Posttraumatic Stress Disorder Symptoms In Children Research Articles

Family therapy and EMDR after child abuse and neglect: moderating effects of child attachment style and PTSD symptoms on treatment outcome

ABSTRACT Background: Effective and appropriate care and treatment for children in order to decrease the psychosocial problems that arose after experiencing child abuse and neglect (CAN) is of vital importance, given the severity of symptomatology that may develop. Objective: The purpose of the present study was to examine whether attachment style and core cluster Posttraumatic Stress Disorder symptoms acted as moderators for treatment outcomes of a new integrative treatment model for trauma and attachment. In this treatment model, family therapy is combined with EMDR and obstacles for trauma processing are tackled first. Method: we included children, ages 6–12 years, with a history of CAN, who did not respond to evidence-based trauma treatment. Target treatment outcomes were problems in attachment, posttraumatic stress symptoms, behaviour, and emotion regulation. We conducted a multiple-baseline ABC Single-Case Experimental Design (SCED). We categorized 12 participants into four groups of attachment style and core cluster PTSD symptoms: (1) non-disorganized & re-experiencing; (2) non-disorganized & avoidance/hyperarousal; (3) disorganized & re-experiencing; & (4) disorganized & avoidance/hyperarousal. We compared the four groups with each other and across time, and the interaction between groups and effect over time. We conducted non-parametric permutation tests and estimated q-values for false discovery rate control. Results: Children with a disorganized attachment style had more severe symptomatology in general, except for posttraumatic stress symptoms. The treatment appeared more effective in targeting and successfully treating children with a non-disorganized attachment style, and specifically children with a non-disorganized attachment style and re-experiencing as core cluster PTSD symptoms. Conclusion: Our study underlines the complexity of treating children who developed a complicated combination of symptomatology after CAN and calls for the continuous development of innovative interventions.

Navigating treatment trajectories for families with young children after domestic violence: A Delphi-study exploring the priorities in terms of trauma-therapy and attachment-based intervention

BackgroundIn families with young children who have experienced domestic violence, both parents and children are at risk to develop post-traumatic stress disorder (PTSD) symptoms, and there is a risk for disrupted parent-child interactions. ObjectiveTo identify the factors on which expert-clinicians agree that they should be considered when deciding on the order of trauma therapy for the parent, trauma therapy for the child, and attachment-based intervention. Participantsand settings: Participants were 16 experienced clinicians, trained in attachment-based intervention for parents and their young children, trauma therapy for adults, and trauma therapy for young children. MethodsA classic three-round Delphi approach was used. Anonymous online surveys were filled out by the participants. Consensus was defined as agreement among 70% of the participants. ResultsAfter the third survey round, there were eleven factors for which there was consensus. These included the preference of the parent for one of the three individual therapies, impaired parental mentalizing capacity, insensitive/disrupted parenting, a problematic attachment history between parent and child, a high level of child PTSD symptoms, a high level of parental PTSD symptoms, severe risks for the development of the child, a very young age of the child, and exposure of the child to one or more traumatic events. ConclusionsAgreement was found on which factors to consider in planning the order of treatments for families who have experienced domestic violence. These factors can provide a starting point from where clinicians can design a treatment plan with a specific family.

Post-traumatic stress and joint hypermobility in children and adolescents of Nepal after exposure to an earthquake.

