Temporal Transitions in Patterns of Posttraumatic Stress Disorder and Depression Among Adolescents Following the Wenchuan Earthquake

Bullying Victimization and Comorbid Patterns of PTSD and Depressive Symptoms in Adolescents: Random Intercept Latent Transition Analysis

Many studies have examined post-traumatic stress disorder (PTSD) or depressive symptoms in adolescents under the background of school bullying, but not their comorbidities and changes over time. This study used random intercept latent transition analysis (RI-LTA) to examine the transitions in comorbid patterns of PTSD and depressive symptoms among 815 adolescents (45.0% boys; Mage-baseline = 13.69, SD = 1.60), who reported their symptoms in a 3-year longitudinal study. Three comorbid patterns were found: low symptoms, predominantly PTSD symptoms, and symptoms of comorbidity. Among these patterns, five trends were found through 3 years: stable low symptoms, stable PTSD symptoms, improving symptoms, worsening symptoms, and an inverted-U pattern. Age, time that parents spend with their child, being an only child, family income and experiencing relational bullying were predictors of these transitions. These suggest that patterns of PTSD and depressive symptoms are heterogeneous and may change over time since trauma events. Developing targeted interventions based on underlying factors through distinct patterns and transitions may help us better optimize and utilize intervention resources to alleviate symptoms from bullying victims.

Comorbidity of posttraumatic stress disorder and depression among adolescents following an earthquake: A longitudinal study based on network analysis

BACKGROUND

High comorbidity between posttraumatic stress disorder (PTSD) and depression among adolescents often follows severe traumatic events. Models on the pathway to comorbidity dispute greatly and how PTSD and depression get comorbidity, remain unclear.

METHODS

A follow-up investigation was conducted of 424 adolescent survivors of the Jiuzhaigou earthquake at 12 months (T1) and 27 months (T2).

RESULTS

Contemporaneous network analysis and cross-lagged panel network analysis showed that PTSD and depression are two separate disorders with strong associations via links between dysphoric symptoms of PTSD and somatic or non-somatic symptoms of depression. However, the association weakened from T1 to T2, and internal connections between symptoms within each disorder became stronger.

LIMITATION

We only measured the comorbidity of PTSD and depression at two time points following the earthquake, which may limit the long-term applicability of our findings following trauma.

CONCLUSIONS

The findings also showed that the centrality in contemporaneous networks may indicate node connectivity rather than the influence or potential causality among nodes. These results help to elucidate the relationship between PTSD and depression and could contribute to the development of appropriate therapies.

Network analysis of comorbid posttraumatic stress disorder and depression in adolescents across COVID-19 epidemic and Typhoon Lekima

BACKGROUND

Network analytic studies indicate that posttraumatic stress disorder (PTSD) may be comorbid with depression at the symptom level, but it remains unclear whether these findings are replicable and generalizable across trauma types.

OBJECTIVE

This study aim was to examine and compare PTSD-depression comorbidity networks of two types of trauma related to Typhoon Lekima and COVID-19 epidemic.

METHODS

Participants were 1605 and 601 adolescents recruited following Typhoon Lekima and the COVID-19 outbreak, respectively.

RESULTS

COVID-19 and Lekima PTSD-depression networks had considerable similarities, including adequate stability and accuracy, connected symptoms of PTSD and depression, symptoms with high centralities, and bridge symptoms. PTSD-depression comorbid symptoms were more complicated in the COVID-19 network but may show more persistence in the Lekima network. Distinct bridge symptoms contributed to the heterogeneity of PTSD-depression comorbidity characteristics between the two networks. Specifically, restricted affect and felt down and unhappy were two important bridge symptoms with high centrality unique to the COVID-19 network.

CONCLUSIONS

PTSD-depression comorbidity network has considerable replicability across trauma types, but specific symptom-level associations and some bridge symptoms may vary across trauma types. These findings also highlight the importance of negative emotions to comorbid PTSD and depression in adolescents following the COVID-19 outbreak compared with Typhoon Lekima.

