Child Posttraumatic Stress Reaction Index Research Articles

Loneliness and posttraumatic stress in U.S. adolescents: A longitudinal study

BackgroundLoneliness and posttraumatic stress (PTS) are common in adolescence. However, there has been little longitudinal research on their association. To address this deficit, this study examined the longitudinal association between these phenomena in a sample of U.S. school students while also exploring if gender was important in this context. MethodsData were analysed from 2807 adolescents (52.1 % female; age at baseline 11–16 years (M = 12.79)) who were followed over a one-year period. Information was obtained on loneliness in year 1 using a single-item question, while PTS was assessed with the self-report Child Post-Traumatic Stress - Reaction Index (CPTS-RI). A full path analysis was performed to assess the across time associations. ResultsAlmost one-third of the students reported some degree of loneliness while most students had ‘mild’ PTS. In the path analysis, when controlling for baseline PTS and other covariates, loneliness in year 1 was significantly associated with PTS in year 2 (β = 0.06, 95%CI: 0.02, 0.09). Similarly, PTS in year 1 was significantly associated with loneliness in year 2 (β = 0.19, 95%CI: 0.15, 0.23). An interaction analysis further showed that loneliness was higher in girls with PTS than in their male counterparts. LimitationsThe use of a single-item measure to assess loneliness that used the word ‘lonely’ may have resulted in underreporting. ConclusionLoneliness and PTS are bidirectionally associated in adolescence. Efforts to reduce loneliness in adolescence may help in combatting PTS, while clinicians should intervene to address loneliness if detected in adolescents with PTS.

An Investigation of Dissociative Symptoms and Related Factors in Autistic Adolescents.

Despite exposure to trauma and adverse life events being frequently reported in Autism Spectrum Disorder (ASD), few studies have examined the relationship between these factors and dissociative symptoms in the autistic population. The aim of the study is to investigate symptoms of dissociation in autistic adolescents, and to explore factors that could be associated with dissociative symptoms in ASD. This cross-sectional study involved 59 autistic adolescents between 12 and 18years old, with the mean age of 14.3 ± 1.8. Dissociation, autism characteristics, childhood traumas, peer bullying, and Post-Traumatic Stress Disorder (PTSD) symptoms were assessed using the Adolescent Dissociative Experiences Scale (ADES), the Childhood Autism Rating Scale (CARS), the Childhood Trauma Questionnaire (CTQ), the Nine-Item Child-Adolescent Bullying Screen (CABS-9), and the Child Posttraumatic Stress Reaction Index (CPTS-RI), respectively. Results from the ADES revealed that 12.5% of the participants scored above the threshold for dissociative disorders. In the linear regression model constructed to evaluate factors associated with dissociative symptoms, an increase in dissociative symptoms was statistically significantly associated with an increase in the total CTQ score (p = 0.002) and age (p = 0.006). The findings of the study indicate that dissociative symptoms may occur in autistic adolescents. It is suggested that dissociative symptoms observed in autistic adolescents may particularly be associated with childhood traumas and increasing age. Further research into dissociative symptoms in ASD is warranted, requiring larger sample sizes, specialized measurement scales, and structured interviews.

The association between posttraumatic stress disorder and mental health of adolescents who exposed to the worst disaster of the century: Extensive data from southeast Turkey.

