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Ascienzo S, Sprang G, Royse D. Are Differences Evident in the Ways Boys and Girls Appraise and Interpret Their Traumatic Experiences? A Qualitative Analysis of Youth Trauma Narratives. VIOLENCE AND VICTIMS 2024; 39:143-167. [PMID: 38955470 DOI: 10.1891/vv-2024-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
The purpose of this study was to explore potential similarities and differences in the ways boys and girls appraise and interpret their traumatic experiences, and better understand how gender roles, performance, and socialization processes may impact trauma experiences, appraisals, and narratives within the context of trauma-focused treatment. We used thematic analysis to analyze the trauma narratives of youth (N = 16) ages 8-16 who had experienced multiple types (M = 5.38) of child maltreatment and who were receiving Trauma-focused Cognitive Behavioral Therapy to address clinically elevated posttraumatic stress symptoms. Four themes emerged: variations in the content of negative cognitions, differences in relational emotion, adoption of socially prescribed gender roles, and symptom differences. Although many similarities existed in youth's trauma narratives, differences emerged that point to the importance of social context and the ways gender role expectations and socialization processes influence youth's appraisal of and responses to traumatic events. Findings indicate the importance of considering distress tolerance, relational emotion, gender identity development, and role socialization within the treatment milieu.
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Affiliation(s)
- Sarah Ascienzo
- School of Social Work, North Carolina State University, Raleigh, NC, USA
| | - Ginny Sprang
- Center on Trauma and Children, Department of Psychiatry, University of Kentucky, Lexington, KY, USA
| | - David Royse
- College of Social Work, University of Kentucky, Lexington, KY, USA
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Seasons M, Morrongiello BA. Returning to sport after injury: the influence of injury appraisals and post-traumatic stress symptoms on adolescent risk-taking intentions post-injury. J Pediatr Psychol 2024; 49:175-184. [PMID: 38281129 DOI: 10.1093/jpepsy/jsae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/07/2023] [Accepted: 01/01/2024] [Indexed: 01/29/2024] Open
Abstract
OBJECTIVE How youth think about injury risk can affect their decisions about whether to engage in behaviors that can lead to injury. Appraisals also influence the development of post-traumatic stress symptoms (PTSS), which occur in approximately 20% of children after a medically treated injury. The current study examined how the injury appraisals of youth are associated with the development of PTSS post-skateboarding injury, and if PTSS or perceived benefits of the sport are also associated with youths' intentions to return to the sport. METHOD One hundred three youth who had a medically treated skateboarding injury within the last year provided survey data on injury appraisals, PTSS, the benefits of skateboarding, and intentions to return to the sport. RESULTS A two-stage moderated statistical mediation path model was specified. In the first stage, there was a positive relationship between pain at injury and PTSS, which was attenuated by the moderator, perceived bad luck. PTSS fully mediated the association between perceived pain at the time of injury and intentions to return to skateboarding. In the second stage of the mediation model, the moderator perceived benefits of skateboarding, reversed the negative relationship between PTSS and intentions to return to skateboarding. CONCLUSIONS Skateboarders are a group at risk for injury that can lead to PTSS, and they also are likely to return to the sport despite PTSS. This research identifies factors that impact the decision to return to skateboarding after injury. Limitations of the study and implications for mental health support and injury prevention are provided.
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Padmanabhanunni A, Pretorius TB. Fear of COVID-19 and PTSD: The Protective Function of Problem-Solving Appraisals in Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:220. [PMID: 38397709 PMCID: PMC10888453 DOI: 10.3390/ijerph21020220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024]
Abstract
The COVID-19 pandemic was experienced by many people as a major traumatic event, and it contributed to high levels of fear, anxiety, and PTSD. Negative cognitive appraisals have been consistently implicated in the onset and maintenance of psychological distress, but there is far less research on the protective role of adaptive appraisals in mental health outcomes. The current study aimed to address this gap by investigating the role of problem-solving appraisals in the relationship between fear of COVID-19 and PTSD. Participants were students (n = 322) who completed the Fear of COVID-19 Scale, the Problem-Solving Inventory, the PTSD Checklist for DSM-5, and the five-item short version of the trait scale of the State-Trait Anxiety Inventory. Participants had a mean age of 26 years (±10.2; range 17-63). The results revealed that problem-solving appraisal mediated the effects of fear of COVID-19 on all the dimensions of PTSD. However, moderated mediation analysis demonstrated that the mediation effect was moderated by anxiety. In this regard, the indirect effects of fear of COVID-19 on PTSD were only significant for respondents with low anxiety levels. Our findings suggest that intervention efforts need to focus on identifying and actively targeting maladaptive appraisals of the problem-solving ability as well as addressing anxiety-related symptoms that may impede coping.
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Affiliation(s)
- Anita Padmanabhanunni
- Department of Psychology, University of the Western Cape, Western Cape, Cape Town 7530, South Africa;
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Padmanabhanunni A, Pretorius TB. Cognitive Adaptation to Stress and Trauma: The Role of Self-Appraised Problem-Solving in Posttraumatic Stress Disorder. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2023; 7:24705470231189980. [PMID: 37520891 PMCID: PMC10375036 DOI: 10.1177/24705470231189980] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023]
Abstract
Background Cognitive appraisals play a fundamental role in mental health outcomes following exposure to trauma. Appraisals influence emotional reactions, coping responses, and adaptation to stress and represent a modifiable factor that can serve as a central focus for intervention. Most studies have primarily focused on the role of dysfunctional cognitions in the persistence of posttraumatic stress disorder (PTSD). In this study, we extend research in this area by investigating the role of problem-solving appraisal, an adaptive cognitive strategy, in the association between stress and PTSD. Methods A total of 322 participants completed the Perceived Stress Scale, the problem-solving inventory (PSI), and the PTSD Checklist for DSM-5. Descriptive statistics were generated, and intercorrelations and mediation analysis were performed. Results Problem-solving confidence and personal control partially mediated the relationship between stress and PTSD. However, contrary to existing research, the approach-avoidance style, which is a subscale of the PSI, did not mediate the relationship between these variables. Conclusion Interventions for PTSD should incorporate a complementary focus on developing and increasing adaptive cognitions pertaining to personal control and confidence in problem-solving abilities. This could potentially form part of a broader process of rebuilding the individual's cognitive worldview following exposure to trauma.
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Affiliation(s)
| | - Tyrone B. Pretorius
- Department of Psychology, University of the Western Cape, Cape Town, South Africa
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Lawrence A, Jones M, Boles J. Helping Children Cope with Loss: Legacy Interventions for the Grieving Classroom. CONTINUITY IN EDUCATION 2022; 3:92-100. [PMID: 38774289 PMCID: PMC11104402 DOI: 10.5334/cie.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/28/2022] [Indexed: 05/24/2024]
Abstract
Early experiences of death and loss have a significant impact on children's coping and development across the lifespan, whether the deceased was a family member, friend, or even classmate. Given the sense of community and continuity that children often garner in schools, teachers are uniquely positioned to tailor and facilitate grief supports to meet the developmental and coping needs of their students in response to loss, especially in the case of a classmate's death. Legacy building interventions, though healthcare-derived, have internationally been applied to promote self-expression and meaning making for grieving children and families; the underlying theory and practice of such interventions may render them useful even in classroom environments. Combining art-based activities with storytelling and reflection, legacy building activities may promote awareness and understanding of death in children and adolescents while encouraging adaptive grief responses. This paper describes how teachers may apply legacy building interventions to support students experiencing the death of a classmate. Two sample curricular plans are provided, one targeted towards elementary school children, the other towards middle and high school students. Although these resources appear ready for immediate implementation, it is essential that teachers adapt them - based on their unique classroom, school system, and sociocultural context - to best meet the needs of grieving students.
