The present study utilized longitudinal data from a high-risk community sample (N = 377; 166 trauma-exposed; 202 males; 175 females; 73% non-Hispanic Caucasian) to test pretrauma measures of adolescent internalizing and externalizing symptoms as unique prospective predictors of type of trauma exposure and PTSD over and above the influence of correlated family adversity (a composite of family conflict, stress, and parental psychopathology). Data were analyzed with logistic and multinomial logistic regressions. Results indicated that females, but not males, with higher levels of internalizing (OR = 2.91) and externalizing (OR = 2.37) symptoms during adolescence were significantly more likely to be exposed to assaultive violence (over and above family adversity). In fact, males with higher levels of internalizing symptoms were significantly less likely to be exposed to assaultive violence (OR = 0.54). Neither internalizing nor externalizing symptoms uniquely predicted exposure to traumatic events that did not involve assaultive violence. Among trauma-exposed participants, the unique association between internalizing symptoms and later PTSD yielded an odds ratio of 1.79 (p = .07) over and above the influences of family adversity, type of trauma exposure, and gender. Assaultive violence exposure fully mediated the association between females' externalizing symptoms and future PTSD. Findings may help inform the prevention of both assaultive violence exposure and PTSD.

译文

本研究利用了来自高风险社区样本的纵向数据 (N = 377; 166创伤暴露; 202男性; 175女性; 73% 非西班牙裔高加索人) 测试青少年内在化和外在化症状的创伤前措施,作为创伤暴露类型和创伤后应激障碍的独特前瞻性预测因子,超越相关家庭逆境 (家庭冲突、压力和父母心理病理学的组合) 的影响。数据采用logistic和多项logistic回归分析。结果表明,女性而不是男性,在青春期具有较高水平的内在化 (或 = 2.91) 和外在化 (或 = 2.37) 症状的女性更容易遭受攻击性暴力 (超过家庭逆境)。事实上,具有较高水平内化症状的男性暴露于攻击性暴力的可能性显著降低 (OR = 0.54)。内部化或外部化症状都不能唯一地预测暴露于不涉及攻击性暴力的创伤事件。在创伤暴露的参与者中,内在化症状与后来的PTSD之间的独特关联产生了1.79的优势比 (p = .07),超出了家庭逆境,创伤暴露类型和性别的影响。攻击性暴力暴露充分介导了女性外在症状与未来创伤后应激障碍之间的关联。研究结果可能有助于预防攻击性暴力暴露和PTSD。

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