This study was conducted to examine the association between posttraumatic stress disorder and mental health status of adolescents exposed to the worst disaster of the century. This study was descriptive, cross-sectional, and correlational. This research was conducted between March 31 and July 1, 2023. The study was conducted with earthquake survivors who migrated from Kahramanmaraş, the epicenter of the earthquake, and Adıyaman and Hatay, the other two cities where it was most effective, to Şanlıurfa. The study was conducted with a total of 947 adolescents. "Personal Information Form,""Child Posttraumatic Stress Reaction Index," and "Symptom Distress Check List- (SCL-90)" were used to collect data. Linear regression method was used in the analysis of the research. Path analysis was performed using PATH analysis. The mean age of the adolescents participating in the study was 16.69 ± 1.41 years. It was found that the Global Severity Index (GSI) of the adolescents was at the pathological level with a mean of 2.36 ± 0.68. Posttraumatic stress reactions of the adolescents who experienced the earthquake was found to explain 97.2% of their mental symptoms (anxiety, depression, somatization, anger-hostility, obsession-compulsion, interpersonal sensitivity, phobic anxiety, paranoid ideation, psychotic symptoms, other problems, and GSI) (p < 0.001). It was found that the age of the adolescents, total number of losses in the earthquake, the time they stayed under the rubble, the time they waited for siblings to be pulled from under the rubble and the state of having loss due to the earthquake explained 74.4% of the posttraumatic stress reactions (p < 0.001). As a conclusion, it was found that the adolescents who experienced the earthquake experienced severe posttraumatic stress symptoms. It was also found that adolescents who experienced high levels of trauma symptoms showed pathological mental symptoms. After the earthquake, adolescents should be evaluated periodically in terms of posttraumatic stress symptoms. In the evaluations to be made, it is important to determine how adolescents are affected especially mentally. In this context, interventions should be implemented for the identified mental symptoms (anxiety, depression, somatization, etc.).

Psychosocial conditions of children after liver transplant: Post-traumatic stress, depression, and anxiety

AimThis study aimed to determine psychosocial conditions, post-traumatic stress, depression, and anxiety of children who underwent a liver transplant. MethodThis is a relational descriptive study, which was conducted between March 2019 and December 2020 in the Inonu University Liver Transplantation Institute Pediatric Liver Transplant Clinic. The “Child Information Form,” “Child Post-Traumatic Stress Reaction Index,” “State-Trait Anxiety Inventory for Children-Trait Form,” and “Children's Depression Inventory” were used to collect data. The study was conducted with 71 children who had a previous liver transplant. ResultsOf the participating children, 56.3% were girls, 63.4% continued their primary school education after the transplant, 32.5% were diagnosed with cirrhosis, 39.4% received the transplant in 2017, 32.4% received it from the mother, and 25.4% received it from a cadaveric donor. Although it had been at least 3 years since the transplant, 47.9% exhibited moderate and 43.7% severe post-traumatic stress responses. There was a significant negative relationship between the age of children with a liver transplant and trait anxiety and post-traumatic stress responses (path coefficients β = −0.268, p = 0.002; β = −0.166, p = 0.023, respectively). There was a significant positive relationship between anxiety and post-traumatic stress responses of the children after the transplant and there was a statistically significant relationship between the path coefficients (β = 0.750; p < 0.001). ConclusionChildren who underwent a liver transplant had post-traumatic stress disorder, depression, and trait anxiety.

A short-term approach for promoting oral health of internally displaced children with PTSD: the key is improving mental health\u2014results from a quasi-randomized trial

