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Sharp TH, Chideya Y, Giuliani A, Hunt X, Tomlinson M, Seedat S, Creswell C, Fearon P, Hamilton-Giachritsis C, Hiller R, Meiser-Stedman R, Du Toit S, Stewart J, Halligan SL. Post-traumatic stress disorder symptoms following exposure to acute psychological trauma in children aged 8-16 years in South Africa: protocol for the Sinethemba longitudinal study. BMJ Open 2024; 14:e085129. [PMID: 38991675 DOI: 10.1136/bmjopen-2024-085129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2024] Open
Abstract
INTRODUCTION Children exposed to trauma are vulnerable to developing post-traumatic stress disorder (PTSD) and other adverse mental health outcomes. In low-and middle-income countries (LMICs), children are at increased risk of exposure to severe trauma and co-occurring adversities. However, relative to high-income countries, there is limited evidence of the factors that predict good versus poor psychological recovery following trauma exposure in LMIC children, and the role of caregiver support in these high-adversity communities. METHODS AND ANALYSIS We will conduct a longitudinal, observational study of 250 children aged 8-16 years and their caregivers in South Africa, following child exposure to acute trauma. Dyads will be recruited from community hospitals following a potentially traumatic event, such as a motor vehicle accident or assault. Potential participants will be identified during their hospital visit, and if they agree, will subsequently be contacted by study researchers. Assessments will take place within 4 weeks of the traumatic event, with 3-month and 6-month follow-up assessments. Participants will provide a narrative description of the traumatic event and complete questionnaires designed to give information about social and psychological risk factors. Child PTSD symptoms will be the primary outcome, and wider trauma-related mental health (depression, anxiety, behavioural problems) will be secondary outcomes. Regression-based methods will be used to examine the association of psychosocial factors in the acute phase following trauma, including caregiver support and responding, with child PTSD and wider mental health outcomes. ETHICS AND DISSEMINATION Ethical approvals have been granted by Stellenbosch University and the University of Bath, with additional approvals to recruit via hospitals and healthcare clinics being granted by the University of Cape Town, the Department of Health and the City of Cape Town. Study findings will be disseminated via publication in journals, workshops for practitioners and policy-makers, and public engagement events.
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Affiliation(s)
| | - Yeukai Chideya
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | | | - Xanthe Hunt
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Stellenbosch, Western Cape, South Africa
- Department of Psychology, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Cathy Creswell
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Pasco Fearon
- University of Cambridge Centre for Family Research, Cambridge, UK
| | | | - Rachel Hiller
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia Norwich Medical School, Norwich, UK
| | - Stefani Du Toit
- Department of Psychiatry, University of Cape Town, Rondebosch, South Africa
| | - Jackie Stewart
- Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
- Department of Surgery, University of Cape Town, Rondebosch, South Africa
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Grigoropoulos I. Can We Talk About Life Without Taking Death Into Account? Early Childhood Educators' Self-Perceived Ability to Approach the Topic of Death With Children. OMEGA-JOURNAL OF DEATH AND DYING 2024; 88:1369-1382. [PMID: 34991408 DOI: 10.1177/00302228211057733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The current explorative cross-sectional study evaluated the knowledge, attitudes, and practices of early childhood educators towards death education and their self-perceived comfort to approach the topic of death in the classroom. All data were collected from June to July 2020. One hundred eight (108) early childhood educators participated in the study. The study was promoted through early childhood educators' support groups and social networks. Demographic characteristics, an ad hoc questionnaire, and the Greek version of the Death Attitude Profile-R questionnaire were used to assess the educators' comfort and attitudes. Results showed that participants' self-perceived ability to approach the topic of death in the classroom was affected by gender and personal attitudes towards death (specifically death avoidance and fear of death). Overall, this study emphasized early childhood educators' role in extreme situations which their students may face as death.
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Affiliation(s)
- Iraklis Grigoropoulos
- Early Childhood Education and Care Department, International Hellenic University, Thessaloniki, Greece
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3
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Hauenstein EJ, Schimmels J. Providing Gender Sensitive and Responsive Trauma-Informed Psychiatric Nursing Care. How Hard Can It Be? Issues Ment Health Nurs 2024; 45:202-216. [PMID: 38412453 DOI: 10.1080/01612840.2024.2310663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
This paper addresses the challenge of providing gender sensitive and responsive trauma-informed care (TIC) in psychiatric nursing practice. Gender identity, gender subordination, and gender-related trauma history are examined as three key individual-level factors that affect nurses' capacity to engage therapeutically to provide gender sensitive and responsive TIC. Using Peplau's Interpersonal Theory and building on a shared trauma and resilience model, gender-sensitive and responsive TIC is situated within interpersonal science and the ability of the psychiatric nurse to attune to her own and her patient's gender ideologies. Strategies for transforming practice including self-reflection, self-compassion, and peer and supervisor support are reviewed. Noting the import of the practice environment, several observations of changes needed at the level of the unit, organization, and society to effect gender equitable policies that enable the implementation of gender-sensitive and responsive TIC are made.
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Affiliation(s)
- Emily J Hauenstein
- School of Nursing, University of Virginia, Charlottesville, Virginia, USA
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Ye Y, Li Y, Jin S, Huang J, Ma R, Wang X, Zhou X. Family Function and Post-Traumatic Stress Disorder in Children and Adolescents: A Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:3151-3169. [PMID: 36226805 DOI: 10.1177/15248380221126182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Family function reflects the operating status of the family system, which plays a vital role in children's mental health. The current meta-analysis examined the association between family function and post-traumatic stress disorder (PTSD) in children and adolescents for the first time. Studies published from 1980 to 2021 were identified via searching and screening. We identified 31 studies (91 unique effects) with 8,684 children. A three-level meta-analysis revealed that overall family function was negatively associated with PTSD (r = -0.205). Among elements of family function, family affect (r = -0.251), communication (r = -0.221), and cohesion (r = -0.184) were associated with less PTSD, whereas family conflict (r = 0.228) was associated with more PTSD in children. Family flexibility (r = -0.103) was not associated with PTSD. Moderator analyses revealed differences between various types of trauma events and family function scales. The findings highlight the differences in the roles of the elements of family function and suggest that interventions should be focused on targeting specific elements of family function.
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Affiliation(s)
- Yingying Ye
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Yifan Li
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Shuxian Jin
- Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jiali Huang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Rong Ma
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Xuan Wang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
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5
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May C, Miller PE, Naqvi M, Rademacher E, Klajn J, Hedequist D, Shore BJ. The Incidence of Posttraumatic Stress Symptoms in Children. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202308000-00007. [PMID: 37579777 PMCID: PMC10424889 DOI: 10.5435/jaaosglobal-d-22-00245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 04/17/2023] [Accepted: 06/30/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVE To determine the incidence of posttraumatic stress disorder (PTSD) symptoms and risk factors for their development in children and adolescents undergoing orthopaedic surgery for trauma. DESIGN Prospective cohort study. SETTING Level-1 trauma center. PATIENTS Children (8 to 18), undergoing surgery for orthopaedic trauma. INTERVENTION Upper and lower extremity surgery for orthopaedic trauma. MAIN OUTCOME MEASUREMENTS PTSD symptoms at postoperative follow-up as determined by the Child PTSD Symptom Scale (CPSS). RESULTS A total of 176 children with an average age at surgery of 13 years (8 to 18.8 years) participated in the study. Twenty-six subjects had high levels of PTSD symptoms (15%; 95% CI = 10.0 to 21.1%). Univariable and multivariable analyses determined that female sex (OR 2.63, 95% CI = 1.06 to 6.67, P = 0.04), older age at surgery (OR 1.25, 95% CI = 1.04 to 1.51, P = 0.02), and undergoing a previous surgery (OR 2.86, 95% CI = 1.06 to 7.73, P = 0.04) were all associated with increased PTSD risk. CONCLUSIONS Children and adolescents experience a high level of PTSD symptoms (15%) after surgery for orthopaedic trauma. Clinicians should be aware of PTSD symptoms in children and adolescents after surgery for orthopaedic injuries and use comprehensive screening to facilitate timely intervention and treatment. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Collin May
- From the Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA
| | - Patricia E. Miller
- From the Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA
| | - Manahill Naqvi
- From the Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA
| | - Emily Rademacher
- From the Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA
| | - Justyna Klajn
- From the Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA
| | - Daniel Hedequist
- From the Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA
| | - Benjamin J. Shore
- From the Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA
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Zang X, Li T, Li M, An Y, Cheng X, Jin J. Resilience Mediates the Relationship Between Parental Attachment and Posttraumatic Growth in Adolescents: A Longitudinal Study. Disaster Med Public Health Prep 2023; 17:e381. [PMID: 37185263 DOI: 10.1017/dmp.2023.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Previous studies have shown that parental attachment was associated with higher levels of posttraumatic growth (PTG) in individuals who have experienced traumatic events. The aim of the current longitudinal study is to investigate resilience as one pathway through which parental attachment is related to PTG among Chinese adolescents following the Yancheng tornado. METHODS A total of 351 adolescent survivors participated in this longitudinal study. Participants completed the revised version of Inventory of Parent and Peer Attachment (IPPA-R) at 12 months (T1), and the revised Chinese version of the Post-Traumatic Growth Inventory (PTGI-R) and the Connor and Davidson's Resilience Scale (CD-RISC) at 18 months (T2) after the tornado, respectively. RESULTS It indicated that parental attachment at T1 has direct and positive effect on PTG at T2, and resilience at T2 fully mediated the relationship between parental attachment at T1 and PTG at T2. CONCLUSION The findings revealed that parental attachment and resilience are two key resources that promote adolescent's PTG, and parental attachment acts through resilience to promote PTG in adolescents.
