1
|
Sloover M, Stoltz SEM, van Ee E. Parent-Child Communication About Potentially Traumatic Events: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:2115-2127. [PMID: 37946404 PMCID: PMC11155229 DOI: 10.1177/15248380231207906] [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: 11/12/2023]
Abstract
Social support plays an important role in children's well-being after experiencing a potentially traumatic event (PTE). One such source of support is the parent-child relationship, specifically by discussing the event. However, current literature provides no consensus on whether parents and children communicate about PTEs, in what way they might communicate and how this affects the child. Hence the goal of the current study is threefold, to explore: (a) whether parents and children communicate about PTEs, (b) what this communication looks like, and (c) how this affects children's well-being. These questions are answered by means of a systematic literature review. Articles were eligible for inclusion if it was an empirical study on communication between parents and children about a PTE that the child (under 18 years) had experienced. Initial searches in electronic databases provided 31,233 articles, of which 26 were deemed eligible for inclusion. Results show that most parents and children have discussed PTEs, but that this may depend on cultural background. What the parent-child communication looks like depends on various factors such as, age of the child, tone, and child's initiation of discussion. Parental post-traumatic stress symptoms seem to negatively impact communication. The results of the impact of communication are less clear-cut, but it seems to have a predominantly positive effect on the child's well-being, depending on parental sensitivity. Clinicians should be watchful for parental symptoms of post-traumatic stress disorder and can focus on promoting parental sensitivity and responsiveness when discussing PTEs with their child or on creating a joint narrative within families.
Collapse
Affiliation(s)
| | | | - Elisa van Ee
- Radboud University Nijmegen, The Netherlands
- Psychotraumacentrum Zuid Nederland, Reinier van Arkel, s-Hertogenbosch, The Netherlands
| |
Collapse
|
2
|
Rinne-Wolf S, Finkeldei S, Kern T. Breaking the news of the violent death of a close person to children under 18 years of age: A qualitative interview study. DEATH STUDIES 2024:1-15. [PMID: 38588451 DOI: 10.1080/07481187.2024.2337210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Children who lose a close person to suicide or homicide will most likely receive this news from a carer. The caregiver's personal beliefs and approaches to addressing the topic will influence the child. A total of 10 interviews were conducted with carers of children aged 0-17 years, and the data were analyzed using reflexive thematic analysis. Four themes were developed, exploring: (1) how carers attempted to manage the task of delivering the news of death to the child and discussing it using careful wording; (2) how some carers' desire to protect the child from the truth hindered honesty and open conversations; (3) how and why some carers deliberately challenged societal taboos; and (4) how external influences prompted conversations about the topic. The discussion projects potential consequences for the children and their families. It also derives necessary societal changes, support measures, and further research suggestions.
Collapse
Affiliation(s)
- Susanna Rinne-Wolf
- AETAS Children's Foundation, Munich, Germany
- Chair for Public Health and Health Services Research, Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität (LMU) Munich, Germany
| | - Simon Finkeldei
- AETAS Children's Foundation, Munich, Germany
- Institute for Psychology, University Innsbruck, Austria
| | - Tita Kern
- AETAS Children's Foundation, Munich, Germany
- Institute for Psychology, University Innsbruck, Austria
| |
Collapse
|
3
|
Chiu HTS, Low DCW, Chan AHT, Meiser-Stedman R. Relationship between anxiety sensitivity and post-traumatic stress symptoms in trauma-exposed adults: A meta-analysis. J Anxiety Disord 2024; 103:102857. [PMID: 38507961 DOI: 10.1016/j.janxdis.2024.102857] [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] [Received: 09/06/2023] [Revised: 12/21/2023] [Accepted: 03/07/2024] [Indexed: 03/22/2024]
Abstract
Given the high rate of trauma exposure among the general population, it is important to delineate the risk factors for post-traumatic stress disorder (PTSD). While historically implicated in panic disorder, anxiety sensitivity is increasingly found to play a role in PTSD. The present review investigated the size of the relationship between anxiety sensitivity and PTSD symptoms among trauma exposed adults. A systematic search on multiple electronic databases (PTSDpubs, CINAHL, MEDLINE and PsycINFO) generated a total of 1025 records, among which 52 (n = 15173) met study inclusion criteria and were included in our random effects meta-analysis. Our results indicated a medium effect size (r = .46, 95% CI =.41,.50) for the relationship between anxiety sensitivity and PTSD symptoms. There was significant between-study heterogeneity. Furthermore, sub-group analyses revealed that study design (cross-sectional vs. longitudinal) may significantly moderate the association between anxiety sensitivity and PTSD severity. No moderation effect was found for assessment of PTSD through interview versus questionnaire, interpersonal versus non-interpersonal trauma, or low versus high study quality. Such patterns of results are consistent with cognitive models of PTSD. Clinical implications, strengths and limitations of the review were discussed.