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Affiliation(s)
| | - Maile Jones
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, US
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Ridings LE, Davidson TM, Walker J, Winkelmann J, Anton MT, Espeleta HC, Nemeth LS, Streck CJ, Ruggiero KJ. Caregivers' and Young Children's Emotional Health Needs After Pediatric Traumatic Injury. Clin Pediatr (Phila) 2022; 61:560-569. [PMID: 35581720 PMCID: PMC9329229 DOI: 10.1177/00099228221097498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pediatric traumatic injury (PTI) is associated with emotional health difficulties, but most US trauma centers do not adequately address emotional recovery needs. This study aimed to assess families' emotional health needs following PTI and determine how technology could be used to inform early interventions. Individual semi-structured, qualitative interviews were conducted with caregivers of children admitted to a Level I trauma center in the Southeastern United States to understand families' experiences in-hospital and post-discharge. Participants included 20 caregivers of PTI patients under age 12 (M = 6.4 years; 70% male, 45% motor vehicle collision). Thematic analysis was used to analyze data from interviews that were conducted until saturation. Caregivers reported varying emotional needs in hospital and difficulties adjusting after discharge. Families responded enthusiastically to the potential of a technology-enhanced resource for families affected by PTI. A cost-effective, scalable intervention is needed to promote recovery and has potential for widespread pediatric hospital uptake.
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Affiliation(s)
- Leigh E. Ridings
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Tatiana M. Davidson
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | | | - Jennifer Winkelmann
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Margaret T. Anton
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Hannah C. Espeleta
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Lynne S. Nemeth
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Christian J. Streck
- Department of Surgery, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Kenneth J. Ruggiero
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
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Xiong T, Milios A, McGrath PJ, Kaltenbach E. The influence of social support on posttraumatic stress symptoms among children and adolescents: a scoping review and meta-analysis. Eur J Psychotraumatol 2022; 13:2011601. [PMID: 35340789 PMCID: PMC8942489 DOI: 10.1080/20008198.2021.2011601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Several risk and protective factors play a role in the development of posttraumatic stress symptoms (PTSS) in children and youth. The evidence for social support (SS) as a protective factor is rising; however, a review of the evidence is lacking. OBJECTIVE This scoping review and meta-analysis aims to map out and synthesize the present research on the influence of social support on PTSS in children and adolescents. METHOD The literature searched through PubMed, MEDLINE, Embase, PsycInfo, and CINAHL identified 3629 abstracts. Ninety articles published from 1999 to 2020 were selected, including a total of 77,439 participants. RESULTS Most papers focused on social and emotional support from family members (36/88) and peers (26/88); other types of support (e.g., informational support and support from professionals) were not widely reported. The cross-sectional studies illustrated an overall significant, but weak, negative correlation between global social support and PTSS. A similar weak negative association was found between family support and PTSS. The association between peer support and PTSS was not significant. For longitudinal studies, 4 of 5 indicated that SS was a significant negative predictor of PTSS. CONCLUSIONS There was conceptual, methodological, and statistical heterogeneity of the identified studies. This review suggests a weak negative relationship between global SS and PTSS in children and adolescents. Higher global SS was related to less PTSS. The evidence regarding family support revealed a more stable negative relationship with PTSS than that for peer support. Investigating social support without specifying the form of support confounds the effect. Studies on informational, teacher, or professional support seem to be lacking. More studies are needed on the longitudinal effects of SS on PTSS.
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Affiliation(s)
- Ting Xiong
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Athena Milios
- College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Patrick J McGrath
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.,Centre for Research in Family Health, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Elisa Kaltenbach
- Centre for Research in Family Health, IWK Health Centre, Halifax, Nova Scotia, Canada
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Lord KA, Suvak MK, Hodgdon HB. Temporal Relationships between PTSD Symptoms and Social Functioning among Adolescents in Residential Care. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2021:1-12. [PMID: 34936524 DOI: 10.1080/15374416.2021.2007486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Theoretical and conceptual models of posttraumatic stress disorder (PTSD) symptom progression in youth have identified social functioning as having a central influence. Yet a dearth of research has examined the bidirectional temporal associations between PTSD symptoms and social functioning. METHOD This study is the first to investigate these temporal dynamics in a sample of adolescents in trauma-informed residential treatment (N= 453; M age = 15.77 [range = 12.12-18.95], SD = 1.55; 57.2% female). The UCLA PTSD Reaction Index for DSM-5 was analyzed as a measure of youth-reported PTSD symptoms and the Interpersonal Problems subscale of the Children's Depression Inventory, 2nd edition was analyzed as a measure of youth-reported social functioning issues. The Social Problems subscale from the Child Behavior Checklist was analyzed as a measure of clinician-reported social functioning difficulties. Measures were completed at baseline and then approximately every three months for the duration of treatment. Multivariate lagged analyses were used to examine the temporal, bidirectional associations between PTSD symptoms and social functioning. RESULTS Results indicated that while controlling for length of stay, trauma exposure, age, and gender, reductions in PTSD symptoms predicted subsequent reductions in social functioning problems across both measures (prs = .12-.16), and that improvement in interpersonal relationships predicted subsequent decreases in PTSD symptoms (pr = .12). CONCLUSIONS Taken together, these findings highlight the importance of healthy social relationships for decreasing adolescent's psychological distress. Treatments that include components that target social functioning in addition to symptom reduction may maximally benefit youth with trauma-related psychopathology.
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Allen L, Jones C, Fox A, Copello A, Jones N, Meiser-Stedman R. The correlation between social support and post-traumatic stress disorder in children and adolescents: A meta-analysis. J Affect Disord 2021; 294:543-557. [PMID: 34330051 DOI: 10.1016/j.jad.2021.07.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 07/03/2021] [Accepted: 07/13/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Risk factors exploring the link between trauma and Post-traumatic stress disorder (PTSD) have been extensively explored in adults, however, less is known about child and adolescent populations. METHODS The current meta-analysis aimed to systematically evaluate and summarise the child focused literature to estimate the strength of the relationship between social support and PTSD symptoms following traumatic events. RESULTS Fifty primary studies reporting an effect size for the relationship between total social support scale or a source of social support with PTSD were included. A small effect size was found for the relationship between social support and PTSD (r = -0.12, 95% CI -0.16 to -0.07, k = 41), with large heterogeneity (I2 = 90.3%). The effect sizes between peer support (r = -0.18, 95% CI -0.10 to -0.25, k = 12), family support (r = -0.16, 95% CI -0.09 to -0.24, k = 13) and teacher support (r = -0.20, 95% CI -0.15 to -0.24, k = 5) and PTSD were also small. Moderator analyses indicated that studies reporting on participants exposed to abuse (r = -0.25) and correlations based on univariate data (r = -0.14) had higher correlations and medium heterogeneity. The main effect size was robust to publication bias and study quality. LIMITATIONS The cross-sectional design of the studies limits the findings and future research using prospective and longitudinal design would help to explain the relationship between social support and PTSD further. CONCLUSIONS The current review suggests that social support may only play a small role in protecting against PTSD and future research may benefit from exploring the link between post-trauma cognitions and social support.
