A Cartoon-Based Measure of PTSD Symptomatology in Children Exposed to a Disaster

Children's Psychological Reactions to Wildfires: a Review of Recent Literature

PURPOSE OF REVIEW

This review aims to synthesize currently available literature regarding the impact of wildfire on mental health, specifically the psychological reactions of children to wildfires. The information gathered from this review will help health experts understand and address the mental health needs of children during wildfire disasters and may serve as a base for future studies to evaluate evidence-based public health responses to mitigate adverse outcomes.

RECENT FINDINGS

The results identified post-traumatic stress disorder (PTSD), anxiety, depression, stress, alcohol/substance misuse, hopelessness, low resilience, reduced quality of life, and self-esteem as the psychological conditions manifesting in children and adolescent post-wildfire disaster. PTSD was the most evaluated psychological reaction in the participants (7 out of eight studies). This review highlights that deleterious mental health effects, such as PTSD, depression, anxiety, and suicidality, can persist in children for years post-wildfire disaster. Factors such as gender, direct exposure to the wildfire, re-traumatization, and resilience informed or ameliorated the severity of the impact of wildfire on children and adolescents. Our findings further emphasize the need for multi-year funding and programs to support children and adolescents' mental health, including children with disabilities in the communities that have experienced wildfire disasters.

Validation of the "Darryl" PTSD Cartoon Test with Abused Children

Background

There is a lack of reliable and valid PTSD tests for young children that cannot read or are weak readers. The semi-projective cartoon test, "Darryl", which is read aloud, is a measure that appeals to this age group. The test has been applied in both clinical and epidemiological studies.

Objective

to validate a cartoon test, "Darryl", for children aged 6 or older in a population of children suspectedly sexually and/or physically abused.

Methods

In the Danish Child Centres, 327 children were screened with Darryl as part of an assessment for further intervention. The Bech Youth Inventory was filled out by 113 children, and 63 caregivers filled out the Strengths & Difficulties Questionnaire. Correlations were used to study the convergent validity between the scales and subscales and effect sizes were estimated. Reliability of the scales was investigated using Cronbach's alpha.

Results

Following the DSM-IV, 55.7% of the children (n = 182) had a possible PTSD diagnosis. More girls (n = 110, 62.9 %) than boys (n = 72, 47.4%) had PTSD. A total of 21.7 % (n = 71) had subclinical PTSD, lacking only one symptom of the full diagnosis. There was no significant difference in PTSD regarding physical or sexual abuse.

Clinical significance

The test allows clinicians in the pediatric field to screen for possible PTSD in a population where systematic self-report data have paramount importance.

Conclusions

Darryl appears to be a valid and reliable test for screening young children who have been physically or sexually abused. The test is helpful for clinician working with young children to identify those have developed trauma symptoms to secure them early treatment.

Post-traumatic stress disorder (PTSD) symptoms in children with severe epilepsy

OBJECTIVES

To assess symptoms of post-traumatic stress disorder (PTSD) in children with severe epilepsy and the associations of trauma symptoms across age, comorbid symptoms, epilepsy-specific factors, parental resources, and psychopathology.

METHODS

Fifty children with severe epilepsy across three different age groups (0-5 yrs., 6-12 yrs., 13-18 yrs.) were assessed with developmental-sensitive and standardized PTSD assessment tools when hospitalized at the tertiary epilepsy center Filadelfia, Denmark. The Diagnostic Infant and Preschool Assessment (DIPA), the Darryl test, and the ITQ questionnaire were used to assess the three age groups, respectively.

RESULTS

Twenty-two percent of the overall sample met the criteria for PTSD, with a prevalence of symptoms increasing with age (6%, 28%, and 40%). Comorbid psychiatric symptoms in preschoolers were present in 81% of the children witnessing a high level of distress in this group. Behavioral difficulties were elevated across all three age groups, and 40% of the children with trauma symptoms had a parent with concurrent psychopathology.

CONCLUSION

To the authors' knowledge, this study is the first to assess trauma symptoms with standardized tests in children with more complicated epilepsies. Trauma symptoms in the group are high; however, there is a need for larger scale studies and research into trauma symptoms in children with more severe epilepsy than those assessable with the included assessment tools. The trauma perspective in severe childhood epilepsy might further clarify the complex associations of biological and contextual variables that affect the children's life quality and enable better preventative treatment options for this group.

Validation of the PTSD screening cartoon test "Darryl" in a Danish clinical sample of children and adolescents

The current study examined the reliability and validity of a Danish adaptation of "Darryl", a cartoon-based measure of DSM-IV symptoms of post-traumatic stress disorder (PTSD) in a sample of Danish children and adolescents. Exposure to potentially traumatizing events, PTSD symptoms and diagnostic status were assessed in 65 children between the ages of 7 and 17 years old. Participants were recruited from a crisis centre for battered women and a school for children with emotional and behavioural problems. The study revealed that Darryl has good internal consistency for the overall scale and adequate reliability for each DSM-IV symptom cluster. Scores from Darryl were significantly correlated with the Clinician Administered PTSD Scale for Children and Adolescents (CAPS-CA) scores and receiver operating characteristic (ROC) analysis showed that it could significantly predict the presence of a PTSD diagnosis according to the CAPS-CA. In comparison to the CAPS-CA, Darryl has comparable psychometric properties and assesses PTSD symptoms in a developmentally appropriate manner. Furthermore, Darryl is quick to administer and was easier for the children in this sample to comprehend than the more traditional measure of PTSD. Overall, Darryl is an effective instrument for screening children at risk of a PTSD diagnosis. The relatively high specificity suggests that screening positive for PTSD using Darryl merits further diagnostic assessment. Copyright © 2016 John Wiley & Sons, Ltd.