1
|
Yuan T, Li X, Liu H, Guo LL, Li JL, Xu G, Li X, Sun L, Wang C, Yang L, Zhang D, Hua Y, Lei Y, Zhang L. Community trauma exposure and post-traumatic stress disorder in Chinese children and adolescents. Front Psychiatry 2023; 14:1151631. [PMID: 37867778 PMCID: PMC10587585 DOI: 10.3389/fpsyt.2023.1151631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 09/13/2023] [Indexed: 10/24/2023] Open
Abstract
Background An increasing number of studies have shown the association between traumatic events occurring in childhood and adolescence and post-traumatic stress disorder (PTSD). A gap remains in the literature on the epidemiology and influencing factors of traumatic events and post-traumatic stress disorder in communities in northern China. This study aimed to determine the prevalence of traumatic events and PTSD in communities in northern China, to explore the types of stressful traumatic events and the impact of these traumatic events on children and adolescents, and to investigate the effect of sociodemographic factors on PTSD. Methods A cross-sectional survey study was conducted among 6,027 students (7-17 years old) from 6 cities in Liaoning Province, China. The sample consisted of 2,853 males (47.34%) and 3,174 females (52.66%). The Essen Trauma-Inventory for Children and Adolescents (ETI-CA) Scale was used. The ETI-CA has 5 sections, which include type of traumatic events, worst traumatic event, post-traumatic symptoms, onset, duration, burden of PTSD, and present difficulties in different areas of life. PTSD symptoms were assessed with 23 items in Part 3 of the ETI-CA. Results We found that 2,068 (34.3%) of 6,027 participants experienced trauma events and 686 (33.2%) of 2,068 reported PTSD. Among trauma-exposed youth (2,068), the sudden death of close relatives (33.9%), serious accidents (20.9%), and parental divorce (15.5%) were reported as the worst traumatic events. Studies have shown that after exposure to stressful life events, more than 30% of people feel nervous or upset (39.8%), scared (33.4%), helpless (32.6%), and about 10% have headaches (15.5%), rapid heartbeat (13.3%), and dizziness (11.8%). Multivariable logistic regression analyses showed that students in middle school [OR = 1.29 (1.016, 1.637)], not a student leader [OR = 0.738 (0.618, 0.881)], and their parents in single marital status significantly predicted higher PTSD prevalence the remarried [OR = 0.474 (0.252, 0.893)], married [OR = 0.42 (0.227, 0.778)]. Conclusion The present study suggests the government to train psychological counselors in schools and communities to provide emotional and psychological support, as well as the school leaders and parents to elevate adolescents' psychological suzhi. Particularly, counseling and professional support should be given to those students whose parents are single.
Collapse
Affiliation(s)
- Ting Yuan
- Department of Gynecology and Obstetrics Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Xiangdong Li
- Department of Gerontology, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, Anhui, China
| | - Lei-lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Jin-long Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Guang Xu
- Department of Radiotherapy, Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wanna Medical College, Wuhu, Anhui, China
| | - Yunxiao Lei
- Department of Gynecology and Obstetrics Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| |
Collapse
|
2
|
Starck A, Gutermann J, Schouler-Ocak M, Jesuthasan J, Bongard S, Stangier U. The Relationship of Acculturation, Traumatic Events and Depression in Female Refugees. Front Psychol 2020; 11:906. [PMID: 32528358 PMCID: PMC7247808 DOI: 10.3389/fpsyg.2020.00906] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/14/2020] [Indexed: 12/31/2022] Open
Abstract
Recent research has identified significant correlations between traumatic events and depression in refugees. However, few studies have addressed the role of acculturation strategies in this relationship. This study explored the relationship between cultural orientation, traumatic events and depression in female refugees from Syria, Afghanistan, Eritrea, Iran, Iraq, and Somalia living in Germany. We expected acculturation strategies to moderate the effect of traumatic experiences on depression. The sample included 98 female refugees in Germany. The depression scale of the Hopkins Symptom Checklist (HSCL) represented the dependent measure. The trauma checklists derived from the Post-traumatic Diagnostic Scale (PDS) and the Harvard Trauma Questionnaire (HTQ) as well as the Frankfurt Acculturation Scale (FRACC) were used as independent measures for traumatic events and orientation toward the host culture as well as orientation toward the culture of origin, respectively. A moderation analysis was conducted to examine whether the relationship between the number of traumatic events and depression was influenced by the women's orientation toward the culture of origin and the host culture. We identified a significant model explaining 26.85% of the variance in depressive symptoms (Cohen's f2 = 0.37). The number of traumatic events and the orientation toward the host culture exerted significant effects on depressive symptoms. The moderating effect was not significant, indicating that the effect of the number of traumatic events was not influenced by cultural orientation. Based on our results, orientation toward the host culture as well as traumatic experiences exert independent effects on depressive symptoms in refugees.
