Posttraumatic stress disorder in children and adolescents: a review and analysis

Israeli youth in the Second Intifada: PTSD and future orientation

OBJECTIVE

To examine the relationship between exposure to political violence and posttraumatic symptoms, future orientation, and attitudes toward peace.

METHOD

A total of 740 boys and girls aged 11.5-15 years from Jerusalem, Gilo, and the Jewish settlements in the disputed territories were assessed in the summer of 2001 using an exposure to terror questionnaire, Child Posttraumatic Stress Reaction Index, Children's Future Orientation Scale, and a question regarding the future of peace talks.

RESULTS

A substantially higher percentage of youths in the settlements (27.6%) than in Jerusalem (12.4%) or Gilo (11.2%) reported moderate to very severe levels of posttraumatic symptoms. Children's Future Orientation responses were moderately optimistic. About two thirds of the adolescents in the settlements rejected the idea of peace talks at any time, whereas around half of the youths in Jerusalem and Gilo supported the continuation of peace talks. Exposure was related to both PTSD symptoms and attitudes toward peace but not to future orientation.

CONCLUSIONS

Our findings present the complex interrelationship of political violence, posttraumatic stress disorder, and attitudes toward peace and raise the need for a combined mental health and peace education intervention to prevent the often overlooked vicious cycle of violence and traumatization.

Gender differences in social reactions to abuse disclosures, post-abuse coping, and PTSD of child sexual abuse survivors

OBJECTIVE

This research examines the understudied issue of gender differences in disclosure, social reactions, post-abuse coping, and PTSD of adult survivors of child sexual abuse (CSA).

METHOD

Data were collected on a cross-sectional convenience sample of 733 college students completing a confidential survey about their demographic characteristics, sexual abuse experiences, disclosure characteristics, post-abuse coping, and social reactions from others.

RESULTS

Female students reported greater prevalence and severity of CSA, more distress and self-blame immediately post-assault, and greater reliance on coping strategies of withdrawal and trying to forget than male students. Women were more likely to have disclosed their abuse to others, to have received positive reactions, and to report greater PTSD symptom severity, but were no more likely to receive negative reactions upon disclosure than men. Women delaying disclosure had greater PTSD symptom severity, whereas men's symptoms did not vary by timing of disclosure. Additional regression analyses examined predictors of PTSD symptom severity and negative and positive social reactions to abuse disclosures.

CONCLUSIONS

Several gender differences were observed in this sample of college students in terms of sexual abuse experiences, psychological symptoms, coping, PTSD, and some aspects of disclosure and social reactions from others.

Post-traumatic stress disorder in maltreated youth: a study of diagnostic comorbidity and child factors

The study of post-traumatic stress disorder (PTSD) in maltreated youth has received increased attention, though extensive comparisons to maltreated youth without PTSD and administrations of anxiety-based structured diagnostic interviews remain needed. We examined maltreated youth with or without PTSD using structured diagnostic interviews and standardized child self-report measures. We hypothesized that maltreated youth with PTSD, compared to their peers without PTSD, would experience significantly greater duration of abuse, diagnostic comorbidity, PTSD symptomatology, dysfunctional family environment, and avoidant coping styles. Results indicated that the group with PTSD did indeed experience significantly greater duration of abuse, diagnostic comorbidity, and PTSD symptomatology, though less so dysfunctional family environment or avoidant coping styles. The presence of a mood or anxiety disorder was highly predictive of PTSD in this sample. Results are discussed within the context of evolving etiological and maintenance models of PTSD in maltreated youth.

Posttraumatic stress disorder and trauma in youth in juvenile detention

OBJECTIVE

To determine prevalence estimates of exposure to trauma and 12-month rates of posttraumatic stress disorder (PTSD) among juvenile detainees by demographic subgroups (sex, race/ethnicity, and age).

DESIGN

Epidemiologic study of juvenile detainees. Master's level clinical research interviewers administered the PTSD module of the Diagnostic Interview Schedule for Children, version IV (DISC-IV), to randomly selected detainees.

SETTING

A large, temporary detention center for juveniles in Cook County, Illinois (which includes Chicago and surrounding suburbs).

PARTICIPANTS

Randomly selected, stratified sample of 898 African American, non-Hispanic white, and Hispanic youth (532 males, 366 females, aged 10-18 years) arrested and newly detained.

MAIN OUTCOME MEASURES

Diagnostic Interview Schedule for Children, version IV.

RESULTS

Most participants (92.5%) had experienced 1 or more traumas (mean, 14.6 incidents; median, 6 incidents). Significantly more males (93.2%) than females (84.0%) reported at least 1 traumatic experience; 11.2% of the sample met criteria for PTSD in the past year. More than half of the participants with PTSD reported witnessing violence as the precipitating trauma.

CONCLUSION

Trauma and PTSD seem to be more prevalent among juvenile detainees than in community samples. We recommend directions for research and discuss implications for mental health policy.

Prevalence of child and adolescent exposure to community violence

Emerging as one of the most significant health issues facing American youth today, child and adolescent exposure to community violence has generated much interest across multiple disciplines. Most research to date has focused on documenting the prevalence of community violence and the emotional and behavioral ramifications. This paper provides an overview of the current literature regarding prevalence of youth exposure to community violence, and identifies those areas where further research is warranted. In addition to examining overall rates of community violence exposure, this paper reviews the prevalence of different types of community violence, such as weapon use, physical aggression, and crime-related events. Predictors of community violence exposure, including gender, age, race, socioeconomic status, behavior patterns, and geography, are discussed.

Maltreatment and trauma: tracking the connections in adolescence

Posttraumatic stress disorder is one of the most common and often prolonged consequences of childhood maltreatment. In this article the authors consider theories of trauma continuity, with emphasis on a relational path to maladjustment that links childhood maltreatment to elevated trauma symptomatology and intimate victimization in adolescent dating relationships.

Mental health needs in New York state following the September 11th attacks

In October 2001, the New York State Office of Mental Health and the Department of Epidemiology of the Mailman School of Public Health of Columbia University conducted a rapid assessment of the nature and magnitude of mental health needs in the state resulting from the September 11th terrorist attacks on the World Trade Center. This effort was carried out during a period of great turmoil and uncertainty as New Yorkers responded to the shocking events of this unprecedented disaster. Using the limited data available at the time, we estimated that over 520,000 persons in New York City and the surrounding counties would experience posttraumatic stress disorder resulting from exposure to the attacks, and that more than 129,000 would seek treatment for this disorder during 2002. This assessment is part of an ongoing collaborative process between public and academic partners; the effort is designed to strengthen the capacity of the mental health system to respond to current and future terrorism. Estimates from this initial assessment will be refined over time as further data concerning the impact of the September 11th attacks become available.

PTSD symptoms of mothers following occurrence of a disaster affecting their children

This study investigated the PTSD symptoms of 37 mothers whose adolescent children had been directly involved in a disaster, the Jupiter sinking in 1988. This group included mothers whose children were (a) not diagnosed with Posttraumatic Stress Disorder and (b) were diagnosed with Posttraumatic Stress Disorder. The measure used was the Posttraumatic Stress Disorder Symptom Scale. Women whose children were involved in the disaster presented PTSD symptoms. 35% (n = 13) were diagnosed with PTSD 3 mo. after the disaster, and 89% (n = 3) of them were diagnosed with PTSD 6 yr. afterward. This effect was greater in the subgroup whose children had developed traumatic stress disorder following the disaster.