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Affiliation(s)
- Leila Allen
- Centre for Applied Psychology, School of Psychology, University of Birmingham, UK.
| | - Christopher Jones
- Centre for Applied Psychology, School of Psychology, University of Birmingham, UK
| | - Andrew Fox
- Centre for Applied Psychology, School of Psychology, University of Birmingham, UK
| | - Alexandre Copello
- Centre for Applied Psychology, School of Psychology, University of Birmingham, UK; Research and Innovation, Birmingham and Solihull Mental Health Foundation NHS Trust, UK
| | - Natalie Jones
- Centre for Applied Psychology, School of Psychology, University of Birmingham, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, UK
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Rameckers SA, van Emmerik AAP, Bachrach N, Lee CW, Morina N, Arntz A. The impact of childhood maltreatment on the severity of childhood-related posttraumatic stress disorder in adults. CHILD ABUSE & NEGLECT 2021; 120:105208. [PMID: 34332332 DOI: 10.1016/j.chiabu.2021.105208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/23/2021] [Accepted: 07/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Childhood maltreatment is relatively common and is related to a range of negative consequences, such as Posttraumatic Stress Disorder (PTSD). There are indications that various maltreatment types are related to PTSD severity, although not all types, such as emotional abuse, meet the PTSD Criterion-A. OBJECTIVE The aim of the present study was to examine the relationship between 5 types of childhood maltreatment (i.e., sexual, physical, and emotional abuse, and physical and emotional neglect) and the severity of adult PTSD and PTSD symptoms. PARTICIPANTS AND SETTING Adult participants (N = 147) with Childhood-related PTSD (Ch-PTSD) recruited from clinical sites completed the Childhood Trauma Questionnaire-short form (CTQ-sf) and 2 PTSD measures: The Clinician Administered PTSD Scale for DSM-5 (CAPS-5) and the PTSD Checklist for DSM-5 (PCL-5). METHODS Childhood maltreatment predictors and 2 covariates, age and gender, were analysed in multivariate multilevel models as participants were nested within sites. A model selection procedure, in which all combinations of predictors were examined, was used to select a final set of predictors. RESULTS The results indicated that emotional abuse was the only trauma type that was significantly related to severity of PTSD and to the severity of specific PTSD symptom clusters (r between 0.130 and 0.338). The final models explained between 6.5% and 16.7% of the variance in PTSD severity. CONCLUSIONS The findings suggest that emotional abuse plays a more important role in Ch-PTSD than hitherto assumed, and that treatment should not neglect processing of childhood emotional abuse.
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Affiliation(s)
- Sophie A Rameckers
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands.
| | | | - Nathan Bachrach
- GGZ Oost Brabant, RINO Zuid and Tilburg University, Helmond, the Netherlands
| | - Christopher W Lee
- Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
| | - Nexhmedin Morina
- Institute of Psychology, University of Münster, Münster, Germany
| | - Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands
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Scharpf F, Mueller SC, Masath FB, Nkuba M, Hecker T. Psychopathology mediates between maltreatment and memory functioning in Burundian refugee youth. CHILD ABUSE & NEGLECT 2021; 118:105165. [PMID: 34171582 DOI: 10.1016/j.chiabu.2021.105165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 06/06/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The detrimental impact of child maltreatment on children and adolescents' academic achievement and later socioeconomic wellbeing is well known. However, it is still unclear (1) whether maltreatment is actually linked to youth's long- and short-term memory deficits and (2) whether potential impairments are due to maltreatment per se or related psychopathology. OBJECTIVE Based on the Attentional Control Theory, we investigated a mediational model in which maltreatment would be related to psychopathology (internalizing symptoms, posttraumatic stress symptoms, posttraumatic cognitions), which would in turn be related to impaired memory functioning. PARTICIPANTS AND SETTING We drew on a sample of 155 Burundian refugee youth (aged 11 to 15) currently living in refugee camps in Tanzania and at high risk of experiencing ongoing maltreatment by parents. METHODS Youth reported on their experiences of maltreatment and psychopathology in structured clinical interviews and completed visuospatial memory tasks involving a short-term and a working memory component (Corsi Block Tapping Test) and delayed recall from long-term memory (Rey-Osterrieth Complex Figure). RESULTS Structural equation modeling showed that psychopathology mediated the association between increased maltreatment and reduced working memory capacity (β = -0.07, p = .02), with a trend towards mediation for short-term memory (β = -0.05, p = .06). Higher levels of maltreatment, but not psychopathology, were directly linked to long-term memory deficits (β = -0.20, p = .02). CONCLUSIONS Preventive efforts targeting maltreatment and interventions focusing on related psychopathology are needed to counter memory deficits and their potential negative implications for academic and socioeconomic outcomes.
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Affiliation(s)
| | - Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium; Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
| | - Faustine Bwire Masath
- Department of Psychology, Bielefeld University, Germany; Department of Educational Psychology and Curriculum Studies, Dar es salaam University College of Education, Tanzania
| | - Mabula Nkuba
- Department of Educational Psychology and Curriculum Studies, Dar es salaam University College of Education, Tanzania
| | - Tobias Hecker
- Department of Psychology, Bielefeld University, Germany; Department of Psychology, University of Zurich, Switzerland
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Mockałło Z, Widerszal-Bazyl M. Role of job and personal resources in the appraisal of job demands as challenges and hindrances. PLoS One 2021; 16:e0248148. [PMID: 33780472 PMCID: PMC8007006 DOI: 10.1371/journal.pone.0248148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 02/22/2021] [Indexed: 11/19/2022] Open
Abstract
Previous research has shown that challenge and hindrance job demands show different effects on employees' wellbeing and performance. Moreover, it has been demonstrated that employees' subjective appraisal of job demands as challenges and hindrances may vary: they can be appraised as challenges or hindrances or both. Subjective appraisal of job demands was found to be also related to employees' wellbeing and productivity. However, little is known about predictors of the appraisals of job demands made by employees. The aim of the study was to identify predictors of such appraisals among job and individual resources. Cross-sectional research was carried out among 426 IT, healthcare and public transport employees. COPSOQ II scales were used to measure job demands (emotional, quantitative, cognitive demands, work pace and role conflicts) and job resources (influence at work, possibilities for development, vertical and horizontal trust), single questions were used to measure employees' subjective appraisals of job demands as hindrances and challenges, and PCQ was used to measure psychological capital. Multiple hierarchical regression analyses showed that only horizontal trust predicted the appraisal of job demands as challenges, and vertical trust predicted the appraisal of job demands as hindrances among four analysed job resources. Individual resource-psychological capital-predicted only the appraisal of job demands as challenges. Control variables-occupation, age and job demands also played a significant role in predicting the appraisal of job demands. Implications and future directions are discussed.
