Maternal posttraumatic stress symptoms, neuroticism, and posttraumatic growth as predictors of children's posttraumatic stress symptoms following the 2023 Kahramanmaraş earthquakes.

Posttraumatic stress disorder is a prolonged stress and anxiety response that occurs after exposure to a traumatic event. Research shows that both parental and child posttraumatic stress symptoms (PTSS) are correlated but parental executive functions (EFs) could buffer this link. EFs refers to a group of high-level cognitive processes that enable self-regulation of thoughts and actions to achieve goal-directed behaviours and can be of importance for both positive parenting interactions and effective coping skills for PTSS. Our study aimed to (1) examine the link between maternal and child PTSS and the moderating role of varying degrees of exposure to severe security threats context, and (2) to identify the moderating role of maternal EFs in this interaction, among families living in southern Israel. Our sample included 131 mothers in their second pregnancy and their firstborn children. Mothers performed computerised tasks to assess their EFs and they reported on their own and their child's PTSS. Results revealed a positive correlation between maternal PTSS and child PTSS. However, the link between maternal and child PTSS was moderated by maternal working memory updating abilities and threat context severity. Among mothers with lower updating capacities, the association between maternal and child symptoms was stronger under higher threat contexts; conversely, among mothers with higher maternal updating abilities, threat context did not modulate the link between maternal and child PTSS, suggesting a stress-buffering effect. Our study contributes to the growing literature on the significant role of parental EFs in the context of parent-child interactions.

Children in war-torn areas are highly susceptible to post-traumatic stress symptoms (PTSS), influenced by direct exposure to war and maternal PTSS. This risk is further heightened by continuous traumatic stress (CTS). However, the relationship between war exposure, maternal PTSS, CTS, and PTSS in children, particularly in different age groups, has not been extensively studied. The current study investigated Israeli children, with a specific focus on treatment-seeking preschoolers (ages 3–7) and school-aged children (ages 8–12). The sample included 220 dyads of children aged 3–12 and their parents, who were seeking treatment for children’s PTSS after the October 7th terrorist attack. They underwent a clinical assessment including sociodemographic information and filled out validated self-report and parent-report questionnaires assessing PTSS. Overall, 69% of preschoolers and 49.2% of school-aged children exhibited probable PTSD, along with 32.4% of their mothers. Maternal PTSS significantly predicted PTSS in preschoolers (b = 0.24, SE = 0.14, p <.01), whereas war exposure significantly predicted PTSS in school-aged children (b = 0.81, SE = 3.84, p <.05). The relationship between CTS condition and children’s PTSS was indirectly associated through maternal PTSS, solely among preschool children (b = 4.81, SE = 1.78, 95% CI [1.84, 8.69]). The study highlights early intervention’s need to target age-specific vulnerabilities to PTSS in children. It stresses the importance of enhancing parental skills and improving children’s resilience towards current and future traumas, particularly in conflict-affected areas. Healthcare services should provide trauma-focused treatment for parents and children to prevent exacerbating symptoms.

The interdependent adjustment of children and their parents following disasters has been welldocumented. We used the Actor-Partner Interdependence Model (APIM) to provide an appropriate analytical framework for examining how family members may contribute to each other's post-disaster mental health. Independent self-reports were collected from parent-child dyads (n = 397) residing in a rural community in Indonesia that was devastated by a major earthquake. Elementary school children (M = 10years; 51% female) and one of their parents (M = 41years; 73% female) each reported on their disaster exposure, posttraumatic stress (PTS) symptoms, and general distress. The APIM was used to examine mental health within dyads and moderation by gender across dyads. Children reported lower disaster exposure and fewer PTS symptoms, but similar general distress levels, as their parents. Children's and parents' disaster-specific PTS symptoms were the strongest predictor of their own general distress. Parents' PTS symptoms were associated with children's general distress (b = 0.14, p < 0.001), but children's PTS symptoms were not associated with parents' general distress (b = -0.02, p > 0.05). Findings were not moderated by parents' or children's gender. Although children and parents may respond differently to natural disasters, they may be best understood as a dyad. APIM analyses provide new evidence suggesting a unidirectional path of influence from parents' disaster-related symptomatology to children's general mental health. Dyadic approaches to understanding mental health and treating symptoms of distress among disaster survivors and their families following trauma are encouraged.