BackgroundSeveral studies have demonstrated that mental (MH) and oral health (OH) of displaced children are negatively affected during the wartime. This may be a result of general self-neglect and psychological suffering. Therefore, previous studies suggested that psychosocial support (PSS) is essential during and after humanitarian crises to prevent immediate and long-term MH and OH problems. This study was undertaken to evaluate the effectiveness of a short-term approach in improving (MH) and (OH) of displaced children suffering from posttraumatic stress disorder (PTSD).MethodsA quasi-randomized clinical trial study was carried out including (118) displaced children suffering from PTSD. The Child Post-Traumatic Stress Reaction Index (CPTSD-RI) was utilized for the diagnosis of PTSD. Children were assigned into two groups (intervention and control group). Children in the intervention group were enrolled in a 6-week PSS program that contained oral health educational components designed especially for this study. Clinical evaluation included plaque index (PI) and gingival index (GI). Oral health related Quality of life (OHRQoL) was also evaluated using child perception questionnaire (CPQ11-14). Study variables were evaluated at baseline and at the end of the program for both groups. Wilcoxon rank test and t-test for independent samples were used for data analysis.ResultsA total of 118 children, aged between 9 and 14 years, participated in the recent study (mean age 11.0 ± 1.4). All participated children were previously diagnosed with PTSD. At baseline, there were no significant differences in the study variables between groups (P > 0.05). At the end of the program, children in the intervention group had significantly decreased PI, GI, CPQ11-14 and CPTSD-RI compared to their baseline scores (P = 0.000). In contrast, controls showed no differences at the end of the program (P > 0.05). Children in the intervention group had significantly (P = 0.000) lower PI (1.52 ± 0.55) and GI (1.48 ± 0.56) when compared to controls (PI = 1.89 ± 0.39, GI = 2.14 ± 0.32) post program. Moreover, the intervention group showed remarkable decline (P < 0.001) in their CPQ11-14 (47.16 ± 12.24) and CPTSD-RI (34.41 ± 12.23) scores compared to controls (CPQ11-14 = 72.65 ± 14.47, CPTSD-RI = 47.91 ± 14.24) post program.ConclusionsThe designed approach could have positive improvements in PTSD symptoms, (OH) and (OHRQoL) of displaced children. Integration between (MH) and (OH) services should be considered during and after humanitarian crises to prevent immediate and long-term MH and OH problems.Trial registration Australian New Zealand Clinical Trials Registry (ACTRN12619000285156), Date registered: 25/02/2019, retrospectively registered. https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377001&isReview=true.

EMDR therapy in children and adolescents who have post-traumatic stress disorder: a six-week follow-up study

Objectives: The purpose of this study is to explore whether eye movement desensitisation and reprocessing (EMDR) is an effective therapy and to investigate whether EMDR affects anxiety levels for children and adolescents.Methods: We conducted this study with 30 clients. The clients completed self-administered questionnaires Child Post-Traumatic Stress Reaction Index Scale and The State-Trait Anxiety Inventory. The questionnaires were conducted before the therapy and 6 weeks after the completion of the therapy.Results: Nineteen clients (63%) had only one traumatic event, but 11 clients (37%) had more than one traumatic event. While the mean score on the PTSD symptom scale was 60 (±8.7), this rate decreased to 24 (±10.1), whereas the mean STAI-T scale was 59 (±8.9) before treatment and 41 (±11.5) after treatment. We found a statistically significant difference between symptom scores as quantified by both questionnaires before and after EMDR therapy (p < .05).Conclusions: As a result, we have shown that EMDR is an effective method for children and adolescents with PTSD in terms of both post-traumatic and anxiety symptom levels; however, we recommend a larger sample size with a control group to further establish the effectiveness of EMDR therapy in children.KEY POINTSPTSD is a common disorder in children and adolescents.Additional psychiatric disorders such as anxiety and depression are common in children and adolescents with PTSD.In PTSD cases applying for psychiatric treatment, trauma associated with sexual abuse is more pronounced and complex.EMDR is an effective therapy in children and adolescents as well as in adults.There is a statistically significant decrease at anxiety and PTSD symptom scores as quantified by questionnaires in patients with PTSD after EMDR therapy.

Mental Health Problems of Syrian Refugee Children: Post-Traumatic Stress, Depression and Anxiety

PurposeThis study aims to examine the levels of post-traumatic stress, depression and anxiety in Syrian children who live in refugee camps. Designs and methodsThis descriptive and correlational study was conducted using the Child Post-Traumatic Stress Reaction Index (CPTS-RI), the State-Trait Anxiety Inventory for Children-Trait Form (STAIC-Trait Form) and the Children's Depression Inventory (CDI). The study sample included 1115 Syrian refugee children. ResultsThe mean age of refugee children was 10.53 ± 2.79 years. Of them, 52% were males and 38% had no diseases while 74% were smokers and smoked 8.39 ± 6.85 cigarettes per day. The children's mean score on CPTS-RI, STAIC-Trait Form and CDI was found to be 60.59 ± 14.50, 54.11 ± 14.55 and 47.57 ± 10.97, respectively. The regression analysis revealed that anxiety and depression had a statistically significant association with post-traumatic stress. ConclusionsThe study findings revealed that refugee children have physical and psychosocial health problems and experience a high level of post-traumatic stress, depression and anxiety. Practice implicationsIn this context, the study recommends that nursing practices should be developed considering that children may have mental health problems due to war.