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Affiliation(s)
- Zofia Mockałło
- Laboratory of Social Psychology, Ergonomics Department, Central Institute for Labour Protection–National Research Institute, Warsaw, Poland
| | - Maria Widerszal-Bazyl
- Laboratory of Social Psychology, Ergonomics Department, Central Institute for Labour Protection–National Research Institute, Warsaw, Poland
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Reiner I, Beutel ME, Winter P, Rommens PM, Kuhn S. Early posttraumatic stress symptoms and levels of distress in trauma patients treated in the resuscitation room: an exploratory study. Scand J Trauma Resusc Emerg Med 2021; 29:22. [PMID: 33509231 PMCID: PMC7841881 DOI: 10.1186/s13049-021-00830-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/02/2021] [Indexed: 11/10/2022] Open
Abstract
Background The aim of the present study was to investigate the incidence of psychological distress and posttraumatic stress symptoms in trauma patients who have been recruited from the resuscitation room. Further, we wanted to explore risk factors for posttraumatic stress symptoms, taking different accident types into account. Methods Our sample consisted of 45 patients who have been treated in the resuscitation room and were interviewed within the first ten days after treatment. Type of accident, third party fault, previous mental health problems and pretraumatic stress were examined. Patients were interviewed with respect to their currently felt distress regarding the accident. Posttraumatic stress symptoms were measured with the German version of the Impact of Event Scale. Injury severity was assessed by means of the Injury Severity Score. Results Our exploratory and cross-sectional project reveals that more severe injuries were associated with higher distress. However, posttraumatic stress symptoms were predicted by high distress and being involved in a car accident, but not by injury severity. Conclusions We identified two potential risk factors for the development of posttraumatic stress in trauma patients recruited from the resuscitation room: Being involved in a car accident and high distress. Trial registration The project has been registered at the Study Center of Mental Disorders (SPE) at the University Medical Center Mainz (No: 92072014).
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Affiliation(s)
- Iris Reiner
- Department of Psychosomatic Medicine and Psychotherapy, Clinic for Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany. .,University of Applied Sciences Darmstadt, Adelungstr. 51, 64283, Darmstadt, Germany.
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, Clinic for Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Philipp Winter
- Department of Psychosomatic Medicine and Psychotherapy, Clinic for Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Pol M Rommens
- Department of Orthopedics and Traumatology, University Medical Center, Johannes Gutenberg-University, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Sebastian Kuhn
- Department of Orthopedics and Traumatology, University Medical Center, Johannes Gutenberg-University, Langenbeckstr. 1, Mainz, 55131, Germany.,Department for Digitale Medizin, Medical Faculty OWL, Bielefeld University, Universitätsstr. 25, 33615, Bielefeld, Germany
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Szkody E, McKinney C. Appraisal and social support as moderators between stress and physical and psychological quality of life. Stress Health 2020; 36:586-595. [PMID: 32419328 DOI: 10.1002/smi.2957] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/14/2020] [Accepted: 05/01/2020] [Indexed: 01/25/2023]
Abstract
One proposed mechanism of social support is the facilitation of primary and secondary reappraisal of stressful situations. The current study examined the expansion of the original stress-buffering hypothesis to include primary or secondary appraisal in an emerging adult population (N = 854) on physical and psychological health outcomes. The additional moderating effects of gender also were examined. Perceived social support (by the Multidimensional Survey of Perceived Social Support) significantly buffered the effects of stress from negative events (by the Risky Behaviour and Stressful Events Scale) on physical and psychological health (by the World Health Organizations Quality of Life Instrument) for females only. Neither primary nor secondary appraisal (by the Stress Appraisal Measure) acted as additional buffers for male or females. Social support may be a more salient buffer for females. Reappraisal mechanisms may have another role in the buffering pathways. Further implications and limitations were discussed.
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Affiliation(s)
- Erica Szkody
- Psychology Department, Mississippi State University, Mississippi State, Mississippi, USA
| | - Cliff McKinney
- Psychology Department, Mississippi State University, Mississippi State, Mississippi, USA
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15
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Pathways of Internalizing and Posttraumatic Stress Symptoms Across Childhood and Adolescence. Res Child Adolesc Psychopathol 2020; 49:103-116. [PMID: 32979128 DOI: 10.1007/s10802-020-00701-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
Research in adult populations has suggested a number of possible explanations for the high co-morbidity between posttraumatic stress symptoms (PTSS) and internalizing symptoms, including shared risk factors and reciprocal causation. Little research has examined these hypotheses in children or has considered the separation of between- and within-person effects. The objective of this study was to examine pathways between PTSS and internalizing symptoms using two samples drawn from the Longitudinal Studies on Child Abuse and Neglect (LONGSCAN, n = 1221) and the first National Survey of Child and Adolescent Well-Being (NSCAW-I, n = 309). Each sample included three waves of data (LONGSCAN: ages 8, 12, and 16; NSCAW: ages 8, 11, 15). It was hypothesized: (1) PTSS would predict future internalizing symptoms; (2) the strength of the relationship between internalizing symptoms and PTSS would increase over time; and (3) childhood trauma would be associated with higher levels of internalizing symptoms and PTSS. The hypotheses were examined using traditional cross-lagged panel models (CLPMs) as well as a CLPM with random intercepts (RI-CLPM), which has the advantage of separating within-person effects from between-person stability in symptoms. Results from both CLPMs and RI-CLPM support rising symptom comorbidity from late childhood to mid-adolescence. Results between the models, however, suggest that the reciprocal influence between symptom complexes over time may not hold after separating between- and within-persons effects, lending stronger support to the shared risk factors hypothesis and highlighting the need for future research to explore other possible explanatory mechanisms for the rising comorbidity of these symptom complexes over development.
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16
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Heimer-McGinn VR, Wise TB, Hemmer BM, Dayaw JNT, Templer VL. Social housing enhances acquisition of task set independently of environmental enrichment: A longitudinal study in the Barnes maze. Learn Behav 2020; 48:322-334. [PMID: 32040697 PMCID: PMC7415481 DOI: 10.3758/s13420-020-00418-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Human studies suggest that healthy social relationships benefit cognition, yet little is known about the underlying neural mechanisms of this protective effect. In rodents, studies on acute isolation and environmental enrichment (EE) confirm the importance of social exposure. Despite the widely recognized importance of sociality, however, rodent models have yet to explore the independent contributions of social housing divorced of other forms of enrichment. This study dissociates the effects of social and physical enrichment on spatial learning and memory from adulthood to old age. Rats were placed in either single or group housing, provided with ample enrichment, and tested at three time points on several phases/versions of the Barnes maze (BM) (standard, retention probes, variable location, and reversal). We found that sustained social housing enhanced cognitive flexibility, as evidenced by superior acquisition of task set (standard BM), adaptability to a new task set (variable BM), and improved reversal learning (reversal BM). Long-term retention (BM retention probes) of spatial memory was unaffected by housing conditions. Recent studies from our lab, including this report, are the first to show that social housing confers cognitive benefits beyond those of physical enrichment. Importantly, our experimental design is ideal for exploring the neural underpinnings of this socially induced cognitive protection. Understanding how sociality influences cognition will be invaluable to translational models of aging, neuropsychiatric disease, and neurological injury.