A substantial body of literature has traditionally addressed the connection between the exposure to catastrophic events and the development of Post-Traumatic Stress disorder (PTSD), especially in the vulnerable stratum of children and adolescents. However, little is known about their biological predisposing factors, and further research is needed, especially in the context of the recent earthquakes in Turkey and Syria. The data of this study was collected 4 months after the 2015 earthquakes in Nepal, with the objective of providing new evidence to the field and documenting the role of a new potential predisposing factor: the Joint Hypermobility Syndrome (JHS). 941 subjects from three different regions of the country, aged 8-18 years, were assessed in a school-based cross-sectional investigation. PTSD, as the main response variable, was assessed using the Child PTSD Symptom Scale (CPSS) questionnaire and analysed considering three sub-dimensions: the severity of symptoms, the severity of impairment, and both taken together. JHS was assessed using the Screening Questionnaire to detect Hypermobility (SQ-CH) questionnaire. The severity of symptoms was strongly predicted by the distance to the epicentre. Females showed more severe symptomatology, but a lower perturbation in the daily functioning. Younger children reported a greater functional impairment. JHS group showed more severe PTSD than non-JHS group. We observed variability in the severity of PTSD according to previously known risk factors such as the distance to the epicentre, sex, and age. We also found an association between PTSD and JHS, which is discussed in reference to the neuroconnective endophenotype. It might be useful to consider the role of each variable when planning a mass intervention after a disaster.

Validation of Patient-Reported Outcome Measurement Information System for Detection of Posttraumatic Stress in Children and Adolescents Following Procedures for Acute Orthopaedic Trauma.

The efficiency and validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) surveys were determined for pediatric orthopaedic trauma patients with posttraumatic stress disorder (PTSD) symptoms in a clinic setting. Prospective cohort study. Single-institution, Level I trauma center. All consecutive children aged 8-18 years undergoing procedures or surgery for orthopaedic trauma. The convergent, divergent, and discriminant validity of the PROMIS Anger and Anxiety computerized adaptive tests (CATs) were evaluated and compared with the previously validated Child PTSD Symptom Scale (CPSS). The efficiency in time to completion of the outcome measures was compared between the CPSS and PROMIS surveys. Cutoffs for increased likelihood of PTSD were established for the PROMIS questionnaires. A total of 233 subjects were included in this study (mean age 13.1 years with SD 2.8 years, 71% male). The majority (51%) of injuries were related to sports, and most (60%) involved the upper extremity. Of those included, 41 patients had high levels of PTSD symptoms on the CPSS (18%; 95% CI, 13.1-23.2%). The CPSS took 182 (interquartile range [IQR] 141-228) seconds versus 52 (IQR 36-84) and 52 (IQR 36-70) seconds for PROMIS Anger and Anxiety CATs, respectively. Convergent validity showed patient scores on both PROMIS instruments significantly correlated with CPSS scores (Anger: P < 0.001, r = 0.51; Anxiety: P < 0.001, r = 0.41). Neither PROMIS score correlated with University of California Los Angeles Activity Score (Anger: r = -0.26; Anxiety: r = -0.22), a functional outcome measure, demonstrating divergent validity. Both PROMIS instruments sufficiently discriminated across PTSD risk groups (Anger P < 0.001; Anxiety P < 0.001). A score of at least 53 on PROMIS Anger or at least 48 on PROMIS Anxiety indicated an increased likelihood of PTSD risk. PROMIS Anger and Anxiety CATs are efficient and valid for evaluating posttraumatic stress in children following orthopaedic trauma procedures. Diagnostic Level I. See Instructions for Authors for a complete description of levels of evidence.

A biomarker of brain arousal mediates the intergenerational link between maternal and child post-traumatic stress disorder

This study examined whether there is a biological basis in the child's resting brain activity for the intergenerational link between maternal interpersonal violence-related posttraumatic stress disorder (IPV-PTSD) and child subclinical symptoms. We used high-density EEG recordings to investigate the resting brain activity in a sample of 57 children, 34 from mothers with IPV-PTSD, and 23 from mothers without PTSD. These children were part of a prospective, longitudinal study focusing on the offspring of mothers with and without IPV-PTSD, reporting how the severity of a mother's IPV-PTSD can impact her child's emotional regulation and risk for developing mental illness. However, we had not yet looked into potential EEG biomarkers during resting state that might mediate and/or moderate effects of maternal IPV-PTSD severity on child mental health, and in particular the risk for PTSD. The alpha band spectral power as well as the aperiodic exponent of the power spectrum (PLE; power-law exponent) were examined as mediators of maternal IPV-PTSD and child PTSD.While there was no difference in alpha spectral power between the two groups, PLE was significantly reduced in children of mothers with IPV-PTSD compared to control children, indicating cortical hyper-arousal. Interestingly, child PLE was negatively correlated with the severity of maternal IPV-PTSD, suggesting an intergenerational interaction. This interpretation was reinforced by a negative correlation between child PLE and child PTSD symptoms. Finally, causal analyses using structural equation modelling indicated that child PLE mediated the relationship between maternal PTSD severity and child PTSD. Our observations suggest that maternal IPV-PTSD has an intergenerational impact on the child neurobehavioral development through a correlated abnormal marker of brain arousal (i.e. child PLE). These findings are potentially relevant to psychotherapy research and to the development of more effective psycho-neurobehavioral therapies (i.e. neurofeedback) among affected individuals.

