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健在养育者在丧亲对儿童发展影响中的作用机制
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摘要
亲人亡故,尤其丧失父母,增加儿童健康成长的风险。但是儿童的不良发展并非丧亲本身造成的,更多受到健在养育者的影响。因此,本文将从性别、丧亲态度、哀伤反应、应对方式、心理健康水平、亲子关系等因素对丧亲家庭健在养育者对儿童的影响和作用机制进行探讨。健在养育者是丧亲儿童进行哀伤适应的主要资源。健在养育者的性别影响儿童的生命质量和学业表现。养育者是母亲时,儿童发展较好。健在养育者对丧亲的开放态度和适当的哀伤反应提供儿童情感表达的模板和促进哀伤表达。养育者接受丧亲和适当的哀伤表露可以促使其对儿童的移情和安慰,增加情感交流和儿童的适应性。另外,健在养育者精神病理学危险的增加是丧亲儿童不适应性的中介,增加儿童焦虑、抑郁、创伤后应激障碍(PTSD)、延长哀伤障碍(PGD)和自杀意念和行为的风险。同时,丧亲后,原有亲子关系的破裂,儿童容易产生被健在养育者抛弃的恐惧,影响同伴关系和恋爱关系的发展,过早发生性行为,增加感染HIV风险。积极教养方式是丧亲家庭健在养育者心理压力和儿童心理健康状况的中介。健在养育者具有温暖和一致的积极教养方式,促进稳定有序亲子关系的建构,增加儿童应对压力的能力。但是丧亲易增加养育者心理压力,破坏积极养育行为,阻碍儿童的发展。未来要对不同的丧亲类型(自然灾害、自杀、事故、疾病等)、积极情感、文化、家庭结构的变化等因素对健在养育者和儿童的影响以及在这些环境下养育者对儿童的作用机制进行研究。
Early traumatic stress is an unique and overwhelming event. Especially a significant loss, the death of a parent, may have potentially traumatic consequences over time for children and increases the risks of children's physical and mental development. However, some studies proposed that the severe difficulties in children's adjustment owed to the surviving caregiver's psychological problems(e.g., substance abuse, psychiatric disorders, severe criminality), not the bereavement. Therefore, the purpose of the present study is designed to identify risk and protective factors that stem from the surviving caregiver's behavioral and psychological reaction(e.g., different gender, attitude to bereavement, grief reaction, mental health, caregiver-child relationship, parenting behavior) and promotes resilience of bereaved children. In bereaved family, the state of caregiver is a major resource for children, which can impact children's adaptation following bereavement, as well as the capacity to respond adaptively to future stress. Many studies also revealed that the surviving caregiver's gender, attitudes to bereavement, reactions of grief, and coping styles(e.g., active coping, coping efficacy) had a profound function on children's grief process. To exemplify, the status of surviving mother is more important than surviving father in children's health and school performance. Caregiver's grief reaction and coping style are potentially factors for the well-being of bereaved children and provide the patterns of emotional expression. After bereavement, The caregiver's appropriate grief reaction contributes to show empathy to children, increases caregiver-child communication and children's adaptability. Parental mental disorder(e.g., anxiety, depression) may lead to children's maladjustment, such as, anxiety, depression, posttraumatic stress disorder(PTSD), prolonged grief disorder(PGD), suicide idea, and suicide behavior. Bereaved children experienced a major disruption in close relationships with the loss. Children's fear of abandonment implicates peer and romantic relationships, early sexual behavior, and increases the risk of HIV, in the next developmental stage. Positive parenting is a mediator of the relations between parental psychological distress and mental health problems of bereaved children. Positive caregiver-child relationships, high parenting function and warmth of the surviving caregiver(e.g., responsiveness, understanding, positive affect, consistent discipline) can reduce the adverse effects on children's adjustment, and increase the ability of copying stress. But, bereavement increases the caregiver's psychological distress, hinders positive parenting and children's development. Future research should focus on the roles of different types of bereavement(e.g., natural disaster, suicide, accident, disease), positive emotion, cultural factors(e.g., Cross-cultural comparisons, religions and spiritual beliefs) and the changes of family function(e.g., cohesion, adaptability, communication). Researchers should identify adaption of the surviving caregiver and bereaved children and restructurings of their recognition and behavior after the disruption, in these environments.
引文

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