Determination of psychosocial conditions of refugee children living in society.

This study aims to determine the psychosocial conditions of refugee children living in society. This descriptive cross-sectional research which used the Socio-demographic Information Form for Children, Child Posttraumatic Stress Reaction Index (CPTS-RI), and Children's Depression Inventory (CDI) included 738 children. Social factors like the educational levels and professions of their parents, as well as economic status could affect the children's level of posttraumatic stress disorder, depression, and anxiety. The regression analysis revealed that depression and anxiety explained 72% of posttraumatic stress disorder in the children studied. Nurses should be aware that the effects of trauma on children who were exposed to war and migration can continue even after much time has passed since the war started.

Posttraumatic stress disorder symptoms in children exposed to circumcision under general or local anesthesia.

Kozanhan B, Kocaoğlu C, Gündüz M, Akça ÖF. Posttraumatic stress disorder symptoms in children exposed to circumcision under general or local anesthesia. Turk J Pediatr 2018; 60: 718-725. The aim of this study was to investigate the impact of general versus local anesthesia on the Posttraumatic Stress Disorder (PTSD) symptoms after circumcision. Of the 134 consecutive children (7-12 years of age) who underwent circumcision, 71 had general anesthesia (GA) and 63 had local anesthesia (LA). All participants completed the child depression inventory (CDI), State Anxiety (SA) and Trait Anxiety (TA) inventories, and Childhood Anxiety Sensitivity Index (CASI) before the operation as well as the Child Posttraumatic Stress Reaction Index (CPSRI) one month after the operation. The CDI, CASI and TA scores of the children were similar in both groups, while the SA scores of the LA group were higher than those in GA group (p < 0.001). The CPSRI scores of the GA group were higher than those of the LA group (p=0.04). When the other parameters were controlled via regression analysis, only the CDI scores and being in the GA group predicted the CPSRI scores. This study suggests that children witnessing the surgical procedure of the circumcision developed no serious symptoms of PTSD. In contrast, children exposed to GA during circumcision developed more serious PTSD symptoms than children who had LA. The severity of depressive symptoms may be important in the development of PTSD symptoms after circumcision.

Basal blood DHEA-S/cortisol levels predicts EMDR treatment response in adolescents with PTSD

Objective: In literature, recent evidence has shown that the hypothalamic–pituitary–adrenal (HPA) axis can be dysregulated in patients with post-traumatic stress disorder (PTSD) and HPA axis hormones may predict the psychotherapy treatment response in patients with PTSD. In this study, it was aimed to investigate changing cortisol and DHEA-S levels post-eye movement desensitization and reprocessing (EMDR) therapy and the relationship between treatment response and basal cortisol, and DHEA-S levels before treatment.Method: The study group comprised 40 adolescents (age, 12–18 years) with PTSD. The PTSD symptoms were assessed using the Child Depression Inventory (CDI) and Child Post-traumatic Stress Reaction Index (CPSRI) and the blood cortisol and DHEA-S were measured with the chemiluminescence method before and after treatment. A maximum of six sessions of EMDR therapy were conducted by an EMDR level-1 trained child psychiatry resident. Treatment response was measured by the pre- to post-treatment decrease in self-reported and clinical PTSD severity.Results: Pre- and post-treatment DHEA-S and cortisol levels did not show any statistically significant difference. Pre-treatment CDI scores were negatively correlated with pre-treatment DHEA-S levels (r: −0.39). ROC analysis demonstrated that the DHEA-S/cortisol ratio predicts treatment response at a medium level (AUC: 0.703, p: .030, sensitivity: 0.65, specificity: 0.86).Conclusion: The results of this study suggested that the DHEA-S/cortisol ratio may predict treatment response in adolescents with PTSD receiving EMDR therapy. The biochemical parameter of HPA-axis activity appears to be an important predictor of positive clinical response in adolescent PTSD patients, and could be used in clinical practice to predict PTSD treatment in the future.