Longitudinal transitions in patterns of post-traumatic stress disorder symptoms and psychological distress among South Korean adults with traumatic experiences

This study aimed to investigate transitions in patterns of post-traumatic stress disorder (PTSD) symptoms and psychological distress among South Koreans with traumatic experiences. This study consists of two parts: In Part 1 the time since trauma ranged between 0 and 41 years, while in Part 2 participants experienced at least one traumatic event within the previous three years. We identified subgroups and transitions between classes over a one-year period using latent profile analysis and latent transition analysis. First, in Part 1, four classes were identified at T1 and T2. Second, we explored whether age, sex, time since trauma, and time perspective (TP) predicted class membership at T1. Age, past-negative (PN), present-fatalistic, and future TPs were significant predictors of class membership at T1. Finally, sex, PN, and future TPs were identified as significant predictors of class transition over time. The same analysis was conducted in Part 2 with individuals chosen from the Part 1 participants. Differential effects of TP on class membership and transitions in PTSD symptoms and psychological distress indicated the need for intervention programs that consider the TP profiles of individuals with traumatic experiences.

Consistencies and differences in posttraumatic stress disorder and depression trajectories from the Wenchuan earthquake among children over a 4-year period

BACKGROUND

Posttraumatic stress disorder (PTSD) and depression are the most prevalent mental disorders following disasters, and they often co-occur. The current study investigated trajectories of PTSD and depression among children after exposure to the Wenchuan earthquake and identified factors associated with PTSD or depression trajectories.

METHODS

Three hundred children who were exposed to the Wenchuan earthquake reported PTSD and depression symptoms 4, 16, 29, 40 and 52 months after the disaster, and potential predictors (age, earthquake exposure, prequake trauma and parental relationship) were identified. The PTSD and depression trajectories were identified with latent growth mixture modeling (LGMM), and the predictors were explored with multinomial logistic regression.

RESULTS

Two depression trajectories emerged: resilient (66.2%) and chronic (33.8%). Three PTSD trajectories emerged: resilient (74.9%), recovery (7.5%) and relapsing (17.7%). Overall, 57.3% of the children had low depression and PTSD symptoms over four years. Depression trajectories were significantly predicted by age and parental relationship, while PTSD trajectories were significantly predicted by trauma exposure and prequake trauma experience.

LIMITATIONS

The children's prequake mental health statuses were unknown, and all assessments relied on self-report questionnaires.

CONCLUSION

The postdisaster developmental course of depression was more stable than that of PTSD, and PTSD and depression had different risk factors. Previous studies that focus only on PTSD or depression trajectories may overestimate children's resilient responses. Longer-term postdisaster intervention should pay more attention to depression than to PTSD.

The role of alexithymia in the mental health problems of home-quarantined university students during the COVID-19 pandemic in China

Objective

While it is well known that mental health problems are common consequences of deadly pandemics, the association with alexithymia is less clear. This study examined this association in an evaluation of home-quarantined university students during the 2019/2020 COVID-19 pandemic in China.

Methods

In total, 2501 home-quarantined students from six southwest Chinese universities completed the following questionnaires: the 20-item Toronto Alexithymia Scale (TAS-20), the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL—C), and the Patients Health Questionnaire-9 (PHQ-9), after which structural equation modeling (SEM) and mediation analyses were employed to extract and evaluate the possible associations.

Results

It was found that participants with probable depression or PTSD also reported more severe alexithymia features, such as difficulties in identifying feelings (DIF) or describing feelings (DDF). Alexithymia was also found to partially mediate the effect of number of exposures on mental health problems.

Conclusion

These results suggested that implementing strategies to assist young people identify and deal with their own emotions and those of others could prevent or mitigate the mental health problems associated with deadly pandemic events. However, future longitudinal studies are needed to examine the specific involvement of DIF or DDF in people with mental health problems.