Previous studies consistently found remarkable prevalence rates of posttraumatic stress symptoms (PTSS) and posttraumatic stress disorders (PTSD) in pediatric patients and their parents. Findings suggest a significant association between child and parent PTSS. The present study examined, in a sample of pediatric patients with different conditions, incidence rates and determinants of PTSS and PTSD in the patients, and their mothers and fathers. Also, associations of maternal, paternal and child PTSS and PTSD were analyzed. Two hundred and nine children (aged 6.5-14.5 years) were interviewed 5-6 weeks after an accident or a new diagnosis of cancer or diabetes mellitus type 1 by means of the Child PTSD Reaction Index. Their mothers (n = 180) and fathers (n = 175) were assessed with the Posttraumatic Diagnostic Scale. Children reported PTSS levels in the mild range. Sixteen percent of the fathers and 23.9% of the mothers met full DSM-IV diagnostic criteria for current PTSD. Type of trauma impacted differently on parents and children. In children, accident-related injury was associated with higher PTSS scores. Conversely, in parents, diagnosis of cancer in their child was associated with more symptoms. Functional status of the child was also found to be an important predictor of PTSS in children and parents. PTSS scores of mothers and fathers were significantly correlated with each other. However, child PTSS were not significantly related to PTSS of mothers and fathers. This was true for total scores as well as for DSM-IV symptom clusters. There is a need for careful evaluation of PTSS and PTSD in pediatric patients with accidental injuries or sudden onset of severe chronic diseases and in their respective parents. Importantly, children, their mothers, and their fathers should be assessed separately, because a significant association between child and parental PTSS may not exist.

COVID-19 pandemic is a public health emergency with potential traumatizing effects on children. However, not many studies have been devoted to investigating the association between fear of COVID-19 and post-traumatic stress symptoms (PTSS) in children during the pandemic. Also, if the association is modulated by cognitive tendencies to focus on negative and positive information in children is unknown. The study recruited 122 native Chinese children from a primary school in mainland China. Self-reported psychological inventories were used to assess the above variables. The prevalence rate of PTSS in Chinese children was approximately 15.1%. Girls had higher post-traumatic stress levels than boys. Fear of COVID-19 was associated with higher level of post-traumatic stress in children. Only cognitive tendency to focus on negative information was significantly associated with the level of post-traumatic stress in children. Moreover, cognitive tendency to focus on negative information was a significant moderator of the relationship between fear of COVID-19 and PTSS. Generalization of the results to adults should be cautious. It was concluded that stronger fear of COVID-19 was related to more PTSS in children. The association of fear of COVID-19 with PTSS was significant only for children with strong tendency to focus on negative information. Cognitive interventions for PTSS may need to be delivered to children who have both strong fear of COVID-19 and strong tendency to focus on negative information.

This study aims to understand if greater severity of maternal posttraumatic stress symptoms (PTSS), related to maternal report of interpersonal violence, mediates the effects of such violence on (a) child PTSS as well as on (b) child externalizing and internalizing symptoms. Study participants were mothers (N = 77) and children 18 to 48 months recruited from community pediatric clinics. Data were analyzed continuously via bivariate correlations and then multiple linear regression. Post hoc Sobel tests were performed to confirm mediation. Paternal violence accounted for 15% of the variance of child PTSS on the PCIP-OR (β = .39, p ≤ .001). While the child's father being violent significantly predicts child PTSS related to domestic violence, as mentioned, when maternal PTSS is included in the multiple regression model, father's being violent becomes less significant, while maternal PTSS remains strongly predictive. Sobel tests confirmed that maternal PTSS severity mediated effects of paternal violence on clinician-assessed child PTSS as well as on maternal report of child externalizing and internalizing symptoms. When presented with a preschool-aged child who is brought to consultation for behavioral difficulties, dysregulated aggression, and/or unexplained fears, clinicians should evaluate maternal psychological functioning as well as assess and treat the effects of interpersonal violence, which otherwise may be avoided during the consultation.