Validity and Reliability of the Turkish Version of the DSM-5 Posttraumatic Stress Symptom Severity Scale-Child Form.

This study assessed the validity and reliability of the Turkish version of the DSM-5 Posttraumatic Stress Symptom Severity Scale-Child Form for use among the Turkish population. The study group consisted of 30 patients that had been treated in a child psychiatry unit and diagnosed with posttraumatic stress disorder and 83 healthy volunteers that were attending middle or high school during the study period. For reliability analyses, the internal consistency coefficient and the test-retest correlation coefficient were measured. For validity analyses, the exploratory factor analysis and correlation analysis with the Child Posttraumatic Stress Reaction Index for concurrent validity were measured. The Cronbach's alpha (the internal consistency coefficient) of the scale was 0.909, and the test-retest correlation coefficient was 0.663. One factor that could explain 58.5% of the variance was obtained and was congruent with the original construct of the scale. As for concurrent validity, the scale showed high correlation with the Child Posttraumatic Stress Reaction Index. It was concluded that the Turkish version of the DSM-5 Posttraumatic Stress Symptom Severity Scale-Child Form can be used as a valid and reliable tool.

Posttraumatic stress disorder symptoms and related factors after circumcision operation performed with general or local anesthesia

ObjectiveElective circumcision operation for male children can affect their psychological status.AimWe aimed to investigate the traumatic effect of the circumcision procedure and the predictive factors that could contribute to this effect.MethodOne hundred and thirty-four children who admitted to urology and child surgery clinics to perform a circumcision procedure were included in the study. The whole group was divided into two groups including general anesthesia (GA) (n = 71) and local anesthesia (LA) (n = 63) groups. The procedure was performed under general and local anesthesia in the relevant groups. All of the participants filled the Child Depression invenTory (CDI), State (SA), and Trait (TA) Anxiety and Childhood Anxiety Sensitivity index (CASI) before the operation, and the Child Posttraumatic Stress Reaction index (CPSRI) 1 month after the operation.ResultsCDI, CASI and TA scores of the children were similar in both groups, however, SA scores of the LA group were higher than GA group (P &lt; 0.001), and CPSRI scores of the GA group were higher than LA group (P = 0.04). When the other parameters were controlled in regression analysis, only CDI scores predicted CPSRI scores in LA group (P = 0.02), and TA scores predicted CPSRI scores in the GA group (P = 0.03).ConclusionChildren who witness the surgical procedure of the circumcision do not develop serious PTSD symptoms. In contrast, children who experience general anesthesia procedure during circumcision develop more serious PTSD symptoms than children operated with local anesthesia. Trait anxiety and depressive symptom severity may be important in developing PTSD symptoms after circumcision operation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Evaluation of a school-based, teacher-delivered psychological intervention group program for trauma-affected Syrian refugee children in Istanbul, Turkey

ABSTRACTObjective: The purpose of this study was to evaluate an innovative, protocol-based, group cognitive behavioral therapy (CBT) program delivered by trained teachers to reduce emotional distress and improve psychological functioning among the war-traumatized Syrian refugee students living in Istanbul.Methods: A total of 32 participants, aged between 10 and 15 years (mean = 12.41, SD = 1.68) and mostly females (m/f = 12/20) were randomly selected from a sample of 113 refugee students based on their trauma-related psychopathology as reflected in the Child Post-Traumatic Stress – Reaction Index (CPTS-RI) total score. The treatment program was implemented by the teachers trained by the study team to deliver a weekly, eight-session, protocol-based intervention in school setting. The degree of the fidelity to the original program was tested via video-recordings and subsequent analyses of the sessions. Effectiveness of the intervention was evaluated by a pre-test/post-test comparison using the CPTS-RI, Spen...