Collapse
Affiliation(s)
- Henry Tak Shing Chiu
- Department of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
| | - Debbie Chi Wing Low
- School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Angel Hiu Tung Chan
- Department of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| |
Collapse
|
4
|
Blix I, Glad KA, Undset A, Wentzel-Larsen T, Ottesen AA, Jensen TK, Dyb G. 'My child could have died': counterfactual thoughts and psychological distress in parents of trauma survivors. Eur J Psychotraumatol 2024; 15:2326736. [PMID: 38506895 PMCID: PMC10956913 DOI: 10.1080/20008066.2024.2326736] [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] [Received: 10/12/2023] [Accepted: 02/28/2024] [Indexed: 03/21/2024] Open
Abstract
Background: After exposure to a potentially traumatic event, survivors may experience thoughts about 'what could have happened', referred to as counterfactual thoughts (CFTs). CFTs have been found to have a negative impact on survivors' mental health. This is the first study to investigate whether parents of trauma survivors experience CFTs and the association with psychological distress in this group.Objective: The main aim of the present study is to investigate CFTs in parents of trauma survivors and the relationship between the frequency and vividness of CFTs and psychological distress.Method: The participants (N = 310, 191 females) were parents of the youths targeted in the terror attack on Utøya island, Norway, in 2011. Frequency and vividness of CFTs, posttraumatic stress reactions (PTSR), and symptoms of anxiety and depression were measured 8.5-9 years post-terror.Results: The majority of the parents (74%) reported having experienced CFTs at some time point since the attack. For almost one-third of the parents, CFTs were still present more than eight years after the attack. Higher frequency and vividness of CFTs were uniquely associated with higher levels of PTSR, anxiety, and depression.Conclusion: The present findings suggest that frequent and vivid CFTs may contribute to mental health problems in parents of trauma survivors and should be addressed in therapy.
Collapse
Affiliation(s)
- Ines Blix
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Department of psychology, Oslo New University College, Oslo, Norway
| | - Kristin Alve Glad
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Andrea Undset
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway
| | | | - Tine K. Jensen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Grete Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
5
|
Afzal N, Lyttle MD, Rajabi M, Rushton-Smith F, Varghese R, Trickey D, Halligan SL. Emergency department clinicians' views on implementing psychosocial care following acute paediatric injury: a qualitative study. Eur J Psychotraumatol 2024; 15:2300586. [PMID: 38197257 PMCID: PMC10783840 DOI: 10.1080/20008066.2023.2300586] [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] [Received: 08/22/2023] [Accepted: 12/18/2023] [Indexed: 01/11/2024] Open
Abstract
Introduction: The early post-trauma period is a key time to provide psychological support to acutely injured children. This is often when they present to emergency departments (EDs) with their families. However, there is limited understanding of the feasibility of implementing psychological support for children and their families in EDs. The aim of this study was to explore UK and Irish ED clinicians' perspectives on developing and implementing psychosocial care which educates families on their children's post-trauma psychological recovery.Methods: Semi-structured individual and group interviews were conducted with 24 UK and Irish ED clinicians recruited via a paediatric emergency research network.Results: Clinicians expressed that there is value in offering psychological support for injured children and their families; however, there are barriers which can prevent this from being effectively implemented. Namely, the prioritisation of physical health, time constraints, understaffing, and a lack of training. Therefore, a potential intervention would need to be brief and accessible, and all staff should be empowered to deliver it to all families.Conclusion: Overall, participants' views are consistent with trauma-informed approaches where a psychosocial intervention should be able to be implemented into the existing ED system and culture. These findings can inform implementation strategies and intervention development to facilitate the development and delivery of an accessible digital intervention for acutely injured children and their families.