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Affiliation(s)
- Victoria R Heimer-McGinn
- Department of Psychology, Providence College, 1 Cunningham Square, Providence, RI, 02918, USA
- Department of Psychology, Roger Williams University, 1 Old Ferry Road, Bristol, RI, 02809, USA
| | - Taylor B Wise
- Department of Psychology, Providence College, 1 Cunningham Square, Providence, RI, 02918, USA
| | - Brittany M Hemmer
- Department of Psychology, Providence College, 1 Cunningham Square, Providence, RI, 02918, USA
| | - Judith N T Dayaw
- Department of Psychology, Providence College, 1 Cunningham Square, Providence, RI, 02918, USA
| | - Victoria L Templer
- Department of Psychology, Providence College, 1 Cunningham Square, Providence, RI, 02918, USA.
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17
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Amin R, Nadeem E, Iqbal K, Asadullah MA, Hussain B. Support for Students Exposed to Trauma (SSET) Program: An Approach for Building Resilience and Social Support Among Flood-Impacted Children. SCHOOL MENTAL HEALTH 2020. [DOI: 10.1007/s12310-020-09373-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Bidirectional Relationships Between Posttraumatic Stress Disorder and Social Functioning During Cognitive Processing Therapy. Behav Ther 2020; 51:447-460. [PMID: 32402260 PMCID: PMC7232057 DOI: 10.1016/j.beth.2019.08.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 07/29/2019] [Accepted: 08/02/2019] [Indexed: 11/24/2022]
Abstract
This study investigated temporal relationships between posttraumatic stress symptoms and two indicators of social functioning during cognitive processing therapy. Participants were 176 patients (51.5% female, M age = 39.46 [SD = 11.51], 89.1% White, 42.6% active duty military/veteran) who participated in at least two assessment time points during a trial of cognitive processing therapy. Posttraumatic stress disorder (PTSD) symptoms (PTSD Checklist for DSM-IV) and interpersonal relationship and social role functioning problems (Outcome Questionnaire-45) were assessed prior to each of 12 sessions. Multivariate multilevel lagged analyses indicated that interpersonal relationship problems predicted subsequent PTSD symptoms (b = .22, SE = 0.09, cr = 2.53, p = .01, pr = .46) and vice versa (b = .05, SE = 0.02, cr = 2.11, p = .04, pr = .16); and social role functioning problems predicted subsequent PTSD symptoms (b = .21, SE = 0.10, cr = 2.18, p = .03, pr = .16) and vice versa (b = .06, SE = 0.02, cr = 3.08, p < .001, pr = .23). Military status moderated the cross-lag from social role functioning problems to PTSD symptoms (b = -.35, t = -2.00, p = .045, pr = .16). Results suggest a robust association between PTSD symptoms and social functioning during cognitive processing therapy with a reciprocal relationship between PTSD symptoms and social functioning over time. Additionally, higher social role functioning problems for patients with military status indicate smaller reductions in PTSD symptoms from session to session.
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Leifker FR, Marshall AD. The impact of negative attributions on the link between observed partner social support and posttraumatic stress disorder symptom severity. J Anxiety Disord 2019; 65:19-25. [PMID: 31125840 DOI: 10.1016/j.janxdis.2019.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 04/19/2019] [Accepted: 05/10/2019] [Indexed: 10/26/2022]
Abstract
Lack of perceived social support is one of the strongest correlates of the development and maintenance of posttraumatic stress disorder (PTSD). However, little is known about observed social support and PTSD. The stress buffering effect of social support may be partly determined by the subjective experience of support, which is created by attributions regarding support behaviors. We examined negative attributions about partner-provided support as a moderator of the expected relation between observed support during couple discussions and PTSD symptom severity. Participants included 128 individuals from 64 heterosexual married or cohabitating couples. Per clinician-administered interview, 72 (56%) participants met subthreshold or diagnostic criteria for PTSD. Receipt of relatively more partner support was modestly associated with lower PTSD symptom severity. Negative causal attributions about partner support were not associated with the amount of support received, but were associated with higher PTSD severity. Additionally, the frequency and quality of received partner support was associated with lower PTSD symptom severity only among those who did not make strong negative causal attributions about partner support. Thus, negative causal attributions may dampen the positive effects of social support on PTSD symptoms. PTSD treatments may more effectively facilitate recovery from trauma by decreasing negative support attributions.
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Affiliation(s)
- Feea R Leifker
- Department of Psychology, The Pennsylvania State University, 140 Moore Building, State College, PA 16802, United States
| | - Amy D Marshall
- Department of Psychology, The Pennsylvania State University, 140 Moore Building, State College, PA 16802, United States.
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Marsac ML, Sprang G, Guller L, Kohser KL, Draus JM, Kassam-Adams N. A parent-led intervention to promote recovery following pediatric injury: study protocol for a randomized controlled trial. Trials 2019; 20:137. [PMID: 30777113 PMCID: PMC6380044 DOI: 10.1186/s13063-019-3207-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 01/17/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Injury is one of the most prevalent potentially emotionally traumatic events that children experience and can lead to persistent impaired physical and emotional health. There is a need for interventions that promote full physical and emotional recovery and that can be easily accessed by all injured children. Based on research evidence regarding post-injury recovery, we created the Cellie Coping Kit for Children with Injury intervention to target key mechanisms of action and refined the intervention based on feedback from children, families, and experts in the field. The Cellie Coping Kit intervention is parent-guided and includes a toy (for engagement), coping cards for children, and a book for parents with evidence-based strategies to promote injury recovery. This pilot research trial aims to provide an initial evaluation of the impact of the Cellie Coping Kit for Children with Injury on proximal targets (coping, appraisals) and later child health outcomes (physical recovery, emotional health, health-related quality of life). METHOD / DESIGN Eighty children (aged 8-12 years) and their parents will complete a baseline assessment (T1) and then will be randomly assigned to an immediate intervention group or waitlist group. The Cellie Coping Kit for Injury Intervention will be introduced to the immediate intervention group after the T1 assessment and to the waitlist group following the T3 assessment. Follow-up assessments of physical and emotional health will be completed at 6 weeks (T2), 12 weeks (T3), and 18 weeks (T4). DISCUSSION This will be one of the first randomized controlled trials to examine an intervention tool intended to promote full recovery after pediatric injury and be primarily implemented by children and parents. Results will provide data on the feasibility of the implementation of the Cellie Coping Intervention for Injury as well as estimations of efficacy. Potential strengths and limitations of this design are discussed. TRIAL REGISTRATION Clinicaltrials.gov, NCT03153696 . Registered on 15 May 2017.