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Affiliation(s)
- Xueyan Zang
- Nanjing Normal University, School of Psychology, Nanjing, Jiangsu, China
| | - Tianyuan Li
- The Education University of Hong Kong, Hong Kong
| | - Mengdan Li
- Nanjing Normal University, School of Psychology, Nanjing, Jiangsu, China
| | - Yuanyuan An
- Nanjing Normal University, School of Psychology, Nanjing, Jiangsu, China
| | - Xuan Cheng
- Nanjing Normal University, School of Psychology, Nanjing, Jiangsu, China
| | - Jialu Jin
- Nanjing Normal University, School of Psychology, Nanjing, Jiangsu, China
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Eslinger J, Sprang G, Jodts J. Keeping children and youth in trauma treatment: Examination of an alliance building dropout management program. Clin Child Psychol Psychiatry 2023; 28:721-733. [PMID: 35762135 DOI: 10.1177/13591045221111849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Evidence-based treatments exist to address traumatic stress related symptoms for children, however dropout from trauma-focused treatment remains a concern. This study examined use of an alliance building dropout management program for a group of children ages 3-17 who received an evidence-based trauma-focused treatment. Logistic regression analysis was conducted to examine the relationships between child gender, race, ethnicity, age, guardianship, externalizing behaviors, participation in a dropout management program and the dose of treatment received. The final model was significant and participation in the dropout management program as well as a child's placement in foster care were significant individual correlates with full completion of treatment. Use of an Alliance Building Dropout Management program may help decrease overall dropout over and above the contribution of other variables known to impact treatment completion.
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Affiliation(s)
- Jessica Eslinger
- Department of Psychiatry, 12252University of Kentucky, Lexington, KY, USA.,Center on Trauma and Children, 4530University of Kentucky, Lexington, KY, USA
| | - Ginny Sprang
- Department of Psychiatry, 12252University of Kentucky, Lexington, KY, USA.,Center on Trauma and Children, 4530University of Kentucky, Lexington, KY, USA
| | - Jenna Jodts
- Center on Trauma and Children, 4530University of Kentucky, Lexington, KY, USA
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Bailey M, Meiser‐Stedman R, Hiller R, Haag K, Lobo S, Halligan SL. Child posttraumatic stress symptoms in an acute injury sample: Patterns of associations among child report, parent report, and child heart rate parameters. J Trauma Stress 2023; 36:333-345. [PMID: 36787341 PMCID: PMC10946953 DOI: 10.1002/jts.22913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 02/15/2023]
Abstract
Parent-child agreement on measures of child posttraumatic stress disorder (PTSD) is moderate at best, and understanding of this discrepancy is limited. To address this, we conducted an item-level investigation of parent-child symptom agreement to examine the potential influence of parental posttraumatic stress symptoms (PTSS) on parents' reports of their child's PTSS. We also examined heart rate (HR) indices as possible independent indicators of child PTSD, examining patterns of association with parent versus child report. Parent-child dyads (N = 132, child age: 6-13 years, 91.7% White) were recruited after the child's hospital admission following an acute, single-incident traumatic event. At 1-month posttrauma, questionnaires assessing children's PTSS (self- and parental reports) and parental PTSS were administered. For a subset of participants (n = 70), children's HR recordings were obtained during a trauma narrative task and analyzed. Parent and child reports of child PTSS were weakly positively correlated, r = .25. Parental PTSS were found to be stronger positive predictors of parental reports of child PTSS than the children's own symptom reports, β = 0.60 vs. β = 0.14, and were associated with higher parent-reported child PTSS relative to child reports. Finally, children's self-reported PTSS were associated with HR indices, whereas parent reports were not, βs = -.33-.30 vs. βs = -.15-.01. Taken together, children's self-reported PTSS could be a more accurate reflection of their posttrauma physiological distress than parent reports. The potential influence of parental PTSS on their perceptions of their child's symptoms warrants further consideration.
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Affiliation(s)
- Megan Bailey
- Department of PsychologyUniversity of BathBathUnited Kingdom
| | - Richard Meiser‐Stedman
- Department of Clinical Psychology and Psychological TherapiesNorwich Medical SchoolUniversity of East AngliaUnited Kingdom
| | - Rachel Hiller
- Division of Psychology & Language SciencesUniversity College LondonLondonUnited Kingdom
- Anna Freud National Centre for Children & FamiliesLondonUnited Kingdom
| | - Katharina Haag
- Department of PsychologyUniversity of BathBathUnited Kingdom
| | - Sarah Lobo
- Department of PsychologyUniversity of BathBathUnited Kingdom
| | - Sarah L. Halligan
- Department of PsychologyUniversity of BathBathUnited Kingdom
- Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
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Chien WT, Lau CT. Traumatised Children's Perspectives on Their Lived Experience: A Review. Behav Sci (Basel) 2023; 13:bs13020170. [PMID: 36829399 PMCID: PMC9952495 DOI: 10.3390/bs13020170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023] Open
Abstract
Introduction: Most children have exposure of traumatic events during their life, such as natural disasters, accidents, and abuses. A review of traumatised children's perspective on traumatic events plays an important role in enhancing our understanding and promoting appropriate tailor-made intervention and support to these children. Methods: Four main health-related electronic databases were searched for all English full-text qualitative research articles over the past 11 years to uncover the recent best available perspective/evidence from traumatised children. The PRISMA checklist was adopted to guide the review process. Results: Five themes about children's experiences and perspectives towards the traumatic events encountered were summarised and integrated from 19 qualitative studies identified. They included daily life problems related to trauma, negative responses to trauma, perceived health needs, coping strategies related to trauma and stress, and growth from traumatic experience. Conclusions: This systematic review provides evidence about responses/impacts and perceived health needs of traumatised children and informs the direction caregivers' training can take, helping these children by early identification and timely intervention. More research is needed to examine/compare traumatised children's responses and coping between diverse traumatic experiences, time from exposure, and the sociodemographic characteristics of these children.
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10
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Lietz CA, Cheung JR. Meeting the Mental Health Needs of College Students with a Background in Foster Care. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2022; 40:193-206. [PMID: 36530754 PMCID: PMC9735276 DOI: 10.1007/s10560-022-00905-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 06/17/2023]
Abstract
Many colleges and universities are creating campus-based programs to support students with a background in foster care. When considering the histories of trauma experienced by these young people, meeting mental health needs is an important part of a portfolio of services. ASuPIRE is a strengths-based, trauma-informed counseling program that was designed to respond to the unique needs of college students who aged-out and/or experienced foster care at any point across their development. This program can stand alone or can be used to supplement campus-based support programs. This approach, including its theoretical framework and related interventions, will be described. A case study is also provided to illustrate the model for other post-secondary institutions interested in adopting this approach.
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Affiliation(s)
- Cynthia A. Lietz
- School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, 411 N. Central Ave, Phoenix, AZ 85004 USA
| | - Justine R. Cheung
- School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, 411 N. Central Ave, Phoenix, AZ 85004 USA
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Kira IA, Al Ibrahim B, Aljakoub J, Shuwiekh HAM. The Effects of Torture in the Context of COVID-19 and Continuous Type III Trauma’s Variants: The Peri-Post Type III Trauma Mental Health Syndrome in Syrian Torture Survivors. JOURNAL OF LOSS & TRAUMA 2022. [DOI: 10.1080/15325024.2022.2070967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ibrahim Aref Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA, USA
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
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12
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The Relationship Between Anxiety Sensitivity and PTSD Symptom Severity Among Trauma-Exposed Inpatient Adolescents. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10294-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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13
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Effects of childhood trauma in psychopathy and response inhibition. Dev Psychopathol 2022; 35:724-729. [PMID: 35074037 DOI: 10.1017/s0954579421001863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Childhood trauma is linked to impairments in executive function and working memory, thought to underly psychological disorders including depression and posttraumatic stress disorder. Research demonstrates that childhood trauma can partially mediate posttraumatic stress disorder in those with executive function deficits. Despite a link with executive function deficit, psychopathy as a consequence of trauma is yet to be studied in this context. The present study investigates the possibility of a relationship between childhood trauma, psychopathic traits, and response inhibition. Eighty participants were tasked to completed the Childhood Traumatic Events Scale (Pennebaker & Susman, 2013), Levenson’s Self-Report Psychopathy Scale (Levenson et al., 1995), and Flanker task of response inhibition (Eriksen & Eriksen, 1974). Scores of trauma exposure, psychopathic traits, and reaction times in the Flanker task were measured. Regression analysis revealed no significance for trauma exposure in predicting psychopathic traits (p = .201) and response inhibition (p = .183), indicating that childhood trauma does not strongly predict susceptibility to psychopathic traits or response inhibition deficits. These findings form an important basis on which to build a further understanding of the consequences of childhood trauma exposure, specifically in terms of understanding how specific cognitive functions may be influenced and providing a clearer understanding of how psychopathic traits develop.
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Pijpers ML, Covers MLV, Houterman S, Bicanic IAE. Risk factors for PTSD diagnosis in young victims of recent sexual assault. Eur J Psychotraumatol 2022; 13:2047293. [PMID: 35401950 PMCID: PMC8986203 DOI: 10.1080/20008198.2022.2047293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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 Sexual assault is associated with a high risk of developing PTSD. Little is known about the PTSD onset in children who have recently been victimized by sexual assault. It is important to identify children at risk for PTSD after sexual assault to prevent chronic problems and revictimization. OBJECTIVE The first aim of this study was to describe the development of post-traumatic stress symptoms in the four weeks after sexual assault. The second aim was to analyse whether pre-assault factors, assault-related factors, social support, and post-traumatic stress, measured at two weeks post-assault, were associated with an indication of PTSD. METHOD From January 2019 to March 2021, data were collected of victims aged 8-17 years (n = 51; mean age = 15.00; SD = 1.78) who had contacted a Sexual Assault Centre. Severity of post-traumatic stress symptoms was measured at two and four weeks post-assault. The study was designed to use a multivariate logistic regression analysis. The study included female victims only. RESULTS Most of the victims (58.8%) showed a decline in the severity of post-traumatic stress symptoms in the four weeks after sexual assault. However, 27.4% showed an increase and 13.7% showed no change in symptoms. More than two-thirds of the children (70.6%) showed severe post-traumatic stress symptoms at four weeks post-assault, i.e. had an indication of PTSD. Since only one significant difference was found, the multivariate analysis was not executed. A significant difference was found between severity of symptoms at two weeks and an indication of PTSD at four weeks (t(49) = -5.79; p < .001). CONCLUSION Children with high levels of post-traumatic stress at two weeks post-assault are at risk for PTSD indication at four weeks post-assault. Further research is needed to determine whether early trauma-based treatment for children with high post-traumatic stress symptoms can prevent the development of PTSD.