Collapse
Affiliation(s)
- Nimrah Afzal
- Department of Psychology, University of Bath, Bath, UK
| | - Mark D. Lyttle
- Emergency Department, Bristol Royal Hospital for Children, Bristol, UK
- Research in Emergency Care Avon Collaborative Hub (REACH), University of the West of England, Bristol, UK
| | - Mohsen Rajabi
- Department of Psychology, University of Bath, Bath, UK
| | | | - Rhea Varghese
- Department of Psychology, University of Bath, Bath, UK
| | | | | | - on behalf of the Paediatric Emergency Research in the UK and Ireland (PERUKI)
- Department of Psychology, University of Bath, Bath, UK
- Emergency Department, Bristol Royal Hospital for Children, Bristol, UK
- Research in Emergency Care Avon Collaborative Hub (REACH), University of the West of England, Bristol, UK
- Anna Freud Centre, UK Trauma Council, London, UK
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Skandsen A, Sand L, Teicher MH, Heradstveit O, Bøe T. Exposure to potentially traumatic events and PTSD symptomatology in Norwegian 11-13-year-olds: results from the Bergen Child Study. Child Adolesc Psychiatry Ment Health 2023; 17:32. [PMID: 36870995 PMCID: PMC9985863 DOI: 10.1186/s13034-023-00578-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Exposure to potentially traumatic experiences (PTEs) is common among children and adolescents, but relatively little is known about the epidemiology of trauma and trauma-related psychopathology in children and youth. The present cross- sectional epidemiological study aimed to explore factors that is associated with posttraumatic stress symptoms (PTSS) in children. METHOD Data stem from the Bergen Child Study, a series of cross-sectional multi-phase surveys of children born between 1993 and 1995 in Bergen, Norway. The sample used is from the second wave of the Bergen Child Study (BCS) conducted in 2006, a two-phase study. The study entailed a detailed psychiatric evaluation using the Development and well-being assessment (DAWBA). The DAWBA was administered to parents or caregivers and covered diagnostic areas, child and family background, and child strengths. A total of 2043 parents participated. RESULTS Out of the total sample, parents reported that 4.8% children had experienced PTEs at some point in their lives. The findings revealed current PTSS in 30.9% of children exposed to PTE, which was 1.5% of the total sample. None of the parents reported PTSS in their children over the threshold for diagnosing posttraumatic stress disorder (PTSD). The most common PTSS cluster was arousal reactivity (90.0%), followed by negative cognitions and mood (80%). The least frequent symptom cluster was intrusions (63.3%) and avoidance (60%). Children with PTSS were reported to live in families with significantly more family stressors (p = 0.001, d = 0.8) and had utilized significantly more sources for help relative to those without PTSS (p = 0.001, d = 0.75). CONCLUSION The present population study on children revealed a lower prevalence rate of PTEs and PTSD than previous studies. It provided findings in the field of trauma on parent- reported PTSS and PTSD symptom clusters not restricted to the clinical level of PTSD. Lastly, it highlighted how family-life stressors and support differed between those who had PTSS and those with no PTSS.