Post-traumatic stress disorder symptoms following exposure to acute psychological trauma in children aged 8–16 years in South Africa: protocol for the Sinethemba longitudinal study

IntroductionChildren exposed to trauma are vulnerable to developing post-traumatic stress disorder (PTSD) and other adverse mental health outcomes. In low-and middle-income countries (LMICs), children are at increased risk of exposure...

Understanding the dyadic mental health of refugee parents and children after fleeing the 2022 Ukraine war.

In February 2022, Ukraine suffered a devastating assault by Russia, leading to destruction, casualties, and displacement. Among those displaced were over 1.5 million families with children. War and displacement expose families to a heightened risk of mental health issues. These risks increase when both the parents and the children are exposed to trauma and develop mental health difficulties. This study investigated the prevalence of posttraumatic stress disorder (PTSD) and other mental health issues among parents and children and the associations between them. The study included 50 dyads of children and parents who had arrived in Israel after fleeing the war in Ukraine. Parents completed self-report questionnaires to assess their mental health and their children's mental health. About 56% of the parents and 2% of the children met the criteria for PTSD, and 50% of the children and 56% of the parents met the cutoff for clinical general psychological distress. Significant correlations were found between the parent's PTSD levels and the children's PTSD symptoms. Significant correlations were found between the parent's general distress and the children's PTSD symptoms, general distress, and externalizing problems. Children whose parents showed high rates of PTSD showed significantly higher PTSD and distress rates. Parents and children of refugees show high levels of mental health difficulties. The children's mental health is associated with the parent's mental health. A deeper understanding of the challenges faced by refugee families can inform the development of targeted assistance programs and the recruitment and training of personnel in host countries. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effect of Interactive Media-Based Music and Art Therapies on Reduction in PTSD Symptoms in Children and Adult Victims of Abduction

The aim of this study was to examine the impact of music and art therapies in reducing symptoms of PTSD among children and adults with abduction experiences in Nigeria. The study was a quasi-experiment with a pre-test, post-test and follow-up assessment design. The participants were divided into control (n = 107), music therapy (n = 108) and art therapy (n = 108) groups. The result of the ANCOVA analysis revealed no significant interactive effect of family happiness on the relationship between the interventions and reduction in PTSD symptoms, F(1,295)0.037 p = 0.848). However, there was a significant main effect of the treatment condition and PTSD scores of the participants at Times 1, 2, and 3, respectively F(1,295). 1640.756, p = 0.001). The degree of the relationship was assessed using partial eta squared, which yielded (ηp 2= 0.848). It was also found that music therapy was more effective in reducing PTSD symptoms in children, while art therapy was more effective in reducing PTSD in adults. The result of this study could be useful for psychologists and mental health experts who may be interested in designing and implementing interventions targeting children and adults with PTSD symptoms. The result also has implications for control mastery theory by showing that music and art therapies could be useful in helping adults and children gain control of their minds after exposure to traumatic events.