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Affiliation(s)
- Mirjam L Pijpers
- Department of Psychology, Catharina Hospital, Eindhoven, Netherlands
| | - Milou L V Covers
- National Psychotrauma Center for Children and Youth, University Medical Center Utrecht, Utrecht, Netherlands
| | - Saskia Houterman
- Department of Education and Research, Catharina Hospital, Eindhoven, the Netherlands
| | - Iva A E Bicanic
- National Psychotrauma Center for Children and Youth, University Medical Center Utrecht, Utrecht, Netherlands
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15
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Gindt M, Fernandez A, Zeghari R, Ménard ML, Nachon O, Richez A, Auby P, Battista M, Askenazy F. A 3-year retrospective study of 866 children and adolescent outpatients followed in the Nice Pediatric Psychotrauma Center created after the 2016 mass terror attack. Front Psychiatry 2022; 13:1010957. [PMID: 36569628 PMCID: PMC9772007 DOI: 10.3389/fpsyt.2022.1010957] [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: 08/03/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The mass terrorist attack in Nice, France, in July 2016 caused deaths and injuries in a local population, including children and adolescents. The Nice Pediatric Psychotrauma Center (NPPC) was opened to provide mental health care to the pediatric population (0-18 years) who experienced traumatic events. OBJECTIVES This study describes the specificity of the care pathway for young trauma victims, with an explanation of how the NPPC works during the first three years. METHODS In this retrospective study, we conducted quantitative and qualitative data collection about new and follow-up consultations, primary and comorbid diagnoses, and the kind of trauma (terrorist attack versus other kinds of trauma). Ethics approval was obtained from the local Ethics committee. RESULTS 866 children and adolescents were followed in the NPPC. We found a high rate of Post-Traumatic Stress Disorder (PTSD; 71%) in this population with a high rate of comorbidities (67%), mainly sleep disorders (34.7%) and mood and anxiety disorders (16.2%). A high number of children and adolescents impacted by the terrorist attack required follow-up consultations after exposure to the mass terrorist attack, the first care-seeking requests continued to occur three years later, although at a slower rate than in the first and second years. New consultations for other kinds of trauma were observed over time. DISCUSSION This study supports previous findings on the significant impact of mass trauma in the pediatric population showing even a higher level of PTSD and a high rate of comorbidities. This may be explained by the brutality of the traumatic event, particularly for this age group. The findings of this study have implications for early interventions and long-term care for children and adolescents to prevent the development of chronic PTSD into adulthood.
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Affiliation(s)
- Morgane Gindt
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Arnaud Fernandez
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Radia Zeghari
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Marie-Line Ménard
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Ophelie Nachon
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Aurélien Richez
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Philippe Auby
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France
| | - Michele Battista
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Florence Askenazy
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
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16
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Carter L, Brooks M, Graham-Kevan N. Emotion Regulation Mediates Posttraumatic Growth and Cluster B Personality Traits After Childhood Trauma. VIOLENCE AND VICTIMS 2021; 36:706-722. [PMID: 34980582 DOI: 10.1891/vv-d-20-00022] [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: 06/14/2023]
Abstract
OBJECTIVES Cluster B personality disorder traits and positive psychological change, known as posttraumatic growth (PTG), are both possible outcomes following childhood trauma. However, existing research has not yet explored whether emotion regulation difficulties can simultaneously explain these negative and positive changes. METHOD A sample of childhood trauma survivors (N = 223) provided responses to an online survey, with findings assessed using structural equation modeling techniques. RESULTS Emotion regulation difficulties were found to mediate between childhood trauma severity and cluster B traits (ab cs = -.05), and between childhood trauma severity and PTG (abcs = .13), with small to medium indirect effects. The final model accounted for more variance in cluster B traits (56%) than PTG (10%). CONCLUSIONS Emotion regulation is therefore a key mediator of positive and negative psychological changes and should be the focus of intervention efforts among childhood trauma survivors.
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Affiliation(s)
- Laura Carter
- School of Psychology, University of Central Lancashire, Preston, UK
| | - Matthew Brooks
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
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17
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Ooms-Evers M, van der Graaf-Loman S, van Duijvenbode N, Mevissen L, Didden R. Intensive clinical trauma treatment for children and adolescents with mild intellectual disability or borderline intellectual functioning: A pilot study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 117:104030. [PMID: 34314951 DOI: 10.1016/j.ridd.2021.104030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/23/2021] [Accepted: 07/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Children and adolescents with mild intellectual disability (MID) or borderline intellectual functioning (BIF) are at increased risk for posttraumatic stress disorder (PTSD) or trauma-related symptoms due to adverse childhood experiences (ACEs). Weekly provided treatment sessions and/or outpatient treatment may not be effective enough. AIMS Investigate feasibility, safety and potential effectiveness of an intensive clinical trauma treatment in children and adolescents with MID-BIF and trauma-related symptoms as a result of ACEs or PTSD. METHODS AND PROCEDURES Thirty-three participants between 6 and 17 years of age received intensive clinical treatment after experiencing multiple ACEs (most commonly physical abuse, emotional neglect or abuse, sexual abuse, domestic violence and bullying). Treatment lasted 8.4 days on average and consisted of a daily program of prolonged exposure, eye movement desensitisation and reprocessing and physical activation, embedded in a trauma-sensitive environment. Data were collected at intake, first day of treatment, last day of treatment and at follow-up. OUTCOMES AND RESULTS There was a significant reduction of trauma-related symptoms and emotional and behavioral problems after treatment. In addition, the number of participants fulfilling the DSM-5 criteria of PTSD decreased from 24 at intake to 8 at the end of treatment. There was no drop out and no adverse events were seen. CONCLUSIONS AND IMPLICATIONS The results of this pilot study suggest that an intensive clinical trauma treatment is a potentially effective and safe option for children and adolescents with MID-BIF.
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Affiliation(s)
| | | | | | - Liesbeth Mevissen
- Trajectum, Zwolle, the Netherlands; Psychotrauma Practice, Rha, the Netherlands
| | - Robert Didden
- Trajectum, Zwolle, the Netherlands; Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
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18
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Vollmer TC, Koppen G. The Parent-Child Patient Unit (PCPU): Evidence-Based Patient Room Design and Parental Distress in Pediatric Cancer Centers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199993. [PMID: 34639296 PMCID: PMC8508188 DOI: 10.3390/ijerph18199993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/08/2021] [Accepted: 09/16/2021] [Indexed: 01/22/2023]
Abstract
Children with cancer are frequently hospitalized during diagnosis and treatment. Since the early 1980s, parents are co-admitted because their presence positively affects children’s adjustment to hospitalization and reduces post-traumatic stress. However, the size and overall architectural design of the rooms were never adapted to the doubling of the occupancy rate. Since studies show that many parents experience high levels of distress due to their child’s illness, the purpose of this study was to investigate the impact of the architecture of the aged patient rooms on parental distress. A video observation targeted parent–child interaction related to five architectural determinants: (a) function and place of interaction, (b) distance between parent and child, (c) used space, (d) withdrawal, and (e) duration of the interaction. A total of 22 families were included in two Dutch children’s hospitals. Results show a significant association between parental distress and three architectural determinants: The less anxious the parents were and the better they estimated their child’s well-being, the more distance they created between themselves and their child, and the more space, privacy, and withdrawal options were used. These findings are discussed within a new patient room typology, the parent–child patient unit (PCPU), which reacts to the evident association of parental distress and the design.
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Affiliation(s)
- Tanja C. Vollmer
- Architectural Psychology and Health, Faculty of Architecture, Technical University of Munich, Arcisstrasse 21, 80333 Munich, Germany
- Correspondence:
| | - Gemma Koppen
- Kopvol architecture & psychology, Mathenesserdijk 396, GV3026 Rotterdam, The Netherlands;
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19
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Increased occurrence of PTSD symptoms in adolescents with major depressive disorder soon after the start of the COVID-19 outbreak in China: a cross-sectional survey. BMC Psychiatry 2021; 21:395. [PMID: 34372807 PMCID: PMC8352150 DOI: 10.1186/s12888-021-03400-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 07/29/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The Coronavirus Disease 2019 (COVID-19) pandemic continues to threaten the physical and mental health of people across the world. This study aimed to understand the psychological impact of this disease on adolescents with major depressive disorder (MDD) at 1 month after the start of the outbreak in China. METHODS Using the Children's Impact of Event Scale (CRIES-13) questionnaire, we investigated the occurrence of posttraumatic stress disorder (PTSD) in two groups of adolescents: MDD patients who were in continuous antidepressant therapy and healthy controls. Total scores and factor subscores were compared between the two groups and subgroups stratified by sex and school grade. Logistic regression was used to identify variables associated with high total CRIES-13 scores. RESULTS Compared to controls (n = 107), the MDD group (n = 90) had higher total CRIES-13 scores and a higher proportion with a total score ≥ 30. They also had a lower intrusion subscore and a higher arousal subscore. In the MDD group, males and females did not differ significantly in total CRIES-13 scores or factor subscores, but junior high school students had higher avoidance subscores than senior high school students. Logistic regression showed high total CRIES-13 scores to be associated with MDD and the experience of "flashbacks" or avoidance of traumatic memories associated with COVID-19. CONCLUSIONS It is crucial to understand the psychological impact of COVID-19 on adolescents with MDD in China, especially females and junior high school students. Long-term monitoring of adolescents with a history of mental illness is required to further understand these impacts. TRIAL REGISTRATION ChiCTR, ChiCTR2000033402 , Registered 31 May 2020.