Collapse
Affiliation(s)
- Annika Skandsen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway. .,Stavanger University Hospital, Gerd Ragna Bloch Thorsens Gate 25, Stavanger, Norway.
| | - Liv Sand
- Stavanger University Hospital, Gerd Ragna Bloch Thorsens Gate 25, Stavanger, Norway
| | - Martin H Teicher
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| | - Ove Heradstveit
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway.,Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Tormod Bøe
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway.,Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| |
Collapse
|
8
|
Post-traumatic Stress Disorder in Parents Following Their Child's Single-Event Trauma: A Meta-Analysis of Prevalence Rates and Risk Factor Correlates. Clin Child Fam Psychol Rev 2021; 24:725-743. [PMID: 34554357 PMCID: PMC8541994 DOI: 10.1007/s10567-021-00367-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 11/25/2022]
Abstract
Evidence suggests parents of children who experience a trauma may develop Post-Traumatic Stress Disorder (PTSD), which can have significant consequences for their own and their child’s functioning. As such, identifying the rates and possible correlates for the development of PTSD in parents is of clinical and theoretical importance, and would enhance our understanding of how best to support families in the aftermath of trauma. This meta-analysis of 41 studies (n = 4370) estimated the rate of PTSD in parents following their child’s single-incident trauma to be 17.0% (95% CI 14.1–20.0%); when removing samples which were mixed, or not exclusively single-incident traumas the prevalence estimate dropped to 14.4% (95% CI 10.8–18.5%). Pooled effect sizes of 32 potential correlates for parents developing PTSD were also identified. Medium-to-large effects were found for factors relating to the parent’s post-traumatic cognition, psychological functioning and coping strategies alongside child PTSD. Small effects were found for pre-trauma factors, objective trauma-related variables and demographic factors for both parent and child. Results are consistent with cognitive models of PTSD, suggesting peri- and post-trauma factors are likely to play a substantial role in its development. These findings indicate the clinical need for screening parents most vulnerable to adverse post-traumatic reactions within the context of child trauma and tailoring interventions to include the family where necessary.
Collapse
|
9
|
van Meijel EPM, Gigengack MR, Verlinden E, van der Steeg AFW, Goslings JC, Bloemers FW, Luitse JSK, Boer F, Grootenhuis MA, Lindauer RJL. Long-Term Posttraumatic Stress Following Accidental Injury in Children and Adolescents: Results of a 2-4-Year Follow-Up Study. J Clin Psychol Med Settings 2020; 26:597-607. [PMID: 30924029 PMCID: PMC6851392 DOI: 10.1007/s10880-019-09615-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
In this study, we determined the long-term prevalence of posttraumatic stress disorder (PTSD) in children and adolescents after accidental injury and gained insight into factors that may be associated with the occurrence of PTSD. In a prospective longitudinal study, we assessed diagnosed PTSD and clinically significant self-reported posttraumatic stress symptoms (PTSS) in 90 children (11–22 years of age, 60% boys), 2–4 years after their accident (mean number of months 32.9, SD 6.6). The outcome was compared to the first assessment 3 months after the accident in 147 children, 8–18 years of age. The prevalence of PTSD was 11.6% at first assessment and 11.4% at follow-up. Children with PTSD or PTSS reported significantly more permanent physical impairment than children without. Children who completed psychotherapy had no symptoms or low levels of symptoms at follow-up. Given the long-term prevalence of PTSD in children following accidents, we recommend systematic monitoring of injured children. The role of possible associated factors in long-term PTSS needs further study.