The Effect of Trauma-Focused Cognitive-Behavioral Therapy on Post Traumatic Stress Disorder (PTSD) Symptoms in Children and Adolescents

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) has been shown to be an effective treatment for reducing PTSD symptoms in children and adolescents. Research has consistently demonstrated that TF-CBT leads to significant decreases in symptom severity, improved emotion regulation, and enhanced emotional well-being. Additionally, TF-CBT has been found to decrease depressive and anxiety symptoms in youth with co-occurring mental health conditions. The approach's effectiveness is influenced by factors such as age, trauma severity, and presence of additional mental health conditions. Furthermore, resilience plays a crucial role in mitigating the impact of adverse childhood experiences on mental health. By fostering effective coping strategies and promoting protective factors, TF-CBT can help children and adolescents develop resilience and improve their overall well-being Keywords: Fake News, Long Short-Term Memory (LSTM), Support Vector Machine, Dependencies Machine Learning, Journal Reference Format: Longe, Bankole-Phillips. A. (2024): The Effect of Trauma-Focused Cognitive-Behavioral Therapy on Post Traumatic Stress Disorder (PTSD) Symptoms in Children and Adolescents. Journal of Behavioural Informatics, Digital Humanities and Development Rese Vol. 10 No. 1. Pp 75-78. https://www.isteams.net/behavioralinformaticsjournal dx.doi.org/10.22624/AIMS/BHI/V10N1P7

Clinical Efficacy of Psychotherapeutic Interventions for Post-Traumatic Stress Disorder in Children and Adolescents: A Systematic Review and Analysis.

Background: This systematic review aggregates research on psychotherapeutic interventions for Post-Traumatic Stress Disorder (PTSD) in children and adolescents. PTSD in this demographic presents differently from adults, necessitating tailored therapeutic approaches. In children and adolescents, PTSD arises from exposure to severe danger, interpersonal violence, or abuse, leading to significant behavioral and emotional disturbances that jeopardize long-term development. The review focuses on describing PTSD within two age groups, children (6 to 12 years) and adolescents (12 to 18 years), while evaluating the effectiveness of various clinical interventions aimed at this condition. Methods: Utilizing the PRISMA guidelines, this review systematically examines studies that assess clinical interventions for PTSD in the younger population. Results: Key symptoms of PTSD in children and adolescents include avoidance, overstimulation, flashbacks, depression, and anxiety. The review identifies several effective treatments, including Cognitive Behavioral Therapy (CBT), Trauma-Focused CBT (TF-CBT), Eye Movement Desensitization and Reprocessing (EMDR), Systemic Therapy, Play Therapy, Exposure Therapy, Relaxation Techniques, and Psychodynamic Psychotherapy. Particularly, TF-CBT is highlighted as the most effective and commonly used method in treating childhood and adolescent PTSD, as supported by most of the studies reviewed. Conclusions: A significant outcome of this study is the short-term effectiveness of CBT in reducing PTSD symptoms in children and adolescents. The findings underline the importance of psychotherapeutic interventions and mark a substantial advancement in understanding PTSD in young populations. It is crucial for practitioners to integrate various psychotherapeutic strategies into their practice to improve patient outcomes and treatment efficacy.

Post-traumatic stress disorder in adolescents during the Covid-19 pandemic: a cross-sectional study of 326 cases

IntroductionSince December 2019, the coronavirus pandemic has led to the deaths of almost 4.37 million people worldwide and 21,905 people in Tunisia. Containment measures, stress due to fear of infection by the virus and death are likely to be traumatic events, particularly in adolescents, and may lead to the development of symptoms of post-traumatic stress disorder (PTSD).ObjectivesTo determine the prevalence of PTSD in a population of adolescents during the COVID-19 pandemic and to identify the factors associated with it.MethodsThis study was a cross-sectional among a representative sample of students enrolled in secondary schools, in the region of Hamma- Gabes. We used a pre-established information sheet comprising 27 questions exploring sociodemographic and family data and specific data relating to the COVID-19 pandemic. The Arabic version of The Child PTSD Symptom Scale (CPSS) was used to screen for PTSD symptoms.Results326 adolescents were collected which the mean age was 16.6 years (14 to 18 years). The family environment was conflictual in 11.9% of cases. Among the adolescents, 5.5% had a history of somatic pathology. A history of psychiatric pathology was noted in 0.6%, dominated by depression. Personal infection by Covid-19 was noted in 4% of adolescents. A family member was affected in 27.3% of cases. Adolescents were exposed to the death of a close relative in 22.4% of cases. PTSD was diagnosed (according to the CPSS) in 37.4% of cases, with mild severity in 6.5%, moderate in 0.6%, moderately severe in 8%, severe in 5.2% and extremely severe in 17.2%. The analytical study showed that PTSD was correlated with a conflictual family environment (p=0.017), personal infection by COVID (P=0.003), infection of a close relative by COVID (P&lt;0.001) and the death of a close relative by COVID (p&lt;0.001).ConclusionsAccording to our study, the frequency of post-traumatic stress disorder among adolescents during the COVID-19 pandemic was high, underlining the need to screen at-risk populations for populations for early intervention.Disclosure of InterestNone Declared