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20
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Mokwena KE. Neglecting Maternal Depression Compromises Child Health and Development Outcomes, and Violates Children's Rights in South Africa. CHILDREN-BASEL 2021; 8:children8070609. [PMID: 34356588 PMCID: PMC8303702 DOI: 10.3390/children8070609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 11/16/2022]
Abstract
The intention of the South African Children’s Act 38 of 2005 is to provide guarantees for the protection and promotion of optimum health and social outcomes for all children. These guarantees are the provision of basic nutrition, basic health care and social services, optimal family or parental care, as well as protection from maltreatment, neglect and abuse services. However, despite these guarantees, child and maternal mortality remain high in South Africa. The literature identifies maternal depression as a common factor that contributes to negative health and social outcomes for both mothers and their children. Despite the availability of easy-to-use tools, routine screening for maternal depression is not carried out in public health services, which is the source of services for the majority of women in South Africa. The results are that the mothers miss out on being diagnosed and treated for maternal depression, which results in negative child outcomes, such as malnutrition, as well as impacts on mental, social and physical health, and even death. The long-term impacts of untreated maternal depression include compromised child cognitive development, language acquisition and deviant behaviors and economic disadvantage in later life. The author concludes that the neglect of screening for, and treatment of maternal depression therefore violates the constitutional rights of the affected children, and goes against the spirit of the Constitution. The author recommends that maternal and child health services integrate routine screening for maternal depression, which will not only satisfy the Constitutional mandate, but also improve the health and developmental outcomes of the children and reduce child mortality.
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Affiliation(s)
- Kebogile Elizabeth Mokwena
- Department of Public Health, Sefako Makgatho Health Sciences University, Molotlegi Drive, Ga-Rankuwa, Pretoria 0204, South Africa
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21
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Xu H, Zhang H, Huang L, Wang X, Tang X, Wang Y, Xiao Q, Xiong P, Jiang R, Zhan J, Deng F, Yu M, Liu D, Liu X, Zhang C, Wang W, Li L, Cao H, Zhang W, Zhou H, Wang W, Yin L. Increased symptoms of post-traumatic stress in school students soon after the start of the COVID-19 outbreak in China. BMC Psychiatry 2021; 21:330. [PMID: 34217234 PMCID: PMC8254054 DOI: 10.1186/s12888-021-03339-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 06/23/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The outbreak of Coronavirus Disease 2019(COVID-19) caused psychological stress in Chinese adults population. But we are unaware of whether the pandemic causes psychological stress on children. METHODS We used the Children's Impact of Event Scale questionnaire (CRIES-13) to investigate the degree of Post-traumatic Stress (PTSD) symptoms caused by the pandemic in students selected from schools in Sichuan, Jiangsu, Henan, Yunnan, and Chongqing provinces of China. RESULTS A total of 7769 students(3692 male and 4077 female), aged 8-18 years, were enrolled in the study, comprising 1214 in primary schools, 2799 in junior high schools and 3756 in senior high schools. A total of 1639 students (21.1%) had severe psychological stress reactions. A large proportion of senior high school students (23.3%) experienced severe psychological stress, and they had the highest median total CRIES-13 score. Female students were more likely to experience severe psychological stress and had higher median CRIES-13 total scores than males. CONCLUSION COVID-19 has placed psychological stresses on primary and secondary school students in China. These stresses are more likely to reach severe levels among female students and senior high school students.
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Affiliation(s)
- Hanmei Xu
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 Sichuan China
| | - Hang Zhang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 Sichuan China
| | - Lijuan Huang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 Sichuan China
| | - Xiaolan Wang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 Sichuan China
| | - Xiaowei Tang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 Sichuan China
| | - Yanping Wang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 Sichuan China
| | - Qingqing Xiao
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 Sichuan China
| | - Ping Xiong
- Chengdu Engineering Technical Vocational School, Chengdu, 610300 Sichuan China
| | - Rongqiu Jiang
- Chengdu Vocational & Technical College of Industry, Chengdu, Sichuan 610218 China
| | - Jie Zhan
- Xuchuan Middle School, Zigong, 643000 Sichuan China
| | - Fang Deng
- The Fourth People’s Hospital of Chengdu, Chengdu, 610036 Sichuan China
| | - Mingya Yu
- Jiangsu Academy of Educational Sciences, Nanjing, 210013 Jiangsu China
| | - Dong Liu
- Wenquan Second Central Primary School, Donghai County, Lianyungang, 222315 Jiangsu China
| | - Xuejun Liu
- Jiangsu Shuangdian Primary School, Rudong County, Nantong, 226404 Jiangsu China
| | - Chunli Zhang
- The Sixth Middle School of Jianshui County, Honghe Prefecture, Jianshui County, 654300 Yunnan China
| | - Wenjun Wang
- Egongyan Primary School, Jiulongpo District, Chongqing, 404000 China
| | - Lu Li
- The 12th Elementary School of Nanyang City, Nanyang, 473002 Henan China
| | - Hongmei Cao
- Hou Central School, Xuzhou, 221000 Jiangsu China
| | - Wenchao Zhang
- grid.263906.8The primary School Attached to SouthWest University, Chongqing, 400700 China
| | - Hongping Zhou
- Chengdu Shuangliu Yongan Middle School, Chengdu, 610219 Sichuan China
| | - Wo Wang
- grid.203458.80000 0000 8653 0555University-Town Hospital of Chongqing Medical University, Chongqing, 401331 China
| | - Li Yin
- Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041, Sichuan, China. .,Institute for System Genetics, Frontiers Science Center for Disease-related Molecular Network, Chengdu, 610041, Sichuan, China.
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22
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Kennedy RS. Bully-Victims: An Analysis of Subtypes and Risk Characteristics. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:5401-5421. [PMID: 30311539 DOI: 10.1177/0886260517741213] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Bully-victims are often found to be the most high-risk group involved in bullying, yet limited prior research has explored differences among bully-victims. This study aims to fill that gap by exploring within-group differences of youth involved in both bullying perpetration and victimization. In a nationally representative sample of 165 youth ages 5 to 17, four bully-victim types were created using cutoff points based on the amount of perpetration and victimization reported: high bully-victims (n = 38), aggression predominant bully-victims (n = 67), victimization predominant bully-victims (n = 23), and moderate bully-victims (n = 37). Analyses revealed distinct differences among the groups, particularly relating to traumatic symptoms, types of bullying involvement, and nonvictimization adversity. The findings confirm that there is heterogeneity among bully-victims. The most substantial difference was found between the high group and the moderate group, with the high group significantly more likely to report depression (p < .05) and anxiety symptoms (p < .05), and more than two times more likely to experience past-year adversity than the moderate group. The findings from this study indicate that youth involved in high amounts of both perpetration and victimization are considerably more at risk of traumatic symptoms and nonvictimization adversity than youth involved in fewer bullying behaviors. These findings can be used to inform both research and practice, particularly in regard to targeted evidence-based interventions that meet the unique needs of each type.
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23
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Child Traumatic Stress and the Sacred: Neurobiologically Informed Interventions for Therapists and Parents. RELIGIONS 2021. [DOI: 10.3390/rel12030163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Children experience trauma and adverse experiences at an alarming rate. The negative impact of traumatic experiences on a child’s developing brain is pervasive, adversely affecting one’s thoughts, feelings, behaviors, physiological reactions, and social relationships. Conversely, the nature, pattern, timing and duration of therapeutic experiences can change the brain in ways that support and cultivate therapeutic growth and healing. The purpose of this paper will be to review and expand on two prominent neurobiological therapeutic frameworks within the field of child trauma therapy: the Neurosequential Model of Therapeutics and Interpersonal Neurobiology. We will discuss the ways in which trauma experiences are organized in the brain and how therapeutic and parenting interventions can address the key areas of the brain that are impacted. Further, this paper will expand on these frameworks to explore how the sacred (within primarily a Judeo-Christian monotheistic religious tradition) can be integrated within the therapeutic process—specifically through the themes of safety, relational connection, and meaning-making.
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24
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VanBergen AM, Bartle-Haring S, Kawar C, Bortz P. Trauma and Relationship Satisfaction in Treatment Seeking Couples: A Dyadic Investigation of Differentiation as a Mediator. CONTEMPORARY FAMILY THERAPY 2021. [DOI: 10.1007/s10591-021-09565-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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de Roos C, Zijlstra B, Perrin S, van der Oord S, Lucassen S, Emmelkamp P, de Jongh A. Predictors and moderators of treatment outcome for single incident paediatric PTSD: a multi-centre randomized clinical trial. Eur J Psychotraumatol 2021; 12:1968138. [PMID: 34621497 PMCID: PMC8491723 DOI: 10.1080/20008198.2021.1968138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND With few RCTs having compared active treatments for paediatric PTSD, little is known about whether or which baseline (i.e. pre-randomization) variables predict or moderate outcomes in the evaluated treatments. OBJECTIVE To identify predictors and moderators of paediatric PTSD outcomes for Eye Movement Desensitization and Reprocessing Therapy (EMDR) and Cognitive Behavioural Writing Therapy (CBWT). METHOD Data were obtained as part of a multi-centre, randomized controlled trial of up to six sessions (up to 45 minutes each) of either EMDR therapy, CBWT, or wait-list, involving 101 youth (aged 8-18 years) with a PTSD diagnosis (full/subthreshold) tied to a single event. The predictive and moderating effects of the child's baseline sociodemographic and clinical characteristics, and parent's psychopathology were evaluated using linear mixed models (LMM) from pre- to post-treatment and from pre- to 3- and 12-month follow-ups. RESULTS At post-treatment and 3-month follow-up, youth with an index trauma of sexual abuse, severe symptoms of PTSD, anxiety, depression, more comorbid disorders, negative posttraumatic beliefs, and with a parent with more severe psychopathology fared worse in both treatments. For children with more severe self-reported PTSD symptoms at baseline, the (exploratory) moderator analysis showed that the EMDR group improved more than the CBWT group, with the opposite being true for children and parents with a less severe clinical profile. CONCLUSIONS The most consistent finding from the predictor analyses was that parental symptomatology predicted poorer outcomes, suggesting that parents should be assessed, supported and referred for their own treatment where indicated. The effect of the significant moderator variables was time-limited, and given the large response rate (>90%) and brevity (<4 hours) of both treatments, the present findings suggest a focus on implementation and dissemination, rather than tailoring, of evidence-based trauma-focused treatments for paediatric PTSD tied to a single event.