Collapse
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, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam & VU University, Amsterdam, 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, Wilhelmina Children's Hospital, 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
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Li Y, Shi X, McReynolds LS, Tang H, Chen H, Wang T, Zhang Y, Geng F, Fan F, Hoven CW. Depressive symptoms between parent and adolescent survivors: A longitudinal actor-partner interdependence model. J Affect Disord 2020; 265:139-145. [PMID: 32090735 DOI: 10.1016/j.jad.2020.01.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 12/04/2019] [Accepted: 01/11/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The association between parent-child depression following disasters has been well documented. However, longitudinal studies of posttraumatic depression using parent-child dyadic are scarce. This study aimed to investigate inter-related effects between parent and child depression, as well as predictors of depressive symptoms, in a large sample of Wenchuan earthquake survivors. METHODS Data are from the Wenchuan Earthquake Adolescent Health Cohort (WEAHC) Study that included 685 parent-child dyads exposed to the earthquake. Depression was assessed with the Self-Rating Depression Scale (for parents) and Depression Self-Rating Scale for Children, at 12 (T12m) and 18 months (T18m) post-earthquake. Longitudinal actor-partner interdependence models (APIMs) were employed to examine depression within dyads. Predictors of depressive symptoms were assessed by the cart algorithm throughout the 6-month follow-up. RESULTS Adjusting for earthquake exposure and previous depressive symptoms, parents' depression at 12 months predicted children's depressive symptoms at 18 months, and vice versa (β = 0.14 for parents and β = 0.12 for children). Psychomotor retardation in parents, and dysphoria/social isolation and positive affect in children were identified as crucial screening indicators identifying parents and children at increased risk for depression. CONCLUSION A bidirectional association was found between parent and child depression following a mass disaster. Both parent and child depression status should be examined when implementing interventions to identify and treat depression in earthquake survivors.
Collapse
Affiliation(s)
- Yuanyuan Li
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China
| | - Xuliang Shi
- College of education, Hebei University, Baoding, China
| | - Larkin S McReynolds
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA
| | - Huilan Tang
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA
| | - Huilin Chen
- Department of Psychology, University of Bath, Bath, Somerset, UK
| | - Tong Wang
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China
| | - Yuechu Zhang
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China
| | - Fulei Geng
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China
| | - Fang Fan
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China.
| | - C W Hoven
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA
| |
Collapse
|
12
|
McGuire R, Hiller RM, Cobham V, Haag K, Halligan SL. A mixed-methods investigation of parent-child posttrauma discussion and the effects of encouraging engagement. Eur J Psychotraumatol 2019; 10:1644127. [PMID: 31489132 PMCID: PMC6711190 DOI: 10.1080/20008198.2019.1644127] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 06/14/2019] [Accepted: 06/23/2019] [Indexed: 11/15/2022] Open
Abstract
Recent developments in the child trauma field include preventative interventions that focus on augmenting parental support. However, we have limited knowledge of how parents experience trauma conversations with children. We examined how parents and children experienced both spontaneous trauma conversations and a structured task in which they generated a joint trauma narrative, following the child's experience of an acute trauma. Parent and child ratings of distress during the structured narrative were low for all 127 families that took part, with child ratings of distress being lower overall than parent ratings. Task-related distress was positively associated with parent and child PTSD symptoms. Thematic analysis of semi-structured interviews conducted with a subset of twenty parents identified both facilitators of (e.g. open and honest relationship with child) and barriers to (e.g. parent/child avoidance of discussion) spontaneous trauma-related conversations with their child. Additionally, parents described the structured trauma narrative task as an opportunity to start the conversation with their child, to understand their child's feelings, and for the child to process the trauma. However, the task was also uncomfortable or upsetting for some parents/children, and resulted in parents becoming more overprotective. The findings can inform development of low-dose interventions that encourage families to engage in trauma-related conversations following child experiences of trauma.