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Affiliation(s)
- Meghan L. Marsac
- Department of Pediatrics, Kentucky Children’s Hospital, Lexington, KY USA
- College of Medicine, Kentucky Children’s Hospital, University of Kentucky, 800 Rose St, MN 472, Lexington, KY 40536 USA
| | - Ginny Sprang
- College of Medicine, Kentucky Children’s Hospital, University of Kentucky, 800 Rose St, MN 472, Lexington, KY 40536 USA
- Center on Trauma and Children, University of Kentucky, Lexington, KY USA
| | - Leila Guller
- Department of Pediatrics, Kentucky Children’s Hospital, Lexington, KY USA
- College of Arts and Sciences, University of Kentucky, Lexington, KY USA
| | - Kristen L. Kohser
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - John M. Draus
- College of Medicine, Kentucky Children’s Hospital, University of Kentucky, 800 Rose St, MN 472, Lexington, KY 40536 USA
- Department of Surgery, University of Kentucky, Lexington, KY USA
| | - Nancy Kassam-Adams
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
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Hiller RM, Meiser‐Stedman R, Lobo S, Creswell C, Fearon P, Ehlers A, Murray L, Halligan SL. A longitudinal investigation of the role of parental responses in predicting children's post-traumatic distress. J Child Psychol Psychiatry 2018; 59:781-789. [PMID: 29197098 PMCID: PMC6849512 DOI: 10.1111/jcpp.12846] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND While parental post-trauma support is considered theoretically important for child adjustment, empirical evidence concerning the specific aspects of parental responding that influence child post-traumatic distress, or the processes via which any such impacts occur, is extremely limited. We conducted a longitudinal examination of whether parental post-trauma appraisals, trauma-specific support style and general parenting style predicted child post-traumatic stress symptom severity (PTSS) following trauma; and whether such influences operated via the child's own appraisals and coping style. METHOD We recruited 132 parent-child pairs following children's experience of acute trauma. We examined whether parental responses assessed at 1-month post-trauma, predicted child PTSS at 6-month follow-up. Parental trauma-specific appraisals and responses, and general parenting style, were assessed via both self-report and direct observations. Child-report questionnaires were used to assess PTSS and potential mediators. RESULTS Initial parent negative appraisals and encouragement of avoidant coping were associated with higher child-reported PTSS at 6-month follow-up. Predictive effects were maintained even when controlling for initial child symptom levels. Observational assessments broadly supported conclusions from self-report. There was evidence that parental influences may operate, in part, by influencing the child's own appraisals and coping responses. In contrast, there was no evidence for an influence of more "adaptive" support or general parenting style on child PTSS. CONCLUSIONS Findings provide important insight into how elements of social support may influence child post-trauma outcomes.
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Affiliation(s)
| | | | - Sarah Lobo
- Department of PsychologyUniversity of BathBathUK
| | - Cathy Creswell
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Pasco Fearon
- Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Anke Ehlers
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
| | - Lynne Murray
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK,Department of PsychiatryUniversity of Cape TownCape TownSouth Africa
| | - Sarah L. Halligan
- Department of PsychologyUniversity of BathBathUK,Department of PsychiatryUniversity of Cape TownCape TownSouth Africa
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22
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Williamson V, Hiller RM, Meiser-Stedman R, Creswell C, Dalgleish T, Fearon P, Goodall B, McKinnon A, Smith P, Wright I, Halligan SL. The Parent Trauma Response Questionnaire (PTRQ): development and preliminary validation. Eur J Psychotraumatol 2018; 9:1478583. [PMID: 29938010 PMCID: PMC6008584 DOI: 10.1080/20008198.2018.1478583] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 05/08/2018] [Indexed: 02/07/2023] Open
Abstract
Background: Following a child's experience of trauma, parental response is thought to play an important role in either facilitating or hindering their psychological adjustment. However, the ability to investigate the role of parenting responses in the post-trauma period has been hampered by a lack of valid and reliable measures. Objectives: The aim of this study was to design, and provide a preliminary validation of, the Parent Trauma Response Questionnaire (PTRQ), a self-report measure of parental appraisals and support for children's coping, in the aftermath of child trauma. Methods: We administered an initial set of 78 items to 365 parents whose children, aged 2-19 years, had experienced a traumatic event. We conducted principal axis factoring and then assessed the validity of the reduced measure against a standardized general measure of parental overprotection and via the measure's association with child post-trauma mental health. Results: Factor analysis generated three factors assessing parental maladaptive appraisals: (i) permanent change/damage, (ii) preoccupation with child's vulnerability, and (iii) self-blame. In addition, five factors were identified that assess parental support for child coping: (i) behavioural avoidance, (ii) cognitive avoidance, (iii) overprotection, (iv) maintaining pre-trauma routines, and (v) approach coping. Good validity was evidenced against the measure of parental overprotection and child post-traumatic stress symptoms. Good test-retest reliability of the measure was also demonstrated. Conclusions: The PTRQ is a valid and reliable self-report assessment of parenting cognitions and coping in the aftermath of child trauma.
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Affiliation(s)
- Victoria Williamson
- Department of Psychology, University of Bath, Bath, UK
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | | | | | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit and Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Pasco Fearon
- Department of Clinical, Education and Health Psychology, University College London, London, UK
| | - Ben Goodall
- Medical Research Council Cognition and Brain Sciences Unit and Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Anna McKinnon
- Medical Research Council Cognition and Brain Sciences Unit and Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Patrick Smith
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Isobel Wright
- Medical Research Council Cognition and Brain Sciences Unit and Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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23
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Cramer H, Anheyer D, Saha FJ, Dobos G. Yoga for posttraumatic stress disorder - a systematic review and meta-analysis. BMC Psychiatry 2018; 18:72. [PMID: 29566652 PMCID: PMC5863799 DOI: 10.1186/s12888-018-1650-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 03/06/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Yoga is increasingly used as a therapeutic treatment and seems to improve psychiatric conditions such as anxiety disorders and depression. The aim of this systematic review was to assess the evidence of yoga for reducing symptoms of posttraumatic stress disorder (PTSD). METHODS The Cochrane Library, Medline/PubMed, PsycINFO, Scopus, and IndMED were searched through July 2017 for randomized controlled trials (RCTs) assessing the effects of yoga on symptoms of PTSD. Mean differences (MD) and standardized mean differences (SMD) with 95% confidence intervals (CI) were computed. The quality of evidence and the strength of recommendation were graded according to the GRADE recommendations. RESULTS Seven RCTs (N = 284) were included. Meta-analysis revealed low quality evidence for clinically relevant effects of yoga on PTSD symptoms compared to no treatment (SMD = - 1.10, 95% CI [- 1.72, - 0.47], p < .001, I2 = 72%; MD = - 13.11, 95% CI [- 17.95, - 8.27]); and very low evidence for comparable effects of yoga and attention control interventions (SMD = - 0.31, 95%CI = [- 0.84, 0.22], p = .25; I2 = 43%). Very low evidence was found for comparable retention of patients in the trial for yoga and no treatment (OR = 0.68, 95%CI [0.06, 7.72]) or attention control interventions (OR = 0.66, 95%CI [0.10, 4.46]). No serious adverse events were reported. LIMITATIONS Few RCTs with only limited sample size were available. CONCLUSIONS Only a weak recommendation for yoga as an adjunctive intervention for PTSD can be made. More high quality research is needed to confirm or disconfirm these findings.