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Affiliation(s)
- Carlijn de Roos
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Bonne Zijlstra
- Department of Child Development and Education, University of Amsterdam (UVA), Amsterdam, The Netherlands
| | - Sean Perrin
- Department of Psychology, Lund University, Lund, Sweden
| | - Saskia van der Oord
- Faculty of Psychology and Educational Sciences, Research Group Clinical Psychology, Ku Leuven, Leuven, Belgium.,Department of Developmental Psychology, University of Amsterdam (Uva), Amsterdam, The Netherlands
| | - Sacha Lucassen
- UvA Minds Academic Treatment Centre, Amsterdam, The Netherlands
| | - Paul Emmelkamp
- Department Of Clinical Psychology, University of Amsterdam (Uva), Amsterdam, The Netherlands.,Paris Institute For Advanced Studies, France
| | - Ad de Jongh
- Department Of Social Dentistry And Behavioral Sciences, Academic Centre for Dentistry Amsterdam (Acta), University of Amsterdam, Amsterdam, The Netherlands.,Institute Of Health And Society, University Of Worcester, Worcester, UK.,School Of Psychology, Queen's University, Belfast, Northern Ireland
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26
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Schiff M, Pat-Horenczyk R, Ziv Y, Brom D. Multiple Traumas, Maternal Depression, Mother-Child Relationship, Social Support, and Young Children's Behavioral Problems. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:892-914. [PMID: 29294915 DOI: 10.1177/0886260517725738] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study examined whether maternal depression, mother-child relationships, and maternal perceived social support mediate the associations between child's exposure to multiple traumatic events and behavioral problems. We recruited a representative sample of 904 Israeli (Jewish and Arab) mothers and their 2- to 6-year-old children. Data collection was conducted through structured face-to-face interviews with the mothers between July and November 2011. All measures were completed by the mothers. We used the child's and mother's exposure to political violence questionnaires, Child Behavior Checklist (CBCL), a short version of the Parental Acceptance-Rejection Questionnaire (PARQ), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Medical Outcomes Study (MOS) Social Support Survey. The research study model was tested using path analysis. The model showed a very good fit to the data, suggesting that maternal rejection, maternal depression, and social support play an important role in child's behavioral problems in the context of multiple traumatic events. Higher levels of maternal rejection were significantly associated with greater children behavior problems. Maternal rejection mediated the associations between maternal depressive symptoms and child's behavioral problems. Maternal perceived social support mediated the associations between child's exposure to multiple traumatic events and child's behavioral problems; child's exposure to multiple traumatic events was associated with lower levels of maternal perceived social support. In turn, lower levels of perceived social support were associated with higher levels of behavioral problems. In conclusion, in accordance with the "social stress framework," social support has a mediation role in the association between exposure to traumatic events and child's behavioral problems. Thus, enhancing social support to mothers to young children in the context of multiple traumatic events is essential for children resiliency.
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Abstract
OBJECTIVES After injury, many children experience posttraumatic stress symptoms (PTSS) that negatively impact recovery. Acute pain and PTSS share neurobiological pathways, and acute dosage of morphine has been linked to reduced PTSS in naturalistic studies. However, the complex interactions between pain, morphine and other opioid use, and PTSS have yet to be investigated in robust pediatric samples.This prospective, longitudinal study examined relationships between acute pain, opioid medications, and PTSS after pediatric injury. METHODS Ninety-six children aged 8 to 13 years (mean = 10.60, SD = 1.71), hospitalized for unintentional injury, completed assessments at baseline (T1) and 12 weeks (T2) later. Pain ratings and opioid administration data were obtained via chart review. RESULTS Structural equation modeling revealed that worst pain endorsed during hospitalization was positively associated with concurrent and later PTSS when controlling for evidence-based risk factors (ie, age, sex, prior trauma history, traumatic appraisals of injury event, heart rate). Neither opioid medications overall nor morphine specifically (milligram/kilogram/day) administered during hospitalization mediated the relationship between pain and T2 PTSS. CONCLUSIONS Pain during hospitalization may increase susceptibility for persistent PTSS above and beyond the influence of other empirical risk factors. Findings suggest that pain assessment may be a useful addition to pediatric PTSS screening tools and highlight the need for additional research on pharmacological secondary prevention approaches. Given that inadequate pain control and persistent PTSS each hinder recovery and long-term functioning, better understanding of interactions between acute pain and PTSS after injury is essential for improving screening, prevention, and early intervention efforts.
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28
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Yang F, Jiang Y. Heterogeneous Influences of Social Support on Physical and Mental Health: Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6838. [PMID: 32962140 PMCID: PMC7558190 DOI: 10.3390/ijerph17186838] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 01/19/2023]
Abstract
Employing a national representative survey (the China Labor-force Dynamics Survey 2016, CLDS2016) data (N = 14246), this paper examines the heterogeneous influences of social support on individual physical and mental health in China. Social support is characterized by four dimensions: emotional support, tangible or instrumental support, interaction or exchange support, and community support. Physical health is measured by self-rated health and body mass index (BMI), while mental health is measured by depression, hopelessness, failure, fear, loneliness, and meaninglessness. The results indicate that different dimensions of social support have heterogeneous effects on individual physical and mental health. Specifically, the correlation between emotional support and individual physical health is not significant, but emotional support is significantly related to some mental health variables. Tangible or instrumental support is significantly related to individual self-rated physical health but not to BMI or mental health. Interaction or exchange support is significantly correlated with individual self-rated health and some mental health variables. In general, there are significant correlations between community support, and individual physical and mental health. The results also suggest that the influences of social support on physical and mental health of individuals at different ages (<60 years and ≥60 years) are heterogeneous. The results of this study provide direction for the dimension selection of social support to promote individual health.
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Affiliation(s)
- Fan Yang
- Department of Labor and Social Security, School of Public Administration, Sichuan University, Chengdu 610065, China
| | - Yao Jiang
- Department of Accounting, School of Management, Sichuan Agricultural University, Chengdu 611130, China;
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Haag AC, Landolt MA, Kenardy JA, Schiestl CM, Kimble RM, De Young AC. Preventive intervention for trauma reactions in young injured children: results of a multi-site randomised controlled trial. J Child Psychol Psychiatry 2020; 61:988-997. [PMID: 31912485 DOI: 10.1111/jcpp.13193] [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] [Accepted: 12/11/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Young children are at particular risk for injury. Ten per cent to twenty-five per cent develop posttraumatic stress disorder (PTSD). However, no empirically supported preventive interventions exist. Therefore, this study evaluated the efficacy of a standardised targeted preventive intervention for PTSD in young injured children. METHODS Injured children (1-6 years) were enrolled in a multi-site parallel-group superiority prospective randomised controlled trial (RCT) in Australia and Switzerland. Screening for PTSD risk occurred 6-8 days postaccident. Parents of children who screened 'high-risk' were randomised to a 2-session CBT-based intervention or treatment-as-usual (TAU). Primary outcomes were PTSD symptom (PTSS) severity, and secondary outcomes were PTSD diagnosis, functional impairment and behavioural difficulties at 3 and 6 months postinjury using blinded assessments. Trials were registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000325606) and ClinicalTrials.gov (NCT02088814). Trial status is complete. RESULTS One hundred and thirty-three children screened 'high-risk' were assigned to intervention (n = 62) or TAU (n = 71). Multilevel intention-to-treat analyses revealed a significant intervention effect on PTSS severity over time (b = 60.06, 95% CI: 21.30-98.56). At 3 months, intervention children (M = 11.02, SD = 10.42, range 0-47) showed an accelerated reduction in PTSS severity scores compared to control children (M = 17.30, SD = 13.94, range 0-52; mean difference -6.97, 95% CI: -14.02 to 0.08, p adj. = .055, d = 0.51). On secondary outcomes, multilevel analyses revealed significant treatment effects for PTSD diagnosis, functional impairment and behavioural difficulties. CONCLUSIONS This multi-site RCT provides promising preliminary evidence for the efficacy of a targeted preventive intervention for accelerating recovery from PTSS in young injured children. This has important clinical implications for the psychological support provided to young children and parents during the acute period following a single-event trauma.
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Affiliation(s)
- Ann-Christin Haag
- Department of Psychosomatics and Psychiatry, and Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Department of Couseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, and Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Justin A Kenardy
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - Clemens M Schiestl
- Division of Plastic Surgery, University Children's Hospital Zurich, Zurich, Switzerland
| | - Roy M Kimble
- Centre for Children's Burns and Trauma Research, Centre for Child Health Research, University of Queensland, Brisbane, QLD, Australia.,The Pegg Leditschke Children's Burns Centre, Queensland Children's Hospital, Brisbane, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Alexandra C De Young
- School of Psychology, University of Queensland, Brisbane, QLD, Australia.,Centre for Children's Burns and Trauma Research, Centre for Child Health Research, University of Queensland, Brisbane, QLD, Australia
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30
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VanBergen A, Blalock J, Bryant A, Bortz P, Bartle-Haring S. Couples and Trauma History: A Descriptive Overview of Interpersonal Trauma and Clinical Outcomes. CONTEMPORARY FAMILY THERAPY 2020. [DOI: 10.1007/s10591-020-09548-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mevissen L, Ooms-Evers M, Serra M, de Jongh A, Didden R. Feasibility and potential effectiveness of an intensive trauma-focused treatment programme for families with PTSD and mild intellectual disability. Eur J Psychotraumatol 2020; 11:1777809. [PMID: 33029319 PMCID: PMC7473050 DOI: 10.1080/20008198.2020.1777809] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Persons with mild intellectual disabilities or borderline intellectual functioning (MID-BIF; IQ 50-85) have a higher risk of being exposed to traumatic events and developing posttraumatic stress disorder (PTSD). EMDR therapy has shown to be applicable, safe and potentially effective for the treatment of PTSD in individuals with MID-BIF. However, in traumatized multi-problem families with MID-BIF and (impending) out of home placement of children, standard PTSD treatment in an outpatient setting may not be appropriate. OBJECTIVE To evaluate the feasibility and potential effectiveness of KINGS-ID, a six-week clinical trauma-focused treatment programme consisting of intensive EMDR therapy with parents and children, and parental skills training followed by two weeks of parent support at home. METHOD Six families (nine parents of whom six had MID-BIF) and 10 children (all having MID-BIF) participated in the KINGS-ID programme. Seven parents and seven children had PTSD. Data were collected within a single case study design. For each family member data were collected during baseline (three measurements), treatment (seven weekly measurements), posttreatment (three measurements) and at follow-up (three measurements). RESULTS None of the family members dropped out. Within the first two treatment weeks all but one child and one parent no longer met PTSD symptom criteria. In both children and parents, trauma-related symptoms and daily life impairment significantly decreased following treatment and in parents a significant decrease in symptoms of general psychopathology and parental stress was found. Results were maintained at six-month follow-up. CONCLUSIONS The findings of the current study are promising given that the treatment programme seems to offer new perspectives for traumatized multi-problem families with MID-BIF.