Cinsel İstismara Uğrayan Çocuk ve Ergenlerin Kendine Zarar Verme, İntihar Davranışı ve Psikiyatrik Bozukluklar Açısından Değerlendirilmesi

Amaç: Çocukluk çağı cinsel istismarının ilerleyen yıllarda kendine zarar verme, intihar, depresyon, disosiyatif bozukluk, travma sonrası stres bozukluğu (TSSB)gibi bozukluklarla ilişkili olduğu bilinmektedir. Bu çalışma- da istismara uğrayan çocuk ve ergenlerin özelliklerinin, kendine zarar verme ve intihar davranışı oranları ile depresyon, TSSB ve disosiyatif bozukluk oranlarının belirlenmesi ve aralarındaki ilişkinin incelenmesi amaçlanmıştır.Gereç ve Yöntem: Erciyes Üniversitesi Tıp Fakültesi Çocuk Psikiyatri Polikliniğine 01.01.2011–31.12.2011 tarihleri arasında adli rapor düzenlenmesi amacıyla gönderilen cinsel istismara maruz kalmış 0–18 yaş arası olgular; yaş, cinsiyet, istismar sıklığı, DSM IV-TR tanı sınıflamasına göre psikiyatrik tanıları, evden kaçma hikayesi ile intihar davranışı açısından retrospektif olarak incelendi. Aileler ve çocuklar tarafından doldurulan Çocuklar için depresyon ölçeği (ÇDÖ), disosiasyon ölçeği (DIS-Q) ve Çocuklar için travma sonrası stres tepki ölçekleri (ÇTSS-TÖ) retrospektif olarak incelendi.Bulgular: Çalışmamızda toplam 556 olgu değerlendirilmiştir. Başvuruları sırasında 24’nün (%4,3) intihar girişiminde bulunduğu, 15’inin(%2,7) kendine zarar verme davranışında bulunduğu, 6’sının(%1,1) intihar fikrine sahip olduğu belirlendi. Travma sonrası stres tepki ölçeği verilen vakaların 33’ünde (%5,6) ÇTSS-TÖ ölçeği puanı TSSB için anlamlı kabul edilen 40 değerinin üstünde bulundu. DIS-Q ölçeği verilen vakaların 8’inde (%1,6) DIS-Q ölçeği anlamlı olarak kabul edilen 2,5 değerinin üstünde bulundu. ÇDÖ ölçeği verilen vakaların 42’sinde (%7,3) depresyon ölçeği değerleri depresyon için anlamlı olarak kabul edilen 19 değerinin üzerinde bulundu.Sonuç: Cinsel istismara uğramış çocukları yakından takip etmek, onların sadece ruh sağlığını korumak için değil, aynı zamanda yine bir kurban olmaktan onları uzak tutmak ve intihar ile kendini yaralama davranışlarını önlemek için de çok önemlidir.

Effect of eye trauma on mental health and quality of life in children and adolescents.

The purpose of this study is to evaluate the effects of eye traumas on mental health and quality of life of children, adolescents, and their parents. Medical records of 20 children and adolescents presented with blunt and open eye injuries between June 2009 and May 2014 were reviewed. Demographics of patients, timing and type of trauma, findings of initial examination, and medical and surgical interventions applied were recorded. To detect mental health, "Affect disorders and schizophrenia interview chart for school children, now and lifelong" (AFSIC-NL) and "Child Post-Traumatic Stress Reaction Index (CPTSD-RI)" were used. "Pediatric scale of quality of life" (PedsQL) was used to assess quality of life for both parents and children. According to AFSIC-NL, 9 patients were diagnosed with mental disorders including posttraumatic stress disorder (n=3, 15% patients), generalized anxiety disorder (n=3, 15% patients), and major depression (n=3, 15% patients). The PedsQL values of both children's and parents' were at their lowest in school and physical health domains for children and in physical health domain for parents. A reverse correlation was detected between the number of surgeries and PedsQL-child physical functionality, school functionality, psychosocial functionality, and total scale point. There was a statistically significant relationship between initial visual acuity or lens damage and PedsQL-parent emotional functionality scale. Regarding CPTSD-RI, the parents of these patients have a mild posttraumatic stress disorder. Eye injuries can lead development of psychopathology in children. Therefore, psychiatric support must be provided in follow-up period for these patients.