Experiences of intimate partner violence (IPV) during pregnancy can have long-lasting effects on children's stress reactivity and psychological development. Despite this, prenatal exposures to IPV are rarely assessed among children with traumatic experiences, and the prenatal effects of these events on children's posttraumatic stress symptomatology remain mostly unknown. This study was a secondary analysis that examined the association between maternal exposure to IPV in pregnancy and child posttraumatic stress symptoms in a cross-sectional sample of 207 ethnically diverse, treatment-seeking, parent-child dyads. Children (Mage = 4.4 years; 55.1% male) had experienced at least one traumatic event since birth, and most children (n = 148, 71.5%) had at least one childhood experience of IPV; 23.7% (n = 49) had at least one prenatal exposure to IPV. Results of a two-step hierarchical regression analysis revealed that children's prenatal IPV exposures were positively associated with child posttraumatic stress symptoms (b = 2.82, 95% CI [0.16, 5.49], β = .15, t(193) = 2.09, p = .038), even after accounting for the effects of childhood IPV exposures and maternal depression. Post-hoc analyses also tested associations between prenatal IPV and children's posttraumatic stress symptom clusters (i.e., arousal, avoidance, intrusion), showing positive associations between prenatal IPV and children's avoidance symptoms [b = 1.24, [0.23, 2.25], β = .18, t(193) = 2.43, p =.016] after accounting for childhood IPV exposures and maternal depression. Findings suggest that prenatal exposures to IPV may be uniquely associated with the development of more severe posttraumatic stress symptomatology among preschool-aged children. This evidence calls for the assessment of prenatal exposures to violence when evaluating and treating trauma-exposed children.

Posttraumatic stress symptoms (PTSS) are high amongst survivors of pediatric brain tumors and their parents; however, early prevalence is unknown. This study aimed to get insight into the prevalence and risk factors of child and parental PTSS shortly after diagnosis. Sixty-five children with brain tumors (6-16years old) and their parents participated. The prevalence of clinical child PTSS (CRIES-13 self- and proxy-report) and parental PTSS (PCL-5) was assessed 1-3months after diagnosis, and compared to the general population (PCL-5; binomial test). Pearson's correlations between child and parental PTSS were calculated. Risk factors were explored with linear regression analyses (psychosocial risk assessed through PAT). Clinical child PTSS scores were reported by 29.4% of the children (self-report) and 11.1% of their parents (proxy-report). Prevalence of clinical parental PTSS was not significantly higher than in the general population (mothers: 12.1%, p = 0.07; fathers: 6.0%, p = 0.20). Self-reported child PTSS scores were associated with proxy-reported child PTSS scores (r = 0.49, p < 0.001), but not with parental PTSS scores (mother r = 0.22, father r = 0.18). No associations were found between demographic factors and child or parental PTSS. Shorter time since diagnosis was associated with more self-reported child PTSS (β = -0.45, p = 0.01). Starting radiotherapy was associated with more mother PTSS (β = 1.04, p < 0.003). Family psychosocial risk was associated with more child PTSS (self-report β = 0.82, p = 0.02; proxy-report β = 0.81, p = 0.02) and mother PTSS (β = 1.33, p < 0.001). Prevalence of PTSS in children with recently diagnosed brain tumors was high, highlighting the need for early psychosocial monitoring and targeted interventions to optimize health-related quality of life.