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Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
| | - Dennis Anheyer
- 0000 0001 2187 5445grid.5718.bDepartment of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Felix J. Saha
- 0000 0001 2187 5445grid.5718.bDepartment of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Gustav Dobos
- 0000 0001 2187 5445grid.5718.bDepartment of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Gusler S, Jackson Y. The role of poly-victimization in predicting differences in foster youths' appraisals. CHILD ABUSE & NEGLECT 2017; 69:223-231. [PMID: 28482254 DOI: 10.1016/j.chiabu.2017.04.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 04/04/2017] [Accepted: 04/24/2017] [Indexed: 06/07/2023]
Abstract
The present article examines the role of poly-victimization (i.e., number of categories of maltreatment experiences and total maltreatment exposure) in predicting differences in appraisals for 272 youth in foster care (ages 8-21). Poly-victimization was hypothesized to be predictive of negative appraisal valence (i.e., interpreting the impact of a stressful life event as being bad/negative) and appraisal rigidity (i.e., interpreting the impact of life events as being consistently positive or negative across different events) above and beyond any single category of maltreatment. Results show a high prevalence of poly-victimization, such that those youth who experience only one form of maltreatment (e.g., physical, sexual, psychological, or neglect) are among the minority of maltreated youth. Additionally, results show that total maltreatment exposure, accounting for not only different categories of maltreatment but also different types or forms of maltreatment within those broader categories, is the most predictive of negative appraisal valence, above and beyond single categories of maltreatment and number of categories of maltreatment experienced. Contrary to the study's hypothesis, neither total exposure nor number of maltreatment categories experienced is significantly predictive of appraisal rigidity above and beyond single categories. Correlations also show that less rigid or more flexible appraisals are associated with more maltreatment experiences than are rigid appraisals. The current study highlights the importance of examining maltreatment from a poly-victimization perspective and begins to explain why some youth have more negative appraisals than others.
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Affiliation(s)
| | - Yo Jackson
- University of Kansas, Clinical Child Psychology, United States
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25
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Mitchell R, Brennan K, Curran D, Hanna D, Dyer KFW. A Meta-Analysis of the Association Between Appraisals of Trauma and Posttraumatic Stress in Children and Adolescents. J Trauma Stress 2017; 30:88-93. [PMID: 28103414 DOI: 10.1002/jts.22157] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 10/28/2016] [Accepted: 10/29/2016] [Indexed: 11/12/2022]
Abstract
Cognitive models of posttraumatic stress disorder (PTSD) place an emphasis on the role of negative appraisals of traumatic events. It is suggested that the way in which the event is appraised determines the extent to which posttraumatic stress symptoms will be experienced. Therefore, a strong relationship between trauma appraisals and symptoms of PTSD might be expected. However, this relationship is not as firmly established in the child and adolescent literature. A systematic literature review of this relationship returned 467 publications, of which 11 met full eligibility criteria. A random effects meta-analysis revealed a large effect size for the relationship between appraisals and PTSD symptoms in children and adolescents, r = .63, 95% CI [.58, .68], Z = 17.32, p < .001, with significant heterogeneity present. A sensitivity analysis suggested that this relationship was not contingent on 1 specific measure of appraisals. Results were consistent with the cognitive behavioral theory of PTSD, demonstrating that appraisals of trauma are strongly related to posttraumatic stress in children and adolescents. However, this relationship was not observed in a sample of 4- to 6-year-olds, indicating that further research is required to explicate cognitive processing of trauma in very young children.
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Affiliation(s)
- Ryan Mitchell
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| | - Kate Brennan
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| | - David Curran
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| | - Donncha Hanna
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| | - Kevin F W Dyer
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland.,Psychological Therapies Service, Holywell Hospital, Northern HSC Trust, Antrim, Northern Ireland
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26
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Münzer A, Ganser HG, Goldbeck L. Social support, negative maltreatment-related cognitions and posttraumatic stress symptoms in children and adolescents. CHILD ABUSE & NEGLECT 2017; 63:183-191. [PMID: 27930959 DOI: 10.1016/j.chiabu.2016.11.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 11/15/2016] [Accepted: 11/21/2016] [Indexed: 06/06/2023]
Abstract
Social support by family, friends and significant others is known to buffer the impact of adverse life events on children's well-being and functioning, however little is known about pathways explaining this association. We investigated whether maltreatment-related cognitions mediate the association between social support and posttraumatic stress symptoms (PTSS). Furthermore, age was introduced as moderator. We assessed the history of maltreatment in 200 maltreated children and adolescents (age 8-17 years) using a semi-structured interview. Participants' perceived current social support, maltreatment-related negative cognitions related to the subjectively "worst" experience of maltreatment and PTSS during the past month were assessed using self-report questionnaires. A set of mediation analyses demonstrated, that negative maltreatment-related appraisals mediated the relation between perceived social support and PTSS. The hypothesized negative associations of social support with PTSS and dysfunctional cognitions did not differ between children (8-11;11 years) and adolescents (12-17;11 years). Thus, the protective function of social support after maltreatment can be explained by fewer negative beliefs maltreated youth have about themselves and the world. These results provide support to models of social-cognitive processing and emphasize the importance of cognitive coping in regard to episodes of maltreatment which can be shaped within social interactions with non-abusive caregivers, friends, and significant others.
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Affiliation(s)
- A Münzer
- University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstr. 1, 89075 Ulm, Germany.
| | - H G Ganser
- University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstr. 1, 89075 Ulm, Germany
| | - L Goldbeck
- University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstr. 1, 89075 Ulm, Germany
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27
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Kangaslampi S, Punamäki RL, Qouta S, Diab M, Peltonen K. Psychosocial Group Intervention Among War-Affected Children: An Analysis of Changes in Posttraumatic Cognitions. J Trauma Stress 2016; 29:546-555. [PMID: 27859680 DOI: 10.1002/jts.22149] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 09/12/2016] [Accepted: 09/12/2016] [Indexed: 11/08/2022]
Abstract
Cognitive theories point to reduction in dysfunctional posttraumatic cognitions (PTCs) as one mechanism involved in recovery from posttraumatic stress symptoms (PTSS), yet research findings have shown individual differences in the recovery process. We tested the cognitive mediation hypothesis above in a previously published psychosocial group intervention among war-affected children. We also examined heterogeneity in children's PTCs during the intervention. We used a cluster randomized trial of Smith et al.'s (2002) teaching recovery techniques (TRT) intervention among 482 Palestinians 10-13 years of age (n = 242 for intervention group, n = 240 for control group). Children reported PTSS, PTCs, and depressive symptoms at baseline, midpoint, postintervention, and at 6-month follow-up. Path analysis results showed that TRT was not effective in reducing dysfunctional PTCs, and the reductions did not mediate intervention effects on PTSS. Using latent class growth analysis, we chose the model with 3 differing trajectories in the intervention group: high, decreasing, moderate, downward trending, and severe, stable levels of PTCs. Higher PTSS and depressive symptoms at baseline were associated with membership in the severe, stable trajectory. The intervention did not produce the kind of beneficial cognitive change needed in the cognitive mediation conceptualization. Nevertheless, cognitive changes differed substantially across children during the intervention, and were associated with their preintervention mental health status. These findings call for more detailed examination of the process of cognitive mediation.
