Posttrauma psychosocial effects in children: A systematic review of measurement scales

A Scoping Review of Mental Health and Wellbeing Outcome Measures for Children and Young People: Implications for Children in Out-of-home Care

Purpose

One of the challenges for mental health research is the lack of an agreed set of outcome measures that are used routinely and consistently between disciplines and across studies in order to build a more robust evidence base for how to better understand young people's mental health and effectively address diverse needs.

Methods

This study involved a scoping review of reviews on consensus of the use of mental health and wellbeing measures with children and young people. We were particularly interested to identify if there are differences in measures that are recommended for children and young people with care experience including those with developmental disabilities.

Findings

We identified 41 reviews, of which two had a focus on child welfare settings, three on childhood trauma and 14 focused on children and young people with developmental disabilities. Overall, our review highlights a lack of consensus and a diversity of measures within the field. We identified 60 recommended measures, of which only nine were recommended by more than one review.

Conclusions

Our review highlights the need for greater agreement in the use of mental health outcome measures. While our review highlights that there is value in identifying measures that can be used with any child or young person, researchers need to take into account additional considerations when working with children and young people with care experience and those with developmental disabilities, to ensure measures are accessible and sensitive to their life experiences.

A Cross Sectional Study to Identify Traumatic Stress, Medical Phobia and Non-Adherence to Medical Care among Very Young Pediatric Patients

After a traumatic medical event, such as surgery or hospitalization, a child may develop a phobia of medical care, sometimes preventing future medical adherence and impairing recovery. This study examined the correlation of Pediatric Medical Traumatic Stress (PMTS) on the development of Medical Phobia (MP) and subsequent treatment adherence. We enrolled 152 parents of children aged 1-6 hospitalized in a surgical ward. During hospitalization, parents completed questionnaires that identified post-traumatic stress symptoms. Four months post hospitalization, parents completed questionnaires on post-traumatic stress, medical phobia, psychosocial variables and medical adherence. We found a positive correlation between PMTS and MP and low adherence to medical treatment. In addition, MP mediated the relationship between PMTS severity and adherence, indicating that PMTS severity is associated with stronger medical phobia, and lower pediatric adherence to medical treatment. Our findings suggest that medical phobia serves as an essential component of PMTS. It is important to add medical phobia to medical stress syndrome definition. In addition, as MP and PMTS are involved in the rehabilitation and recovery process and subsequent success, it is an important aspect of treatment adherence.

Development and validation of the parents' cognitive perception inventory of disaster effects on children's well-being (PCP-DCWB)

BACKGROUND

Parents' cognition about the type and nature of consequences a disaster may pose on the children's psychosocial health, could be a major protective factor against the long-term overwhelming complications. Given the lack of a reliable instrument to measure parents' cognition about disasters' effects on children's well-being, this study was conducted to develop and validate the parents' cognitive perception inventory of disaster effects on children's well-being (PCP-DCWB).

METHODS

In this cross-sectional study 300 parents of the survived primary school aged children from the Iran's northwest earthquake on August 2012 were recruited in the city of Varzegan. Exploratory factor analysis (EFA) was applied to identify the subcomponents and Cronbach's alpha and Guttmann Split-half coefficients were calculated to assess the internal consistency reliability of the scale.

RESULTS

Structural indicators of the Kaiser-Meyer-Olkin measure (0.69) and Bartlett's test of Sphericity (P < 0.001, df = 153, X² = 618.35) verified interpretability of the EFA output. Applying principal component analysis and direct oblimin rotation in the EFA four latent factors were identified (i.e., perception about child overall mental health, coping with trauma's long-term effects, children or parents' continuing memory of past disaster and perception about behavioral and educational problems) which explained 49.32% of the total variance. The estimated Cronbach's alpha and split-half reliability coefficients (0.71 and 0.52 respectively) supported good internal consistency of the instrument.

CONCLUSION

The study findings revealed sound psychometric attributes of the PCP-DCWB to be applied in assessment of parents' cognition about psychological impacts of a traumatic event on the survived children. The instrument application can shed light on level of pre-disaster preparations in local, national and international scales and help effectiveness assessment of interventions that target maintenance of psycho-social well-being among disaster-affected survivors over time.

Assessment of PTSD and posttraumatic symptomatology in very young children: A systematic review

CONTEXT

Very young children are said to be a vulnerable group for exposure to trauma, and for a psychopathological response (e.g., PTSD) after a risk-exposure. The specific assessment of young children is necessary to enable them to be enrolled in an appropriate care pathway.

OBJECTIVE

The objective was to identify the instruments available in the English language for the assessment of posttraumatic symptoms in very young children (from 0- to 5-year old).

DESIGN

This article reports on a systematic review, conducted using the search engines Google Scholar, Science Direct, PsycArticles, and PubMed.

RESULTS

Nine instruments are available to specifically assess traumatic symptomatology in very young children (0-7-year old), five instruments are available for the broader assessment of very young children (1-6-year old), six instruments are available for the assessment of traumatic symptoms in very young children and in older children (2-18-year old), one instrument did not correspond to any category. These 21 tools are adapted to different ages, built according to different objectives, and do not rely on the same diagnostic algorithm.

CONCLUSION

Future research should compare the instruments quantitatively to identify those most specific and sensitive to the assessment of trauma symptoms in young children.

The relationship between insomnia and trait anger and anger expression among adolescents

PROBLEM

Sleeplessness and inadequate sleep may cause an adolescent to experience reduced self-control and behavioral problems that include anger and an inclination toward crime. This study aimed to examine the relationship between insomnia and trait anger and anger expression among adolescents.

METHODS

The study was conducted with 749 students from 27 high schools who were selected by using the stratified cluster sampling method. The data were collected with an Individual Characteristics Form, the Trait Anger/Anger Expression Inventory, and the Insomnia Severity Index.

FINDINGS

The insomnia scores of 14.0% of the participants were over the clinical insomnia threshold of 15 points. A positive relationship was found between insomnia and trait anger, anger-in, anger-out scores but a negative relationship with anger control scores. It was observed that the determinants of the severity of insomnia were trait anger and anger-in, dozing off in class, feeling anger after a sleepless night, sleeping <6 h a night during the week and over the weekend.

CONCLUSION

It was found that 14.0% of the participants experienced insomnia and there was a two-way correlation between insomnia and anger among adolescents.