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Affiliation(s)
| | | | | | - Ad de Jongh
- Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.,Research Department, PSYTREC, Bilthoven, The Netherlands.,School of Health Sciences, Salford University, Manchester, UK.,Institute of Health and Society, University of Worcester, Worcester, UK.,School of Psychology, Queen's University, Belfast, Northern Ireland
| | - Robert Didden
- Trajectum, Zwolle, The Netherlands.,Behavioural Science Institute (BSI), Radboud University, Nijmegen, The Netherlands
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32
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Salawali SH, Susanti H, Daulima NHC, Putri AF. Posttraumatic growth in adolescent survivors of earthquake, tsunami, and liquefaction in Palu Indonesia: a phenomenological study. Pediatr Rep 2020; 12:8699. [PMID: 32905079 PMCID: PMC7463141 DOI: 10.4081/pr.2020.8699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Indexed: 11/23/2022] Open
Abstract
Exploration of posttraumatic growth (PTG) experiences in adolescent survivors of earthquakes, tsunamis, or liquefaction are needed by nurses to maximize the potential for recovery and growth of adolescents from trauma after natural disasters. The study used a qualitative method with a descriptive phenomenology approach. Data were collected through in-depth interviews with 16 adolescent survivors and were analyzed using the Colaizzi method. The results of this study have two main themes: trauma becoming the basis for realizing the meaning of life and escaping from disaster as a second chance to live better. PTG is a positive change that needs to be pursued. Escaping from disaster and realizing the meaning of life are the key points to get success in pursuing PTG to live a better life. In addition, support from mental health nurses through cognitive therapy (CT) and acceptance commitment therapy (ACT) are needed to increase the PTG.
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van Meijel EPM, Gigengack MR, Verlinden E, van der Steeg AFW, Goslings JC, Bloemers FW, Luitse JSK, Boer F, Grootenhuis MA, Lindauer RJL. Short and Long-Term Parental Posttraumatic Stress After a Child's Accident: Prevalence and Associated Factors. Child Psychiatry Hum Dev 2020; 51:200-208. [PMID: 31494749 PMCID: PMC7067753 DOI: 10.1007/s10578-019-00924-2] [Citation(s) in RCA: 2] [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: 11/25/2022]
Abstract
Studies on the long-term prevalence of parental posttraumatic stress symptoms (PTSS) following child accidental injury are scarce, and findings on risk factors vary. In this follow-up study (T2, n = 69) we determined the prevalence of parental PTSS 2-4 years after accidental injury of their child, compared with 3 months after the accident (T1, n = 135). Additionally, we examined the association between parental and child factors and PTSS severity. Children were 8-18 years old at the time of the accident. Parent and child PTSS was assessed by self-report. Other data were retrieved from medical records and a telephone interview. Parental PTSS was 9.6% at T1 and 5.8% at T2. Acute parental stress as measured within 2 weeks of the child's accident was significantly associated with parental PTSS severity (T1 and T2), as was the child's hospitalization of more than 1 day at T1 and the child's permanent physical impairment at T2. To prevent adverse long-term psychological consequences we recommend identifying and monitoring parents at risk and offering them timely treatment.
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Affiliation(s)
- Els P M van Meijel
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands. .,de Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.
| | - Maj R Gigengack
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands.,de Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Eva Verlinden
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
| | - Alida F W van der Steeg
- Pediatric Surgical Center of Amsterdam, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam & VU University, Amsterdam, The Netherlands.,Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - J Carel Goslings
- Trauma Unit Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Frank W Bloemers
- Department of Trauma Surgery, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Jan S K Luitse
- Emergency Department, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Frits Boer
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
| | - Martha A Grootenhuis
- Pediatric Psychology Department of the Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Ramón J L Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands.,de Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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34
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Chen XY, Chen J, Shi X, Jiang M, Li Y, Zhou Y, Ran M, Lai Y, Wang T, Fan F, Liu X, Chan CLW. Trajectories of maternal symptoms of posttraumatic stress disorder predict long-term mental health of children following the Wenchuan earthquake in China: A 10-year follow-up study. J Affect Disord 2020; 266:201-206. [PMID: 32056877 DOI: 10.1016/j.jad.2020.01.084] [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: 12/05/2019] [Revised: 01/16/2020] [Accepted: 01/20/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Maternal psychopathology can be an important factor associated with psychological adjustment of children. However, there is limited research on long-term impacts of maternal posttraumatic stress disorder (PTSD) on children's mental health. This study examined how PTSD trajectories of women exposed to the 2008 Wenchuan earthquake in China predicted their children's mental health symptoms 10 years after the earthquake. METHODS 410 dyads of mothers and their adolescent children who exposed to the Wenchuan earthquake were investigated at 12 and 18 months post-earthquake. While the mothers completed measures of earthquake exposure and PTSD symptoms, the children completed measures of earthquake exposure, PTSD, depression and anxiety symptoms. In the 10-year follow up, 257 out of the 410 children completed measures of PTSD, depression and anxiety symptoms. Data were analyzed using linear regression. RESULTS Four trajectories of maternal PTSD symptoms were identified: (a) chronic (9.5%); (b) resilient (66.3%); (c) delayed (7.6%); and (d) recovery (16.6%); More importantly, the findings demonstrated that children whose mothers experienced chronic PTSD reported higher level of PTSD and anxiety symptoms 10 years after the earthquake. LIMITATIONS Only two waves of maternal PTSD were collected, self-reported tools other than clinical reviews were used to collect data, and a significant proportion of participants did not respond at the 10-year follow-up. CONCLUSIONS This study identified maternal PTSD trajectories following the Wenchuan earthquake. Chronic PTSD symptoms in mothers were associated with increased risk of children's PTSD and anxiety 10 years after the earthquake.
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Affiliation(s)
- Xiao-Yan Chen
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, Guangdong, China
| | - Jieling Chen
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Xuliang Shi
- College of Education, Hebei University, Hebei, China
| | - Min Jiang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, Guangdong, China
| | - Yuanyuan Li
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, Guangdong, China
| | - Ya Zhou
- Department of Psychology, Lund University, 221 00 Lund, Sweden
| | - Maosheng Ran
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Yuan Lai
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, Guangdong, China
| | - Tong Wang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, Guangdong, China
| | - Fang Fan
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, Guangdong, China.
| | - Xianchen Liu
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, Guangdong, China
| | - Cecilia Lai Wan Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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35
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Ireland JL, Mann S, Lewis M, Ozanne R, McNeill K, Ireland CA. Psychopathy and trauma: Exploring a potential association. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2020; 69:101543. [PMID: 32241459 DOI: 10.1016/j.ijlp.2020.101543] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 12/13/2019] [Accepted: 01/10/2020] [Indexed: 06/11/2023]
Abstract
This research presents a series of linked studies exploring the association between psychopathy and trauma. It comprises a systematic review (n = 58), followed by an expert Delphi (n = 19), and patient file trawl using a male forensic psychiatric patient sample (n = 66). An association between psychopathy and developmental trauma was predicted. It was further predicted that different types of trauma would be associated with different subtypes of psychopathy and that the severity of trauma would be important. The systematic review identified the following core themes: presence of Post-Traumatic Stress Disorder and/or symptoms; trauma type; trauma/abuse variables; and sex differences. The ensuing Delphi study indicated the specific variant of psychopathy to be important, with secondary psychopathy particularly relevant. The final study found that the severity of developmental trauma related differentially to primary and secondary psychopathy. Implications and directions for future research are discussed, most notably with regards to the conceptualisation of psychopathy.