Depression and post-traumatic stress disorder in child victims of sexual abuse: perceived social support as a protection factor

Background Social support has been shown to play a protective role against the development of post-traumatic stress disorder (PTSD) and depression in individuals exposed to trauma.Aims The purpose of this study was to investigate the effect of perceived social support on depression and PTSD in child victims of sexual abuse and to determine the relationship between them.Method In total 182 victims of sexual abuse aged 6–18 at time of interview were assessed. Clinical interviews, the Children’s Depression Inventory (CDI) and the Child Posttraumatic Stress Reaction Index (CPTS-RI) were used to assess children’s psychological status, while the Perceived Social Support Scale-Revised (PSSS-R) was used to measure social support.Results Girls had significantly higher median CDI and CPTS-RI scores than boys, while no significant difference was determined between boys and girls in terms of PSSS-R scores. A statistically significant negative correlation was determined between CDI and PSSS-R scores, CPTS-RI scores and PSSS-R scores in girls, while no significant correlation was identified in male victims.Conclusions In conclusion, we think that social support networks for victims of sexual abuse need to be broadened and increased, and that importance should be attached to protective approaches in that context.

Relations between depression and PTSB and perceived social support in female child victims of incest

Objective: This study investigated the association between psychological stress and perceived social support by examining the source of perceived social support (family, peers or teachers). Methods: Female victims of incest subjected to sexual abuse aged 9-18 years (n=31) and a control group consisting of age- and gender-matched girls with no history of psychological trauma were enrolled. All participants completed the Child Depression Inventory, Child Post-traumatic Stress Reaction Index and Perceived Social Support Scale-Revised. Results: The results showed that post-traumatic stress disorder (PTSD) and depression symptoms in victims of decreased significantly as perceived social support scores increased. Although the social support that incest victims perceived from families was significantly lower, perceived social support from families nevertheless significantly reduced symptoms of both depression and PTSD. No significant correlation was determined between perceived support from peers and psychological symptoms, while perceived social support from teachers reduced symptoms of PTSD. Discussion: Endeavors aimed at better understanding the interaction between sources of social support and psychological impact in incest experienced by children are important in terms of guiding preventive measures and treatment.

Decreased dehydroepiandrosterone sulphate levels in adolescents with post-traumatic stress disorder after single sexual trauma

Background: Recent evidence shows that the hypothalamic–pituitary–adrenal (HPA) axis can be dysregulated in chronic sexual abuse victims with post-traumatic stress disorder (PTSD). We hypothesized that PTSD in adolescents exposed to a single sexual trauma may function as a chronic stressor leading to HPA-axis dysregulation. Aims: The objective of this study was to assess dehydroepiandrosterone sulphate (DHEA-S) and cortisol levels in female adolescents |with single sexual trauma-related PTSD compared to healthy controls. Method: We assessed 20 female adolescent (age 12–18) single sexual trauma victims with PTSD from the Ondokuz Mayis University Department of Child and Adolescent Psychiatry between December 2013 and December 2014. PTSD symptoms were assessed using the Child Depression Inventory (CDI) and Child Posttraumatic Stress Reaction Index (CPSRI). Blood cortisol and DHEA-S were measured in 20 female adolescent sexual abuse victims with PTSD and 20 healthy adolescents after 12-h fasting using the chemiluminescence method. Results: Compared to age-matched controls, female adolescent sexual abuse victims with PTSD had significantly lower DHEA-S levels (U = 70.00, Z = − 3.517, p = 0.01, r = 0.55). There was also a significant negative correlation between DHEA-S and CDI scores (Spearman r = − 0.522, p < 0.01). Conclusions: Decreased DHEA-S levels and correlation with depressive symptoms are evidence for a dysregulated HPA-axis in female adolescent single sexual trauma victims with PTSD. Further research is now recommended with large patient groups in order to maximize generalizations.

