ISSN 1671-3710
CN 11-4766/R

心理科学进展 ›› 2022, Vol. 30 ›› Issue (10): 2154-2163.doi: 10.3724/SP.J.1042.2022.02154

• 研究构想 • 上一篇    下一篇


郭静(), 刘笑晗, 黄宁   

  1. 北京大学公共卫生学院卫生政策与管理系, 北京100191
  • 收稿日期:2022-02-14 出版日期:2022-10-15 发布日期:2022-08-24
  • 通讯作者: 郭静
  • 基金资助:

Mechanism of prognosis and intervention strategy for child posttraumatic stress disorder: Based on the long tail effect theory

GUO Jing(), LIU Xiaohan, HUANG Ning   

  1. Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
  • Received:2022-02-14 Online:2022-10-15 Published:2022-08-24
  • Contact: GUO Jing


儿童PTSD具有“长尾效应”, 疾病负担重、发展结局存在较大异质性, 但是少有研究对我国儿童PTSD的转归进行系统性研究, 其转归类型、路径尚不明晰, 更缺少促进儿童PTSD复原的干预研究。因此, 本研究拟对儿童及青少年进行追踪调查和准实验研究, 探讨儿童PTSD的发展轨迹及转归类型和机制, 验证基于学校的综合干预服务对促进儿童PTSD恢复的效果, 为儿童PTSD干预及个性化诊疗提供证据。

关键词: 创伤后应激障碍, 长尾效应, 转归机制, 干预策略


Prevention and intervention of post-traumatic stress disorder (PTSD) in children is an important issue of the healthy China strategy. The world health organization (WHO) predicted that global burden of child injury will continue to rise, especially in low and middle-income countries. It is estimated that 10% to 20% of children after traumatic events will experience post-traumatic stress disorder symptoms such as warning, evasion, and negative emotions. PTSD confer a heavy long term burden of disease among children. And Child PTSD was indicated to have a long tail effect, as great heterogeneity exists among children with PTSD regarding their following health outcomes. In addition, post-traumatic stress disorder in children is highly correlated with behavior problems, depression, substance abuse, crime, and suicide, and its negative effects can last into adulthood and even have intergenerational transmission effects. Current studies on the developmental outcome of PTSD in children mostly focus on whether PTSD symptoms decrease, increase or persist in children, while ignoring the types, mechanisms of prognosis, and intervention strategies of Child PTSD. Specifically, the types, characteristics, and mechanism of the developmental outcome of PTSD (transforming into physical and mental health, behavioral health, and other problems) have rarely been systematically explored, especially in the Chinses cultural context. For the reduction in the occurrence and development of PTSD, the trauma-focused cognitive behavioral intervention was proved to be rather effective in reducing the level of PTSD. However, there is not enough evidence from large-sample-sized, long-term randomized controlled studies based on school settings, and a shortage of targeted interventions for different stages of PTSD development. Therefore, it is of great academic value and practical significance to clarify the pathway of the occurrence and trajectory of PTSD in children, provide joint intervention programs based on the school setting, and reduce the risk of their transition to other physical and mental diseases. Moreover, based on a school-based teacher-children-parents cooperation framework, we would provide targeted intervention services to reduce the risk of Child PTSD, further shed light on individual-centered care in clinical practice. The purpose of this study is to conduct a follow-up investigation and quasi-experimental study on children and adolescents, focusing on: (1) the developmental trajectory and outcome types of children with PTSD. (2) What is the mechanism of prognosis for PTSD among children? (3) Whether school-based intervention services can promote the recovery of children with PTSD and reduce the risk of their transition to other physical and mental disorders? (4) According to the characteristics of Chinese children, how to develop early health service plans focusing on reducing traumatic events and promoting the recovery ability of children with PTSD? This study will identify the long-term trajectory types and mechanisms of Child PTSD prognosis in China, reduce the risk of children's PTSD to other physical and mental diseases through the joint intervention program based on the school setting, verify the effect of comprehensive intervention services on promoting the recovery of children's PTSD, and provide evidence for children's PTSD intervention and personalized diagnosis and treatment. Simultaneously, multiple theories were integrated to build the early-warning model, to interpret prognosis mechanism and comprehensive intervention strategy. Based on the "long tail theory", the early-warning model explore the trajectory and trait of the PTSD children. The prognosis mechanism of Child PTSD, incorporated the basic essence of the stress model and the resilience model, will reveal the developmental mechanism of Child PTSD. The process-based intergrated intervention strategy synthesized the characteristics of the long term effect, psychological environmental mechanism and task-shifting model. And this strategy could provide theoretical guidance for the school-based interventions of Child PTSD in the Chinese context.

Key words: posttraumatic stress disorder, long tail effect, mechanism of prognosis, intervention strategy