The parent-child relationship influences children's mental health (e.g., posttraumatic stress symptoms, psychosocial difficulties) and adaptive outcomes (e.g., posttraumatic growth, resilience) following the death of a loved one. The current study employed a person-centered approach to identify patterns of parenting and their associations with bereaved children's functioning. This study included 112 bereaved children, aged 8-17 (Mage = 12.41, SD = 2.58; 52.2% female), recruited from community organizations in the MidSouth, United States. A latent profile analysis was used to identify parenting subgroups and examine differences between classes on children's posttraumatic stress symptoms, psychosocial difficulties, posttraumatic growth, and resilience. A three-class solution best fit the data: Passive Parenting (42.86%), Negative Parenting (34.82%), and Positive Parenting (22.32%). Children in the Positive Parenting class reported fewer psychosocial difficulties than those in the Passive (Est. = -8.33, p < .001, d = 0.86) and Negative (Est. = -15.82, p < .001, d = 1.67) Parenting classes; those in the Passive Parenting class had fewer psychosocial difficulties than the Negative Parenting class (Est. = -7.49, p < .001, d = 0.79). Children in the Positive Parenting class reported higher levels of resilience compared to the Negative (Est. = 8.95, p = .015; d = 0.51) and Passive (Est. = 11.44, p < .001; d = 0.69) Parenting classes; no significant differences on posttraumatic stress symptoms or posttraumatic growth were found. Bereaved children whose parents are more involved, prioritize open communication, and use more positive reinforcement strategies report fewer difficulties and more resilience. In contrast, children's trauma-related outcomes following a death were not influenced by parenting patterns and may be better explained by other relational factors.

Parenting is related to children's adjustment, but little research has examined the role of parenting in children's responses to disasters. This study describes parenting responses specific to the 9/11 terrorist attacks and examines pre-9/11 parenting, child temperament, and 9/11-specific parenting as predictors of children's posttraumatic stress (PTS) symptoms among children geographically distant from the attack locations. A community sample of children and parents (n = 137, ages 9–13 years) participating in an ongoing study were interviewed 1 month following 9/11. Parents reported engaging in a number of parenting responses following 9/11. Pre-9/11 acceptance and 9/11-specific, self-focused parental responses predicted PTS symptoms. Pre-9/11 parenting and temperament interacted to predict PTS symptoms, suggesting that parenting and temperament are important prospective predictors of children's responses to indirect exposure to disasters.

Trauma-therapy in children and adolescents often involves the inclusion of their parents. A multi-informant approach was used to investigate whether trauma-focused cognitive-behavioral therapy (TF-CBT) changes dysfunctional posttraumatic cognitions (PTCs) in participating parents. This, in turn, may mediate their child's posttraumatic stress symptoms (PTSS) posttreatment. Children and adolescents (6-17 years old) were assigned to either a TF-CBT (n = 57) or a waitlist (n = 56) condition, within a multisite randomized controlled trial conducted in Germany. They were assessed using the Clinician Administered PTSD Scale for Children and Adolescents, version for DSM-IV and they completed the University of California at Los Angeles Post-Traumatic Stress Disorder Reaction Index for Children and Adolescents (UCLA). Their parents completed the UCLA, caregiver report, and the Posttraumatic Cognitions Inventory to rate their dysfunctional PTCs related to their child's trauma. The mediation hypothesis was tested using a multiple mediation model. The change in parental PTCs was stronger in the TF-CBT condition (b = 13.19, 95% confidence interval [CI] [2.89, 23.49]). It mediated the relationship between the group (TF-CBT vs. waitlist) and the caregiver report on the child's PTSS (b = -.08, 95% CI [-.15, -.01]), but not the child's PTSS, assessed using the interview (b = .01, 95% CI [-.14, .17]) and the self-report questionnaire (b = .01, 95% CI [-.08, .10]), posttreatment. TF-CBT helped participating parents to challenge their dysfunctional PTCs related to their child's trauma. The change in parental PTCs only mediated their perception of their child's PTSS but not their child's self-perception or the clinical evaluation of their child's PTSS. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Posttraumatic stress symptoms (PTS) have been observed in children exposed to family violence. Although functioning improves for many children after cessation of violence, pathways to recovery are poorly understood. This study tests the mediating pathways between changes in family violence and children's PTS through children's emotional security, parental stress, and parents' PTS. We used longitudinal data of 562 children and their parents who were referred to child protection service. Data included three waves over a one and a half years period. Questionnaire data of both children and parents were analyzed in R Lavaan with Random Intercept Cross Lagged Panel Models to examine intrafamilial associations. Child-reported, but not parent-reported, decreases in family violence predicted decreases in child PTS from the first to the second wave. Changes in parental stress, parent PTS, and emotional security did not mediate the associations between change in family violence and child PTS. We found in exploratory analyses that decreases in parental stress predicted decreases in parent-reported family violence. The results emphasize the importance of reducing family violence for children to recover from PTS. Parental stress may be a factor in restoring safety.