Collapse
Affiliation(s)
| | | | - Vanessa Cobham
- School of Psychology, The University of Queensland, Brisbane, Australia.,Children's Health QLD, Child and Youth Mental Health Service, Brisbane, Australia
| | | | - Sarah L Halligan
- Department of Psychology, University of Bath, UK.,Department of Psychiatry, University of Cape Town, Rondebosch, South Africa
| |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
Hiller RM, Meiser‐Stedman R, Lobo S, Creswell C, Fearon P, Ehlers A, Murray L, Halligan SL. A longitudinal investigation of the role of parental responses in predicting children's post-traumatic distress. J Child Psychol Psychiatry 2018; 59:781-789. [PMID: 29197098 PMCID: PMC6849512 DOI: 10.1111/jcpp.12846] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND While parental post-trauma support is considered theoretically important for child adjustment, empirical evidence concerning the specific aspects of parental responding that influence child post-traumatic distress, or the processes via which any such impacts occur, is extremely limited. We conducted a longitudinal examination of whether parental post-trauma appraisals, trauma-specific support style and general parenting style predicted child post-traumatic stress symptom severity (PTSS) following trauma; and whether such influences operated via the child's own appraisals and coping style. METHOD We recruited 132 parent-child pairs following children's experience of acute trauma. We examined whether parental responses assessed at 1-month post-trauma, predicted child PTSS at 6-month follow-up. Parental trauma-specific appraisals and responses, and general parenting style, were assessed via both self-report and direct observations. Child-report questionnaires were used to assess PTSS and potential mediators. RESULTS Initial parent negative appraisals and encouragement of avoidant coping were associated with higher child-reported PTSS at 6-month follow-up. Predictive effects were maintained even when controlling for initial child symptom levels. Observational assessments broadly supported conclusions from self-report. There was evidence that parental influences may operate, in part, by influencing the child's own appraisals and coping responses. In contrast, there was no evidence for an influence of more "adaptive" support or general parenting style on child PTSS. CONCLUSIONS Findings provide important insight into how elements of social support may influence child post-trauma outcomes.
Collapse
Affiliation(s)
| | | | - Sarah Lobo
- Department of PsychologyUniversity of BathBathUK
| | - Cathy Creswell
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Pasco Fearon
- Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Anke Ehlers
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
| | - Lynne Murray
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK,Department of PsychiatryUniversity of Cape TownCape TownSouth Africa
| | - Sarah L. Halligan
- Department of PsychologyUniversity of BathBathUK,Department of PsychiatryUniversity of Cape TownCape TownSouth Africa
| |
Collapse
|
15
|
Watson RS, Choong K, Colville G, Crow S, Dervan LA, Hopkins RO, Knoester H, Pollack MM, Rennick J, Curley MAQ. Life after Critical Illness in Children-Toward an Understanding of Pediatric Post-intensive Care Syndrome. J Pediatr 2018; 198:16-24. [PMID: 29728304 DOI: 10.1016/j.jpeds.2017.12.084] [Citation(s) in RCA: 141] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/06/2017] [Accepted: 12/28/2017] [Indexed: 12/12/2022]
Affiliation(s)
- R Scott Watson
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA; Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington, Seattle, WA.
| | - Karen Choong
- Department of Pediatrics and Critical Care, McMaster University, Hamilton, Ontario, Canada
| | - Gillian Colville
- Paediatric Psychology Service, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Sheri Crow
- Department of Pediatrics and Health Services Research, Mayo Clinic, Rochester, MN
| | - Leslie A Dervan
- Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington, Seattle, WA
| | - Ramona O Hopkins
- Psychology Department and Neuroscience Center, Brigham Young University, Provo, UT; Center for Humanizing Critical Care, Intermountain Health Care, Murray, UT; Department of Medicine, Pulmonary & Critical Care Division, Intermountain Medical Center, Murray, UT
| | - Hennie Knoester
- Emma Children's Hospital/Academic Medical Centre, University of Amsterdam, The Netherlands
| | - Murray M Pollack
- Children's National Health System, George Washington University, Washington, DC
| | - Janet Rennick
- Department of Nursing, Montreal Children's Hospital, Ingram School of Nursing and Department of Pediatrics (Division of Critical Care), Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Martha A Q Curley
- Family and Community Health, School of Nursing, Anesthesia and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Critical Care and Cardiovascular Program, Boston Children's Hospital, Boston, MA
| |
Collapse
|
16
|
van de Schoot R, Sijbrandij M, Depaoli S, Winter SD, Olff M, van Loey NE. Bayesian PTSD-Trajectory Analysis with Informed Priors Based on a Systematic Literature Search and Expert Elicitation. MULTIVARIATE BEHAVIORAL RESEARCH 2018; 53:267-291. [PMID: 29324055 DOI: 10.1080/00273171.2017.1412293] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
There is a recent increase in interest of Bayesian analysis. However, little effort has been made thus far to directly incorporate background knowledge via the prior distribution into the analyses. This process might be especially useful in the context of latent growth mixture modeling when one or more of the latent groups are expected to be relatively small due to what we refer to as limited data. We argue that the use of Bayesian statistics has great advantages in limited data situations, but only if background knowledge can be incorporated into the analysis via prior distributions. We highlight these advantages through a data set including patients with burn injuries and analyze trajectories of posttraumatic stress symptoms using the Bayesian framework following the steps of the WAMBS-checklist. In the included example, we illustrate how to obtain background information using previous literature based on a systematic literature search and by using expert knowledge. Finally, we show how to translate this knowledge into prior distributions and we illustrate the importance of conducting a prior sensitivity analysis. Although our example is from the trauma field, the techniques we illustrate can be applied to any field.
