.3% response rate); median age 67 (20-99) years; 51% were men. 58% of patients underwent surgery for cancer; 23% had emergency surgery. 28% of patients screened positive for at least one psychological condition, with 20% screening positive for anxiety, 22% for depression and 14% for PTSD. Patients who were younger, women, had surgery as an emergency, for benign conditions, had stomas and had critical care stay were more likely to have poorer psychological outcomes. Multiple linear regression found that only younger age (P = 0.000) and female gender (P = 0.048) were significant risk factors. CONCLUSION:The prevalence of anxiety, depression and PTSD appears to be high in patients who have undergone colorectal surgery. Younger patients and women are particularly at risk. Further work is needed to determine how best to prevent, detect and treat people with adverse psychological outcomes following colorectal surgery.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Although pregnancy was once thought of as a time of emotional wellbeing for many women, conferring 'protection' against psychiatric disorders, a recent meta-analysis of 21 studies suggests the mean prevalence rate for depression across the antenatal period is 10.7%, ranging from 7.4% in the first trimester to a high of 12.8% in the second trimester. Due to maternal treatment preferences and potential concerns about fetal and infant health outcomes, non-pharmacological treatment options are needed. OBJECTIVES:The primary objective of this review is to assess the effects, on mothers and their families, of psychosocial and psychological interventions compared with usual antepartum care in the treatment of antenatal depression. SEARCH STRATEGY:We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (September 2006), the Cochrane Collaboration Depression Anxiety and Neurosis Group's Trials Registers (CCDANCTR-Studies and CCDANCTR-References) (July 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 3), MEDLINE (1966 to July 2006), EMBASE (1980 to July 2006) and CINAHL (1982 to July 2006). We also scanned secondary references and contacted experts in the field to identify other published or unpublished trials. SELECTION CRITERIA:All published, unpublished and ongoing randomised controlled trials of preventive psychosocial or psychological interventions in which the primary or secondary aim is to treat antenatal depression. We excluded quasi-randomised trials (for example, those randomised by delivery date, or odd versus even medical record numbers) from the analysis. DATA COLLECTION AND ANALYSIS:All review authors participated in the evaluation of methodological quality and data extraction. Results are presented using relative risk for categorical data and weighted mean difference for continuous data. MAIN RESULTS:One US trial was included in this review, incorporating 38 outpatient antenatal women who met Diagnostic and Statistical Manual for Mental Disorders-IV criteria for major depression. Interpersonal psychotherapy, compared to a parenting education program, was associated with a reduction in the risk of depressive symptomatology immediately post-treatment using the Clinical Global Impression Scale (one trial, n = 38; relative risk (RR) 0.46, 95% confidence interval (CI) 0.26 to 0.83) and the Hamilton Rating Scale for Depression (one trial, n = 38; RR 0.82, 95% CI 0.65 to 1.03). AUTHORS' CONCLUSIONS:The evidence is inconclusive to allow us to make any recommendations for interpersonal psychotherapy for the treatment of antenatal depression. The one trial included was too small, with a non-generalisable sample, to make any recommendations.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:The aim was to examine how traumatic and stressful events, responses to violence, child characteristics, and mothering quality, as measured in middle childhood predict psychological distress and positive resources in adolescence. METHOD:The participants were 65 Palestinian adolescents (17+/-.85 years; 52% girls), who had been studied during the First Intifada (T1), during the Palestinian Authority rule (T2) and before the Second Al Aqsa Intifada (T3) in Gaza. Psychological distress was indicated by PTSD, and depressive symptoms and positive resources by resilient attitudes and satisfaction with quality of life, all measured at T3. The predictors that were measured at T1 were exposure to military violence, active coping with violence and children's intelligence, cognitive capacity, and neuroticism. Mothering quality and stressful life-events were measured at T2, the former reported by both the mother and the child, and the latter by the mother. RESULTS:Adolescents' PTSD symptoms were most likely if they had been exposed to high levels of traumatic and stressful experiences and had poor cognitive capacity and high neuroticism in middle childhood. Only high levels of childhood military violence and stressful life-events predicted high depressive symptoms and low satisfaction with quality of life in adolescence. CONCLUSIONS:Military violence in childhood forms risks for both increased psychological distress and decreased positive resources. However, child characteristics such as cognitive capacity and personality are important determinants of psychological vulnerability in military trauma.

背景与目标：

BACKGROUND & AIMS: OBJECTIVES:Improving Access to Psychological Therapies (IAPT) is a national-level dissemination programme for provision of evidence-based psychological treatments for anxiety and depression in the United Kingdom. This paper sought to review and meta-analyse practice-based evidence arising from the programme. DESIGN:A pre-registered (CRD42018114796) systematic review and meta-analysis. METHODS:A random effects meta-analysis was performed only on the practice-based IAPT studies (i.e. excluding the clinical trials). Subgroup analyses examined the potential influence of particular methodologies, treatments, populations, and target conditions. Sensitivity analyses investigated potential sources of heterogeneity and bias. RESULTS:The systematic review identified N = 60 studies, with N = 47 studies suitable for meta-analysis. The primary meta-analysis showed large pre-post treatment effect sizes for depression (d = 0.87, 95% CI [0.78-0.96], p < .0001) and anxiety (d = 0.88, 95% CI [0.79-0.97], p < .0001), and a moderate effect on functional impairment (d = 0.55, 95% CI [0.48-0.61], p < .0001). The methodological features of studies influenced ESs (e.g., such as whether intention-to-treat or completer analyses were employed). CONCLUSIONS:Current evidence suggests that IAPT enables access to broadly effective evidence-based psychological therapies for large numbers of patients. The limitations of the review and the clinical and methodological implications are discussed. PRACTITIONER POINTS:IAPT interventions are associated with large pre-post treatment effect sizes in depression and anxiety measures. IAPT interventions are associated with moderate treatment effect sizes with regards to work and social adjustment. A reduction in dropout and also the prevention of post-treatment relapse via the offer of follow-up support are important areas for future development.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:The purpose of this study is to detail the natural coping strategies used by children involved in everyday road traffic accidents (RTAs). The relationship between coping strategies, post-traumatic stress disorder (PTSD), gender and age was investigated. DESIGN:Children aged 7-18 who attended an accident and emergency department following involvement in a RTA were assessed, 6 weeks after their accident (N = 97). A subgroup of 36 children were re-assessed approximately 8 months after the trauma. METHODS:The presence of PTSD was determined via a semi-structured interview incorporating the Clinician Administered Post-traumatic Scale for Children (CAPS-C). Self-completed psychometric assessments were undertaken to assess the presence of clinically significant levels of depression (Birleson Depression Inventory), anxiety (Revised Manifest Anxiety Scale) and coping style (Kidcope). RESULTS:Children involved in RTAs used between 5 and 7 different coping strategies. Younger children and those with PTSD used more strategies than older children and those not suffering from PTSD. Children with PTSD were more likely to use the strategies of distraction, social withdrawal, emotional regulation and blaming others. CONCLUSION:The limitations of Kidcope are discussed and the need to develop more complex ways of assessing childhood coping within a developmental framework highlighted.

背景与目标：