501 Maternal PTSD and Child Brain Function During Implicit Emotion Regulation

OBJECTIVES/GOALS: Maternal mental health, such as post-traumatic stress disorder (PTSD), is closely linked to child mental health. PTSD in mothers is associated with their children’s emotional responses. We examined associations between maternal PTSD and child brain function during emotion regulation. METHODS/STUDY POPULATION: Eight children ages 10-12 years, whose mothers had trauma histories, performed the Emotional N-Back task during functional MRI scanning. Mothers and children each reported on their trauma exposure and PTSD symptom severity. BOLD response to fearful faces during the Emotional N-Back was extracted from two specific brain regions of interest, amygdala and anterior cingulate cortex. These regions are involved in emotional response and attentional control, which are processes intrinsic to emotion regulation. An independent samples t-test was conducted on children’s BOLD response to fearful faces, with maternal PTSD symptom severity (high, low) as the independent variable. A parallel analysis was conducted with child PTSD symptom severity (high, low) as the independent variable. RESULTS/ANTICIPATED RESULTS: We found a main effect of maternal PTSD within brain regions of relevance to implicit emotion regulation. Compared to children whose mothers reported low PTSD symptom severity (n=4), children whose mothers reported high PTSD symptom severity (n=4) showed greater responsiveness to fearful faces in anterior cingulate cortex (t=2.04, p=.09,d=1.44) and amygdala (t=2.44, p=.05, d=1.72) at trending significance. A parallel analysis with child PTSD symptom severity showed no differences in brain function by this factor (ps=.55-.61). DISCUSSION/SIGNIFICANCE: Our pilot study is the first, to our knowledge, to examine associations between maternal PTSD and brain function during emotion regulation in their children. This study lays a foundation for future work; our goal is to explore dysfunction in emotion regulation neurocircuitry as one mechanism linking maternal PTSD to their children’s mental health.

Coping Mechanisms and Posttraumatic Stress Exhibited by Children in Areas of Yemen's Armed Conflict in Southern Saudi Arabia.

This study is an attempt to explore war-related trauma, its stressful effects, and the coping strategies of Saudi schoolchildren. The authors hypothesized that children exposed to war-related trauma will show higher levels of PTSD, and that those with higher levels of PTSD symptoms use more maladaptive coping strategies. The study describes the correlation between traumatic events and posttraumatic stress disorder (PTSD) as well as coping strategies. Five hundred twenty-seven intermediate and high school students, 12 to 18 years old, living in the conflict zone in southern Saudi Arabia completed three standardized self-reported scales: the War Zone Traumatic Events Checklist, the Child PTSD Symptom Scale, and the Children's Coping Strategies Checklist. Each participating student was randomly chosen. Analysis was based on two groups: the high-PTSD symptoms group (182 children) and the low-PTSD symptoms group (345 children). The study was conducted between September 2020 and April 2022 while the war was ongoing as part of an ongoing larger study. Children exposed to war-related traumatic events exhibited greater prevalence rates for PTSD. The children reported high levels of PTSD symptoms and applied a variety of coping strategies to manage related stress. Participants rarely reported that psychological or educational interventions had been used to manage the war-related traumatic experiences and PTSD or to improve related coping styles. The results are discussed in the context of mental health services needed for children in the conflict zone. To bridge the gap between health care services and the needs of children with PTSD, and for better understanding and interventions, health professionals are invited to develop a biopsychosocial model that identifies the risks of PTSD related to exposure to war-related traumatic events in school-aged children and, hence, provide a multidisciplinary intervention program that educates, encourages, and supports teachers and parents in following medical recommendations and goals.