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Affiliation(s)
- Samuli Kangaslampi
- School of Social Sciences and Humanities / Psychology, University of Tampere, Tampere, Finland
| | - Raija-Leena Punamäki
- School of Social Sciences and Humanities / Psychology, University of Tampere, Tampere, Finland
| | - Samir Qouta
- Faculty of Education, Islamic University of Gaza, Gaza City, Palestine
| | - Marwan Diab
- Gaza Community Mental Health Programme, Gaza City, Palestine
| | - Kirsi Peltonen
- School of Social Sciences and Humanities / Psychology, University of Tampere, Tampere, Finland
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28
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Marsac ML, Ciesla J, Barakat LP, Hildenbrand AK, Delahanty DL, Widaman K, Winston FK, Kassam-Adams N. The role of appraisals and coping in predicting posttraumatic stress following pediatric injury. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2016; 8:495-503. [PMID: 27065067 DOI: 10.1037/tra0000116] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Given the millions of children who experience potentially traumatic injuries each year and the need to maximize emotional and physical health outcomes following pediatric injury, the current study examined the individual and collective contributions of the malleable variables of appraisals and coping in predicting posttraumatic stress symptoms (PTSS) in children following injury. METHOD This study combined data from 3 prospective investigations of recovery from pediatric injury (N = 688) in which children ages 8-17 years were recruited shortly after an injury (within 4 weeks). At baseline (T1), children completed measures of their threat appraisals of the injury event and PTSS. Six to twelve weeks later (T2), children completed a measure of coping and PTSS. Finally, PTSS was assessed again 6 months post-injury (T3). RESULTS Structural equation modeling analyses provide evidence that appraisals and coping contribute to PTSS. Furthermore, results suggest that escape coping mediates the relationship between threat appraisals and PTSS. CONCLUSIONS Early interventions designed to prevent or reduce PTSS after pediatric injury may be more successful if they primarily target modifying escape coping behaviors. To best inform clinical practice, future research should examine factors influencing the development of children's appraisals and coping behaviors in the context of potentially traumatic events. (PsycINFO Database Record
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Affiliation(s)
- Meghan L Marsac
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia
| | | | - Lamia P Barakat
- Division of Oncology, The Children's Hospital of Philadelphia
| | - Aimee K Hildenbrand
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia
| | | | - Keith Widaman
- Department of Psychology, University of California-Davis
| | - Flaura K Winston
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia
| | - Nancy Kassam-Adams
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia
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29
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Marsac ML, Kassam-Adams N. A novel adaptation of a parent-child observational assessment tool for appraisals and coping in children exposed to acute trauma. Eur J Psychotraumatol 2016; 7:31879. [PMID: 27652595 PMCID: PMC5031795 DOI: 10.3402/ejpt.v7.31879] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 07/08/2016] [Accepted: 07/08/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Millions of children worldwide are exposed to acute potentially traumatic events (PTEs) annually. Many children and their families experience significant emotional distress and/or functional impairment following PTEs. While current research has begun to highlight a role for early appraisals and coping in promoting or preventing full recovery from PTEs, the exact nature of the relationships among appraisals, coping, and traumatic stress reactions as well as how appraisals and coping behaviors are influenced by the child's environment (e.g., parents) remains unclear; assessment tools that reach beyond self-report are needed to improve this understanding. OBJECTIVE The objective of the current study is to describe the newly created Trauma Ambiguous Situations Tool (TAST; i.e., an observational child-parent interview and discussion task that allows assessment of appraisals, coping, and parent-child processes) and to report on initial feasibility and validation of TAST implemented with child-parent dyads in which children were exposed to a PTE. METHOD As part of a larger study on the role of biopsychosocial factors in posttraumatic stress reactions, children (aged 8-13) and parents (n=25 child-parent dyads) completed the TAST during the child's hospitalization for injury. RESULTS Children and parents engaged well with the TAST. The time to administer the TAST was feasible, even in a peri-trauma context. The TAST solicited a wide array of appraisals (threat and neutral) and coping solutions (proactive and avoidant). Forced-choice and open-ended appraisal assessments provided unique information. The parent-child discussion portion of the TAST allowed for direct observation of parent-child processes and demonstrated parental influence on children's appraisals and coping solutions. CONCLUSIONS The TAST is a promising new research tool, which may help to explicate how parents influence their child's developing appraisals and coping solutions following a PTE. More research should examine the relationships of appraisals, coping, and parent-child processes assessed by the TAST with traumatic stress outcomes.
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Affiliation(s)
- Meghan L Marsac
- The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.,Department of Pediatrics, Kentucky Children's Hospital, Lexington, KY, USA.,College of Medicine, University of Kentucky, Lexington, KY, USA;
| | - Nancy Kassam-Adams
- The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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30
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Haag AC, Zehnder D, Landolt MA. Guilt is associated with acute stress symptoms in children after road traffic accidents. Eur J Psychotraumatol 2015; 6:29074. [PMID: 26514158 PMCID: PMC4626649 DOI: 10.3402/ejpt.v6.29074] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/01/2015] [Accepted: 10/05/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Although previous research has consistently found considerable rates of acute stress disorder (ASD) in children with accidental injuries, knowledge about determinants of ASD remains incomplete. Guilt is a common reaction among children after a traumatic event and has been shown to contribute to posttraumatic stress disorder. However, its relationship to ASD has never been examined. OBJECTIVE This study assessed the prevalence of ASD in children and adolescents following road traffic accidents (RTAs). Moreover, the association between peritraumatic guilt and ASD was investigated relying on current cognitive theories of posttraumatic stress and controlling for female sex, age, socioeconomic status (SES), injury severity, inpatient treatment, pretrauma psychopathology, and maternal posttraumatic stress symptoms (PTSS). METHODS One hundred and one children and adolescents (aged 7-16 years) were assessed by means of a clinical interview approximately 10 days after an RTA. Mothers were assessed by questionnaires. RESULTS Three participants (3.0%) met diagnostic criteria for full ASD according to DSM-IV, and 17 (16.8%) for subsyndromal ASD. In a multivariate regression model, guilt was found to be a significant predictor of ASD severity. Female sex, outpatient treatment, and maternal PTSS also predicted ASD severity. Child age, SES, injury severity, and pretraumatic child psychopathology were not related to ASD severity. CONCLUSIONS Future research should examine the association between peritraumatic guilt and acute stress symptoms in more detail. Moreover, guilt appraisals in the acute phase after an accident might be a relevant target for clinical attention.
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Affiliation(s)
- Ann-Christin Haag
- Department of Psychosomatics and Psychiatry, University Children's Hospital, Zurich, Switzerland.,Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | | | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital, Zurich, Switzerland.,Children's Research Center, University Children's Hospital, Zurich, Switzerland.,Department of Child and Adolescent Health Psychology, Institute of Psychology, University of Zurich, Switzerland;
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