High psychiatric comorbidity in adolescents with dissociative disorders.

The aim of this study was to evaluate psychiatric comorbidity rates and patterns in a sample of clinically referred adolescents diagnosed with dissociative disorders (DD) by using a structured interview. All participants completed a comprehensive test battery, which consisted of a questionnaire for sociodemographic data and clinical history, Child Posttraumatic Stress Reaction Index, Childhood Abuse and Neglect Questionnaire and the Adolescent Dissociative Experiences Scale. Diagnosis was made by the Structured Clinical Interview for DSM-IV Dissociative Disorders. Psychiatric comorbidity was assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children - Present and Lifetime Version. A total of 25 adolescent subjects aged 12-18 years participated in the study. Ten adolescents were diagnosed as having dissociative identity disorder and 15 of them were diagnosed as having dissociative disorder-not otherwise specified based on the Structured Clinical Interview for DSM-IV Dissociative Disorders findings. Adolescents with dissociative identity disorder were found to have higher scores on the Adolescent Dissociative Experiences Scale and Child Posttraumatic Stress Reaction Index than the dissociative disorder-not otherwise specified group. Sexual and physical abuses were also found to be among the main traumatic events. Incest was reported in six cases of the study sample. All subjects had at least one comorbid psychiatric disorder. The most common psychiatric diagnoses were major depressive disorder (n = 25; 100%) and post-traumatic stress disorder (n = 22; 88%). High psychiatric comorbidity rates were found in adolescents diagnosed with DD. A prevalent history of abuse and traumatic events was represented. Clinicians should be aware of the impacts of DD on adolescents' mental health.

Validation of the French version of the Child Post-Traumatic Stress Reaction Index: psychometric properties in French speaking school-aged children.

BackgroundAlthough the reliable and valid Child Post-Traumatic Stress Reaction Index (CPTS-RI) is a widely used measure of posttraumatic stress disorder (PTSD) symptoms in children, it has not been validated in French-speaking populations. The present study aims to assess the psychometric properties of the CPTS-RI in three samples of French-speaking school-children.MethodsData was obtained from three samples. Sample 1 was composed of 106 children (mean (SD) age = 11.7(0.7), 50% females) victims of an industrial disaster. Sample 2 was composed of 50 children (mean (SD) age = 10.8(2.6), 44% females) who had received an orthopaedic surgical procedure after an accident. Sample 3 was composed of 106 children (mean (SD) age = 11.7(2.2), 44% females) admitted to an emergency department after a road traffic accident. We tested internal consistency using Cronbach's alpha. We examined test-retest reliability using intraclass correlation coefficient. In order to assess the convergent validity of the French version of the CPTS-RI and the Clinician Administered PTS Scale-Child and Adolescent (CAPS-CA), spearman-correlation coefficient was computed. To verify the validity of the cut-off scores, a ROC curve was constructed which evaluated the sensitivity and specificity of each score compared to the diagnosis with the CAPS-CA. We also used principal components analysis with varimax rotation to study the structure of the French version of the CPTS-RI.ResultsCronbach's alpha coefficient was 0.87 for the French version of the CPTS-RI. Two-week test-retest intraclass correlation coefficient (n = 30) was 0.67. The French version of the CPTS-RI was well correlated with the CAPS-CA (r = 0.76, p<0.001). Taking the CAPS-CA as the diagnostic reference, with a diagnostic cut-off of >24 for the CPTS-RI, the sensitivity and specificities were 100% and 62.6%, respectively. The French version of the CPTS-RI demonstrated a three-factor structure.ConclusionsThe CPTS-RI is reliable and valid in French-speaking children.