Longitudinal Associations Between Pain, Risk for Posttraumatic Stress Disorder, Posttraumatic Stress Symptoms, and Pain Characteristics in Children After Unintentional Injury.

Approximately 20% of children demonstrate persistent posttraumatic stress symptoms (PTSS) after unintentional injury, with more severe pain intensity predicting concurrent and later PTSS. Examining additional pain characteristics like pain behaviors, impairment related to pain, and subjective experiences of pain might provide additional insight into the mechanisms that reinforce relationships between risk for posttraumatic stress disorder (PTSD), PTSS, and pain. During hospitalization for unintentional injury, the Screening Tool for Predictors of PTSD (STEPP) was administered and the highest pain score was collected. One month later, the Child PTSD Symptom Scale and PROMIS questionnaires assessed PTSS and pain characteristics respectively, including intensity, interference, behaviors, and quality. Correlations between PTSS and PROMIS questionnaires were significant. STEPP predicted future PTSS and all PROMIS questionnaires. The highest pain score predicted future PTSS, as well as pain interference and pain behavior, and did not predict pain intensity and pain quality. When STEPP and highest pain score were combined into a single regression, STEPP and highest pain score predicted future PTSS but only STEPP continued to predict all PROMIS questionnaires. PTSD risk significantly predicted PTSS and pain characteristics 1 month later. The highest pain score predicted future PTSS and several pain characteristics but no longer had predictive value for pain-related outcomes when combined with PTSD risk. These results indicate that risk factors for PTSD are stronger predictors than pain-related risk factors in predicting pain outcomes. Addressing PTSD risk, as well as pain intensity during hospitalization, may result in improved outcomes for children with unintentional injury.

Psychological implications of man-made trauma and efficacy of “Teaching Recovery Techniques” on children and adolescents exposed to trauma

Trauma is a mental state of distress and pain resulting from memories of an unexpected, terrifying experience that threatens the survivor's sense of security, especially in children. The present research aimed to examine the Psychological Implications of man-made trauma and the efficacy of Teaching Recovery Techniques (TRT) to children and adolescents exposed to trauma.The Study comprises two parts. First, it aimed to find out the relationship between Child trauma (ChT) and Post-Traumatic Stress and Depressive Symptoms (PSTD) in children and adolescents who were exposed to fire incidents and terrorist attacks. Non-probability Purposive sampling was used in which 80 participants (45 boys and 35 girls) aged 8—17 years were selected from Joseph Colony and Yohanabad Christian Community of Lahore, and the second aimed to assess the TRT on the children and adolescents exposed to terrorist attacks. The results revealed a significant positive relationship between ChT and PTSD in children and adolescents exposed to fire incidents and terrorist attacks. Significant differences were found between the two groups in PTSD symptoms experienced by the participants. Furthermore, participants exposed to terror attacks experienced more PTSD symptoms than fire attacks. Age and proximity to the traumatic incident were significant predictors of PTSD symptoms. The intervention was given in five sessions at the Sunday school of Christ Church Yohanabad Lahore, and the results were promising. It concludes that significant improvement in post-intervention reduces PTSD symptoms in children and adolescents. The study findings can be applied to other such man-made and natural traumas in the future.