Collapse
Affiliation(s)
- Rens van de Schoot
- a Department of Methods and Statistics , Utrecht University
- b Optentia Research Program, Faculty of Humanities , North-West University
| | - Marit Sijbrandij
- c Clinical, Neuro- en Developmental Psychology , VU University Amsterdam
| | | | - Sonja D Winter
- a Department of Methods and Statistics , Utrecht University
| | - Miranda Olff
- e Department of Psychiatry, Academic Medical Center , University of Amsterdam
- f Arq Psychotrauma Expert Group , Diemen the Netherlands
| | - Nancy E van Loey
- g Department of Clinical Psychology , Utrecht University
- h Association of Dutch Burns Centers , Department of Behavioral Research
| |
Collapse
|
17
|
Williamson V, Creswell C, Butler I, Christie H, Halligan SL. Parental responses to child experiences of trauma following presentation at emergency departments: a qualitative study. BMJ Open 2016; 6:e012944. [PMID: 27821599 PMCID: PMC5128846 DOI: 10.1136/bmjopen-2016-012944] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Parents are often children's main source of support following fear-inducing traumatic events, yet little is known about how parents provide that support. The aim of this study was to examine parents' experiences of supporting their child following child trauma exposure and presentation at an emergency department (ED). DESIGN Semistructured qualitative interviews analysed using thematic analysis. SETTING The setting for this study was two National Health Service EDs in England. PARTICIPANTS 20 parents whose child experienced a traumatic event and attended an ED between August 2014 and October 2015. RESULTS Parents were sensitive to their child's distress and offered reassurance and support for their child to resume normal activities. However, parental beliefs often inhibited children's reinstatement of pretrauma routines. Support often focused on preventing future illness or injury, reflective of parents' concerns for their child's physical well-being. In a minority of parents, appraisals of problematic care from EDs contributed to parents' anxiety and perceptions of their child as vulnerable post-trauma. Forgetting the trauma and avoidance of discussion were encouraged as coping strategies to prevent further distress. Parents highlighted their need for further guidance and support regarding their child's physical and emotional recovery. CONCLUSIONS This study provides insight into the experiences of and challenges faced by parents in supporting their child following trauma exposure. Perceptions of their child's physical vulnerability and treatment influenced parents' responses and the supportive strategies employed. These findings may enable clinicians to generate meaningful advice for parents following child attendance at EDs post-trauma.
Collapse
Affiliation(s)
| | - Cathy Creswell
- Department of Psychology, University of Reading, Reading, UK
| | - Ian Butler
- Department of Psychology, University of Bath, Bath, UK
| | - Hope Christie
- Department of Psychology, University of Bath, Bath, UK
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK
- Department of Psychiatry, University of Cape Town, South Africa
| |
Collapse
|
18
|
La Greca AM, Comer JS, Lai BS. Commentary: Key Issues, Concluding Thoughts, and Future Directions for the Study of Trauma and Child Health. J Pediatr Psychol 2015; 41:149-58. [PMID: 26416828 DOI: 10.1093/jpepsy/jsv088] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 08/18/2015] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | - Betty S Lai
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University
| |
Collapse
|