Collapse
Affiliation(s)
- Annabelle Starck
- Clinical Psychology and Psychotherapy, Department of Psychology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Jana Gutermann
- Clinical Psychology and Psychotherapy, Department of Psychology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Meryam Schouler-Ocak
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Berlin, Germany
| | - Jenny Jesuthasan
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Berlin, Germany
| | - Stephan Bongard
- Clinical Psychology and Psychotherapy, Department of Psychology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Ulrich Stangier
- Clinical Psychology and Psychotherapy, Department of Psychology, Goethe-University Frankfurt, Frankfurt, Germany
| |
Collapse
|
3
|
de Haan A, Tutus D, Goldbeck L, Rosner R, Landolt MA. Do dysfunctional posttraumatic cognitions play a mediating role in trauma adjustment? Findings from interpersonal and accidental trauma samples of children and adolescents. Eur J Psychotraumatol 2019; 10:1596508. [PMID: 31069022 PMCID: PMC6493315 DOI: 10.1080/20008198.2019.1596508] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 03/07/2019] [Accepted: 03/09/2019] [Indexed: 11/10/2022] Open
Abstract
Background: Trauma adjustment varies in children and adolescents. Studies on objective risk factors of posttraumatic stress symptoms (PTSS) yielded inconsistent results. Dysfunctional posttraumatic cognitions (PTCs) might play a mediating role between risk factors and posttraumatic symptomatology. Objective: To investigate the interplay of the characteristics of the trauma (e.g. trauma type), the characteristics of the individual (e.g. age, sex), and the characteristics of the social environment (e.g. parental distress, marital status) on PTSS and depression, taking the child's dysfunctional PTCs into account as a possible mediator. Method: Structural equation modelling was used to better understand trauma adjustment in two heterogeneous samples of children and adolescents: a sample of 114 participants aged 7-16 after accidental trauma and a sample of 113 participants aged 6-17 after interpersonal trauma. Results: In the accidental trauma sample, dysfunctional PTCs mediated the positive associations of younger age and lower parental educational level on child PTSS, but not on depression. In the interpersonal trauma sample, being female positively predicted child depression. Furthermore, parental dysfunctional PTCs positively predicted both child PTSS and depression. No mediation effect of child dysfunctional PTCs was found in the interpersonal trauma sample. Child dysfunctional PTCs moderately to strongly predicted child PTSS and depression in both trauma samples. Conclusions: The impact of the characteristics of the individual and the characteristics of the social environment on child PTSS and depression might depend on the type of trauma experienced. Dysfunctional PTCs mediated between the characteristics of the individual and the characteristics of the social environment and the severity of PTSS in the aftermath of accidental trauma, but not of interpersonal trauma.
Collapse
Affiliation(s)
- Anke de Haan
- Department of Psychology - Division of Child and Adolescent Health Psychology, University of Zurich, Zurich, Switzerland.,Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland
| | - Dunja Tutus
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Lutz Goldbeck
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Markus A Landolt
- Department of Psychology - Division of Child and Adolescent Health Psychology, University of Zurich, Zurich, Switzerland.,Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
6
|
Stevens AE, Michael KD. Trauma-Focused Cognitive Behavioral Therapy Applied to Childhood Traumatic Grief in the Aftermath of a Motor-Vehicle Accident. Clin Case Stud 2014. [DOI: 10.1177/1534650113517932] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Symptoms of posttraumatic stress, depression, and unresolved grief can appear in children and adolescents following the witnessing or experiencing of a traumatic event and respond with intense fear, helplessness, or horror. Those who lose a loved one in a traumatic manner can develop childhood traumatic grief (CTG), where typical grieving is hindered by trauma symptoms, causing significant impairment in daily functioning, relationships, and academic pursuits. The following is a case study describing a trauma-focused cognitive behavioral approach to treat posttraumatic stress disorder and CTG in a 16-year-old driver of a motor vehicle accident in which his peer was killed. A graduate student clinician provided treatment under supervision within the context of a school mental health program. The results of the intervention were associated with significant reductions in symptoms and impairments in daily living. The implications of these data and recommendations for clinicians treating CTG are provided.
Collapse
|