Although concurrent associations between parent and child posttraumatic stress symptoms (PTSS) have been well-documented, few longitudinal studies have examined bidirectional influences by modeling the effects of both parent and child PTSS simultaneously over time. The current study examines patterns of PTSS in children and their mothers beginning in preschool and continuing through elementary school age (ages 4-9 years) in a large, heterogeneous sample (N = 331 mother-child dyads). Mothers reported on their own and their child's posttraumatic stress symptoms. A random intercept cross-lagged panel model (RI-CLPM) was used to examine associations between symptoms across six time points. Results indicated that maternal and child symptoms were associated with each other at concurrent time points and tended to fluctuate in a synchronized manner relative to their overall mean symptom levels. Longitudinal cross-lagged paths were significant from mother to child, but non-significant from child to mother, suggesting that mothers' symptom fluctuation at one time point predicted significant fluctuation in children's symptoms at the subsequent time point. The concurrent co-variation of maternal and child symptoms and the predictive nature of maternal symptom flare-ups have important implications for both maternal and child mental health interventions and underscore the importance of attending to mothers' symptomatology early in treatment.

Children and adolescents with a congenital heart defect (ConHD) frequently undergo painful or frightening medical procedures and hospitalizations. They often need multiple invasive procedures at a very young age and require regular checkups during their entire life. From other pediatric populations, it is known that these kinds of experiences can result in acute stress reactions and even in post-traumatic stress disorder (PTSD) in the long-term. PTSD and also subthreshold PTSD can lead to serious (psychosocial) impairment. However, limited information is available about PTSD in children with ConHD. Therefore, the aim of this review is to provide a summary of the current literature on post-traumatic stress (PTS) in children and adolescents with ConHD describing the prevalence of PTSD and its predictors/correlates. This review indicates that a range of 12–31% of children undergoing cardiac surgery develop PTSD. A range of 12–14% shows elevated post-traumatic stress symptoms (PTSS). These findings are comparable to those of hospitalized children without ConHD. Noteworthy, most studies used varying self-report questionnaires to measure PTSD and only one study used a semistructured interview. Although all studies point in the same direction of elevated PTSD and PTSS, systematic research is necessary to be able to draw firm conclusions. At present, as far as we know, in most clinics treating patients with ConHD, there is no regular screening for PTS in children with ConHD. In the reviewed literature, there is strong consensus that screening for PTSS and (preventive) psychological care for children and adolescents with ConHD is urgently needed.

We investigated the distinct longitudinal trajectories of posttraumatic stress symptoms in a sample of 167 children, who witnessed death of two mothers of their schoolmates. The cohort was followed-up at 2 days (T1), 2 months (T2), 6 months (T3), and 30 months (T4) after the traumatic event. The children's posttraumatic stress symptoms (T1-T4), depression (T1, T3 and T4), state anxiety (T1, T3 and T4), and quality of life (T4) were assessed, along with parental stress related to child rearing (T4). Different trajectory patterns of the children's posttraumatic stress symptoms were identified using growth mixture modeling (GMM). Four different patterns of symptom change were identified, which were consistent with the prototypical model, and were named Recovery (19.9%), Resilience (72.7%), Chronic Dysfunction (1.8%), and Delayed Reactions (5.6%). Significant differences were found in depression and anxiety scores, children's quality of life, and parental rearing stress according to the distinct longitudinal trajectories of posttraumatic stress symptoms. The present study suggests that individual differences should be taken into account in the clinical course and outcome of children exposed to psychological trauma. The two most common trajectories were the Resilience and the Recovery types, together suggesting that over 90% of children were evidenced with a favorable 30-month outcome. The latent classes were associated with significant mean differences in depression and anxiety scores, supporting the clinical validity of the distinct trajectories.