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Affiliation(s)
- Jane L Ireland
- School of Psychology, University of Central Lancashire, Preston & Ashworth Research Centre, Mersey Care NHS Trust, Liverpool, UK.
| | - Sophie Mann
- School of Psychology, University of Central Lancashire, Preston & Ashworth Research Centre, Mersey Care NHS Trust, Liverpool, UK
| | - Michael Lewis
- School of Psychology, University of Central Lancashire, Preston & Ashworth Research Centre, Mersey Care NHS Trust, Liverpool, UK
| | - Rebecca Ozanne
- School of Psychology, University of Central Lancashire, Preston & Ashworth Research Centre, Mersey Care NHS Trust, Liverpool, UK
| | - Kimberley McNeill
- School of Psychology, University of Central Lancashire, Preston & Ashworth Research Centre, Mersey Care NHS Trust, Liverpool, UK
| | - Carol A Ireland
- School of Psychology, University of Central Lancashire, Preston & Ashworth Research Centre, Mersey Care NHS Trust, Liverpool, UK
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36
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Louison Vang M, Ali SA, Christiansen DM, Dokkedahl S, Elklit A. The role of age and mode of delivery in the STEPS intervention: a longitudinal pilot-study in treatment of posttraumatic stress symptoms in Danish survivors of sexual assault. Eur J Psychotraumatol 2020; 11:1701778. [PMID: 32082508 PMCID: PMC7006682 DOI: 10.1080/20008198.2019.1701778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 10/22/2019] [Accepted: 11/11/2019] [Indexed: 11/05/2022] Open
Abstract
Background: The STEPS programme has been succesfully implemented as a group-based treatment of trauma symptoms after rape for adolescents. The STEPS intervention was translated from Dutch to Danish and offered to adults in addition to adolescents as well as an individual intervention in addition to a group-based intervention at a Danish Centre for Rape Victims through 2011 to 2014. The programme was translated from Dutch to Danish and expanded to adults in addition to adolescents as well as to an individual intervention in addition to a group-based intervention at a Danish Centre for Rape Victims through 2011 to 2014. Objective: The present study observes development in trauma symptoms and ICD-11 diagnostic status during an adapted version of the intervention programme 'STEPS' for survivors of sexual assault. Methods: A prospective uncontrolled study was conducted, monitoring symptoms of posttraumatic stress and other trauma-related symptomatology before treatment, after treatment and at 6 and 12 months' follow up for 103 referrals receiving individual or group-based STEPS. Tentative diagnoses of posttraumatic stress disorder (PTSD) and complex PTSD were assigned to participants according to the ICD-11 to observe the development in diagnostic status across time, and multilevel modelling was used to assess the development of symptom severity and to assess the moderating effect of age-group and mode of delivery. Results: A loglinear function representing large and statistically significant decline in symptomatology over time provided the best fit for all measures of trauma-related symptomatology. The decline was not moderated by age-group or mode of intervention. Dropout rates were independent of mode of intervention and age. Conclusion: The adaption of the STEPS programme to adults and as an individual intervention is feasible and maintains effect sizes comparable to those observed in the original intervention. Further research using randomized controlled trials is needed to ascribe the observed effect to the STEPS programme.
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Affiliation(s)
- M Louison Vang
- School of Psychology, Ulster University, Northern Ireland, UK.,The Collaborative Network for Training and Excellence in Psychotraumatology (CONTEXT).,National Center for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - S A Ali
- National Center for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - D M Christiansen
- National Center for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - S Dokkedahl
- National Center for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - A Elklit
- National Center for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
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37
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Cho S, Glassner S. Examining the Mediating Effects of Negative Emotions on the Link between Multiple Strains and Suicidal Ideation: A Longitudinal Analysis. Arch Suicide Res 2020; 24:380-399. [PMID: 30857498 DOI: 10.1080/13811118.2019.1586604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Research suggests that various strains contribute to suicidal ideation, and the source of strain often indirectly affects suicidal ideation through negative affective states. The current study examines if the mediating effects of negative emotions from multiple strains is non-0, and the extent to which negative emotions transmis the effect of multiple strains on suicidal ideation. Self-reported data from a sample of Korean youth are analyzed in the mediation tests conducted here. Results indicate that bullying victimization, child abuse, and peer conflict have a direct effect on suicidal ideation in the causal steps analysis. However, the direct effects disappear when using the causal steps approach, which accounts for the mediating effect of negative emotions. Overall, it appears that various strains indirectly affect suicidal ideation through negative emotions. Implications and directions for future research are discussed.
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Affiliation(s)
- Sujung Cho
- Sujung Cho, Department of Criminology and Criminal Justice, Southern Illinois University, Carbondale, IL, USA
| | - Steven Glassner
- Steven Glassner, School of Criminology, Criminal Justice, and Strategic Studies, Tarleton State University, Stephenville, TX, USA
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38
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Haag K, Hiller R, Peyk P, Michael T, Meiser-Stedman R, Fearon P, Ehlers A, Halligan SL. A Longitudinal Examination of Heart-Rate and Heart Rate Variability as Risk Markers for Child Posttraumatic Stress Symptoms in an Acute Injury Sample. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 47:1811-1820. [PMID: 31073881 PMCID: PMC6805807 DOI: 10.1007/s10802-019-00553-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Heart rate (HR) alterations in the immediate aftermath of trauma-exposure have been proposed to be potentially useful markers for child and adolescent posttraumatic stress disorder (PTSD). However, it is not yet clear if this holds true for measures taken more distal to the trauma, and no studies have investigated the predictive validity of more sensitive HR variability (HRV) indices. We recruited 76 parent-child pairs (child age 6 to 13 years) after the child experienced a traumatic event leading to presentation at a hospital emergency department. At 1-month post trauma (T1), HR recordings were obtained at rest, and while children verbally recounted their traumatic experience, both alone and together with a parent. Child post-traumatic stress symptoms (PTSS) were assessed concurrently (T1), and at 3 (T2) and 6-month (T3) follow-ups. We found that for T1, elevated mean HR during trauma narratives, but not at baseline, was positively associated with PTSS, with some evidence that HRV-indices were negatively cross-sectionally associated with PTSS. Furthermore, T1 HR indices predicted PTSS at T2 and partially at T3, although these effects did not hold when T1 PTSS were added to the model. Findings suggest that, consistent with the adult literature, HR indices in children may be a concurrent marker of higher PTSS and may be predictive of longer term distress. The findings encourage further investigations that track child HR and HRV in relation to PTSS over time after trauma, in order to examine how biological profiles evolve in those with persistent symptoms.
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Affiliation(s)
| | - Rachel Hiller
- Department of Psychology, University of Bath, Bath, UK
| | - Peter Peyk
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
| | - Tanja Michael
- Department for Clinical Psychology and Psychotherapy, University of Saarland, Saarbrücken, Germany
| | | | - Pasco Fearon
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Anke Ehlers
- Department of Psychology, University of Oxford, Oxford, UK
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK.
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
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Marusak HA, Harper FW, Taub JW, Rabinak CA. Pediatric cancer, posttraumatic stress and fear-related neural circuitry. Int J Hematol Oncol 2019; 8:IJH17. [PMID: 31467663 PMCID: PMC6714068 DOI: 10.2217/ijh-2019-0002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
This review examines the neurobiological effects of pediatric cancer-related posttraumatic stress symptoms (PTSS). We first consider studies on prevalence and predictors of childhood cancer-related PTSS and compare these studies to those in typically developing (i.e., noncancer) populations. Then, we briefly introduce the brain regions implicated in PTSS and review neuroimaging studies examining the neural correlates of PTSS in noncancer populations. Next, we present a framework and recommendations for future research. In particular, concurrent evaluation of PTSS and neuroimaging, as well as sociodemographic, medical, family factors, and other life events, are needed to uncover mechanisms leading to cancer-related PTSS. We review findings from neuroimaging studies on childhood cancer and one recent study on cancer-related PTSS as a starting point in this line of research.
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Affiliation(s)
- Hilary A Marusak
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy & Health Sciences, Wayne State University, Detroit, MI 48201, USA.,Population Studies & Disparities Research Program, Karmanos Cancer Institute, Detroit, MI 48201, USA
| | - Felicity W Harper
- Population Studies & Disparities Research Program, Karmanos Cancer Institute, Detroit, MI 48201, USA.,Department of Oncology, School of Medicine, Wayne State University, Detroit, MI 48201, USA
| | - Jeffrey W Taub
- Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI 48201, USA.,Children's Hospital of Michigan, Detroit, MI 48201, USA
| | - Christine A Rabinak
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy & Health Sciences, Wayne State University, Detroit, MI 48201, USA.,Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy & Health Sciences, Wayne State University, Detroit, MI 48201, USA.,Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI 48201, USA
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40
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The Prevalence of PTSD Symptoms and Depressive Symptoms and Related Predictors in Children and Adolescents 3 Years After the Ya'an Earthquake. Child Psychiatry Hum Dev 2019; 50:300-307. [PMID: 30302576 DOI: 10.1007/s10578-018-0840-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The objectives of this study were to investigate the prevalence of post-traumatic stress disorder (PTSD) symptoms and depressive symptoms in teenage survivors three years after the Ya'an earthquake to assess the differences between left-behind (LBC) and non-left-behind (non-LBC) children, and to explore predictors for PTSD symptoms and depressive symptoms. The participants were assessed using children's revised impact of event scale (CRIES) and short mood and feelings questionnaire (SMFQ), after which t tests, Chi square tests, and a multivariate logistic regression were conducted to examine the differences in the LBC and identify the associated predictors. It was found that the PTSD and depressive symptom prevalences were 13.10% and 20.75%, with the LBC having a significantly higher prevalence than the non-LBC. The PTSD and depression symptoms tended to be highly comorbid (r = .52, p < .001). Being female, being aged less than 15, having siblings, being an LBC, and having higher exposure were found to be associated with PTSD and depressive symptoms.
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Williamson V, Creswell C, Butler I, Christie H, Halligan SL. Parental Experiences of Supporting Children with Clinically Significant Post-Traumatic Distress: a Qualitative Study of Families Accessing Psychological Services. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2019; 12:61-72. [PMID: 32318180 PMCID: PMC7163877 DOI: 10.1007/s40653-017-0158-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of this study was to investigate the experiences of parents in providing support to their child following trauma exposure in cases where children are experiencing clinically significant levels of post-traumatic distress. Qualitative interviews were conducted with parents whose child was exposed to a trauma and referred for psychological treatment. Parents reported considerable anxiety in coping with their child's post-traumatic distress. Avoidance of trauma-related discussions was encouraged due to concerns that non-avoidant approaches may worsen children's post-trauma difficulties. Nonetheless, parents were often sensitive to their child's distress and offered reassurance and other forms of support. Many barriers existed to accessing psychological treatment, and perceptions of inadequate guidance from therapists on supporting child adjustment contributed to parental distress. The results illustrate the strategies used by parents in supporting their child post-trauma and may assist mental health professionals in providing acceptable guidance to parents following child trauma.
