Temporal Relationships between PTSD Symptoms and Social Functioning among Adolescents in Residential Care

Exploring curvilinear and reciprocal relationships between posttraumatic stress and growth in adolescents and mothers following a major earthquake

Posttraumatic stress disorder (PTSD) commonly occurs in adolescents and adults following earthquakes. Conversely, they may also experience posttraumatic growth, which can enhance their functioning and overall well-being. Notably, parental and children's PTSD and posttraumatic growth can be reciprocal, particularly in cases where both parents and children are exposed to the disaster. The present study examined PTSD symptoms and posttraumatic growth among both adolescents and their mothers in the aftermath of the 2023 Kahramanmaraş earthquake in Türkiye. This study included adolescents (n = 198) aged 10-18 years and their mothers, all of whom were patients at a child and adolescent psychiatry outpatient clinic. Data were collected through structured face-to-face interviews, adhering to DSM-5 criteria, from July to August 2024, approximately 17-18 months post-earthquake. According to clinical evaluations, 6.1% of adolescents (n = 12) were diagnosed with PTSD. There was a curvilinear relationship between PTSD symptoms and posttraumatic growth in both adolescents and their mothers. Additionally, adolescents' posttraumatic growth positively predicted maternal posttraumatic growth scores, but not vice versa. These findings underscore the interconnectedness of PTSD symptoms between parents and children, emphasizing the need to monitor both groups' well-being during the post-earthquake period. Additional longitudinal research is needed to comprehensively investigate the relationship between PTSD and posttraumatic growth in both adolescents and their parents.

Reciprocal changes in functioning and PTSD symptoms over the course of psychotherapy

Psychotherapies for posttraumatic stress disorder (PTSD) assume that PTSD symptom improvement will lead to improvements in functioning. Yet, few studies have examined the dynamic interplay between these constructs. Using a random intercepts cross-lagged panel model, we examined the association between functioning and PTSD, both modeled as a total score and as the DSM-5 subclusters, across twelve sessions of treatments that chiefly target functioning. Participants were 161 Veterans with PTSD enrolled in a randomized controlled trial comparing present centered therapy and an enhanced version of adaptive disclosure. Overall, PTSD symptoms, measured as the total PTSD score, led to changes in functioning more frequently than functioning predicting PTSD symptoms, although these effects did not appear until session 7. In terms of subclusters, functioning predicted changes in the PTSD subclusters B (intrusions), C (avoidance), and E (alterations in arousal and reactivity) at more timepoints compared to timepoints at which these subclusters predicted functioning. The dynamic relationships between PTSD and functioning in the context of functioning-focused treatments are complex, with functioning playing an important role in reduction of some of the core symptoms of PTSD.