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Affiliation(s)
| | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6UA UK
| | - Ian Butler
- Department of Humanities and Social Sciences, University of Bath, Bath, BA2 7AY UK
| | - Hope Christie
- Department of Psychology, University of Bath, Bath, BA2 7AY UK
| | - Sarah L. Halligan
- Department of Psychology, University of Bath, Bath, BA2 7AY UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, 7700 South Africa
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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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Mangelsdorf SN, Mehl MR, Qiu J, Alisic E. How Do Mothers and Fathers Interact With Their Children After An Injury? Exploring the Role of Parental Acute Stress, Optimism, and Self-Efficacy. J Pediatr Psychol 2019; 44:311-322. [DOI: 10.1093/jpepsy/jsy107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 11/28/2018] [Accepted: 12/05/2018] [Indexed: 01/23/2023] Open
Affiliation(s)
- Shaminka N Mangelsdorf
- School of Psychological Sciences, Monash University
- Monash University Accident Research Centre, Monash University
| | | | - Jianrong Qiu
- Monash University Accident Research Centre, Monash University
| | - Eva Alisic
- Murdoch Children’s Research Institute
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, The University of Melbourne
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Gindt M, Thümmler S, Soubelet A, Guenolé F, Battista M, Askenazy F. Methodology of "14-7" Program: A Longitudinal Follow-Up Study of the Pediatric Population and Their Families Exposed to the Terrorist Attack of Nice on July 14 th, 2016. Front Psychiatry 2019; 10:629. [PMID: 31572232 PMCID: PMC6751885 DOI: 10.3389/fpsyt.2019.00629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 08/05/2019] [Indexed: 11/24/2022] Open
Abstract
Introduction: After a traumatic event, children and adolescents may present several clinical consequences, the most common being Post-Traumatic Stress Disorder (PTSD). Most children and adolescents with PTSD have comorbid disorders, such Attention Deficit Hyperactivity Disorder, depression, attachment and anxiety disorders, sleep disturbances and behavior problems. However, epidemiological studies on the development of PTSD and other psychiatric disorders in children and adolescents as a consequence of a terrorist attack and mass murder are lacking. Long-term follow-up of exposed children and adolescents will help identify risk and protective factors of developing psychiatric and psychological conditions after exposure to traumatic events or situations. The main objective of this article is to present the methodology of "14-7" program. The aim of "14-7" program is to characterize the risk and protective psychosocial factors affecting the clinical evolution of a pediatric population sample, exposed to the terrorist attack of July 14th, 2016 in Nice. Method and Analysis: "14-7" program is a multicentre longitudinal cohort study. Major inclusion criteria are children and adolescents exposed to the terrorist attack and aged under 18 years on July 14th, 2016. These children and adolescents will be compared to a non-exposed to the "14-7" terrorist attack group, matched on age and gender. Participants will be assessed at baseline (T1), 2 years (T2) and 5 years (T3) after the initial assessment (T1), and every 5 years until they are 25 years old. Multiple domains are assessed: 1) mental health disorders, 2) intensity of PTSD symptoms, 3) intensity of comorbid symptoms, 4) quality of the parent-child relationship, 5) intelligence quotient, 6) parental symptoms. We will also establish a biological collection of saliva samples, magnetic resonance imaging (MRI) and actigraphy data collection. Main analyses comprise analyses of variance and regression analyses of predictors of clinical evolution over time. Ethics and Dissemination: The National Ethics Committee "NORD OUEST III" approved the "14-7" Program protocol (number 2017-A02212-51). All patients and their caregivers signed informed consent on enrolment in the "14-7" Program. Inclusions started on November 21st, 2017. Three hundred thirty-five individuals have been included (191 children and adolescents, 144 parents). Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03356028.
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Affiliation(s)
- Morgane Gindt
- Hôpitaux Pédiatriques de Nice CHU-Lenval, Nice, France.,Université Côte d'Azur, Nice, France
| | - Susanne Thümmler
- Hôpitaux Pédiatriques de Nice CHU-Lenval, Nice, France.,Université Côte d'Azur, Nice, France
| | - Andréa Soubelet
- Hôpitaux Pédiatriques de Nice CHU-Lenval, Nice, France.,Université Côte d'Azur, Nice, France
| | | | | | - Florence Askenazy
- Hôpitaux Pédiatriques de Nice CHU-Lenval, Nice, France.,Université Côte d'Azur, Nice, France
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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.
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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
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Centrality of Event and Mental Health Outcomes in Child and Adolescent Natural Disaster Survivors. SPANISH JOURNAL OF PSYCHOLOGY 2018; 21:E61. [PMID: 30477589 DOI: 10.1017/sjp.2018.58] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The experience of trauma could be considered a central event in one's life, such that it could be a core component of one's identity and life story. Indeed, trauma memories are well-remembered, vivid, intense, and easily accessible (Berntsen & Rubin, 2006). The present study investigated the mediating role of sensory-based trauma memory quality in the relationship between centrality of event and mental health outcomes among child and adolescent survivors of a natural disaster (N = 225) in its immediate aftermath. Results of mediation analyses revealed that centrality of trauma event is related to symptoms of acute stress disorder and depression through sensory-based trauma memory quality (indirect effect 95% C.I. [.06, .11] and [.04, .10], respectively). These findings support the contention that centrality of event is associated to heightened accessibility and vividness of sensory-based trauma memory quality, which in turn is related to an increase in trauma-related symptoms in the immediate aftermath of a natural disaster, where the reminders of trauma are particularly salient in the survivors' environment and daily activities.
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47
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Diab SY, Palosaari E, Punamäki RL. Society, individual, family, and school factors contributing to child mental health in war: The ecological-theory perspective. CHILD ABUSE & NEGLECT 2018; 84:205-216. [PMID: 30118970 DOI: 10.1016/j.chiabu.2018.07.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 07/12/2018] [Accepted: 07/29/2018] [Indexed: 06/08/2023]
Abstract
Mental health problems are common in war-affected areas, but children have different levels of vulnerability. Based on ecological theory (Bronfenbrenner, 2005), this study analyses how factors related to the child (cognitive capacity), their family (parental depression and parenting styles), and their school (teachers' practices and peer relations) mediate the association between traumatic stress (traumatic war experiences and stressful life-events) and child mental health (posttraumatic stress and psychological distress symptoms). The participants were 303 Palestinian children (51.2% girls) of 10-13 years (M = 10.94 ± 0.50) and their parents from the Gaza Strip. The children filled in questionnaires during school classes and the parents did so at their homes. The results of structural equation modeling substantiated the hypothesis that parental depression, poor parenting and low-quality peer relations mediated between traumatic stress and children's mental health problems. Contrary to the hypothesis, child-related factors did not mediate that association. To conclude, parents and peers provide important age-salient social resources for children in war conditions, and psychosocial interventions should therefore enhance their beneficial functions.
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Affiliation(s)
| | - Esa Palosaari
- University of Tampere, Tampere, Aalto University, Helsinki, Finland
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48
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Bruce MM, Kassam-Adams N, Rogers M, Anderson KM, Sluys KP, Richmond TS. Trauma Providers' Knowledge, Views, and Practice of Trauma-Informed Care. J Trauma Nurs 2018; 25:131-138. [PMID: 29521782 PMCID: PMC5968451 DOI: 10.1097/jtn.0000000000000356] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Trauma-informed interventions have been implemented in various settings, but trauma-informed care (TIC) has not been widely incorporated into the treatment of adult patients with traumatic injuries. The purpose of this study was to examine health care provider knowledge, attitudes, practices, competence, and perceived barriers to implementation of TIC. This cross-sectional study used an anonymous web-based survey to assess attitudes, knowledge, perceived competence, and practice of TIC among trauma providers from an urban academic medical center with a regional resource trauma center. Providers (nurses, physicians, therapists [physical, occupational, respiratory]) working in trauma resuscitation, trauma critical care, and trauma care units were recruited. Descriptive statistics summarized knowledge, attitudes, practice, competence, and perceived barriers to TIC and logistic regression analyses examined factors predicting the use of TIC in practice. Of 147 participants, the majority were nurses (65%), followed by therapists (18%) and physicians (17%), with a median 3 years of experience; 75% answered the knowledge items correctly and 89% held favorable opinions about TIC. Nineteen percent rated themselves as less than "somewhat competent." All participants rated the following as significant barriers to providing basic TIC: time constraints, need of training, confusing information about TIC, and worry about retraumatizing patients. Self-rated competence was the most consistent predictor of providers' reported use of specific TIC practices. Despite some variability, providers were generally knowledgeable and held favorable views toward incorporating TIC into their practice. TIC training for trauma providers is needed and should aim to build providers' perceived competence in providing TIC.
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Affiliation(s)
- Marta M. Bruce
- Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Nancy Kassam-Adams
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
- Children’s Hospital of Pennsylvania, Philadelphia, PA, USA
| | - Mary Rogers
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kerstin Prignitz Sluys
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Red Cross University College, Stockholm, Sweden
| | - Therese S. Richmond
- Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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49
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Measuring Adolescent Coping Styles Following a Natural Disaster: An ESEM Analysis of the Kidcope. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9288-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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50
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Abstract
PURPOSE OF REVIEW This review summarizes the latest evidence and developments in the validation of PTSD diagnostic criteria for children 6 years and under (PTSD<6Y), discusses the limitations of the current diagnostic criteria, and highlights areas for future research. RECENT FINDINGS Research has found that the DSM-5 PTSD<6Y, and a similar version in the DC:0-5, currently provides the most developmentally sensitive classification of PTSD for young children. In contrast, preliminary evidence suggests that the ICD-11 criteria might not appropriately capture PTSD in young children. The inclusion of PTSD<6Y, the first developmental subtype in the DSM-5, represents an important step towards having a diagnostic system that is developmentally sensitive and relevant across the life span. However, further validation work and research with regard to the definition of trauma and functional impairment as well as with the age-appropriate description of symptoms is needed, especially in the youngest age group (0-3 years).
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Affiliation(s)
- Alexandra C De Young
- Child Health Research Centre, The University of Queensland, Level 7, 62 Graham Street, South Brisbane, QLD, 4101, Australia.
| | - Markus A Landolt
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland.,Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland
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