PTSD in Children and Adolescents in the Educational Context. A Conceptual Approach

This paper explores the multifaceted aspects of Post-Traumatic Stress Disorder (PTSD) in children and adolescents within educational contexts. It investigates the complexity of diagnosing PTSD in this demographic, recognizing the role of cognitive function, expression barriers, and parental influence. Considering the diverse and unique presentations of PTSD symptoms in children, the study highlights the challenges in identifying and treating PTSD among school-age children and adolescents, especially among highly vulnerable populations such as refugees. Through an extensive review of existing literature, the paper compares and contrasts the criteria from DSM-5 and ICD-11 for PTSD diagnosis and evaluates the efficacy of treatment options such as EMDR, CBT, and school-based interventions. The impact of PTSD on academic performance and social integration is emphasized, underlining the implications for educators, mental health professionals, and policy makers. Furthermore, the study calls attention to the co-occurrence of PTSD with other mental health conditions and the significant effects beyond educational achievement, including developmental, social, and cognitive domains. Drawing on current research, it advocates for integrated intervention strategies that promote socio-emotional learning, and underscores the importance of a secure, supportive educational environment.

Joint developmental trajectories of depression and post-traumatic stress disorder symptoms among Chinese children during COVID-19

BackgroundIn early 2020, Chinese children started to demonstrate severe depression and post-traumatic stress disorder symptoms (PTSS) caused by lockdown and self-isolation (measures taken at the beginning of the COVID-19 pandemic). ObjectivesConcerning the significant impact of the pandemic on children's physical and mental development, the study aimed to explore children's depression and PTSS during the COVID-19 pandemic and the protective effects of family resilience on the trajectories. Methods883 children participated and completed three waves of online follow-up questionnaires. The latent growth mixture modeling (LGMM) analysis was used to explore the trajectories of children's depression and PTSS based on the individual approach. ResultsTwo types of depression trajectories were identified and defined as the resilient group (83.01 %) and the recovery group (16.99 %); Two types of PTSS trajectories were identified and defined as the resilient group (71.12 %) and the recovery group (28.88 %); Two types of the joint trajectories of depression and PTSS were identified and defined as the resilient group (83.47 %) and the chronic group (16.53 %). The results indicated that maintaining a positive outlook (a dimension of family resilience) was the potential predictor of PTSS trajectories. ConclusionThe trajectories of depression and PTSS among Chinese children during the COVID-19 pandemic were heterogeneous, and there were similar evolving subtypes. Family resilience could be a critical protective factor for children and families.

Effect of Acceptance and Commitment Therapy on Emotional Regulation, Psychological Flexibility, and Stress in Children of Veterans With PTSD: A Randomized Controlled Clinical Trial

Objectives The present study aims to investigate the effect of acceptance and commitment therapy (ACT) on emotional regulation, psychological flexibility, and symptoms of post-traumatic stress disorder (PTSD) in children of veterans with PSTD. Methods This is a randomized controlled clinical trial with a pre-test/post-test/follow-up design. Participants were 70 children of veterans with PTSD (boys and girls) aged 15-19 years, who were selected using simple random sampling method and randomly divided into two groups of 35 including ACT and control. Before, immediately after, and 12 months after the intervention, people were measured using the acceptance and action questionnaire-II, difficulty in emotional regulation scale, and the PTSD checklist for DSM-5. The intervention group received group ACT at 8 sessions of 60-90 minutes. For the control group, life skills education was presented at 7 sessions of 60-90 minutes. Finally, the data was analyzed using SPSS software, version 22. Results The results of analysis of covariance showed a significant difference in difficulty in emotional regulation, psychological flexibility and PTSD symptoms in the post-test and follow-up phases in two groups (P&lt;0.01). Moreover, the two ACT and control groups were significantly different in the hyperarousal symptom of PTSD at follow-up phase, but there was no significant difference in two symptoms of re-experiencing trauma and negative alterations in mood/avoidance (P&gt;0.05). Conclusion The ACT can improve emotional regulation skills and psychological flexibility and reduce PTSD symptoms in children of veterans with PTSD. Therefore, this method can be used in counseling and mental health centers to improve these children’s symptoms.

Post-traumatic stress disorder in adolescents during the COVID-19 pandemic: a cross-sectional Tunisian study

ObjectivesEvaluate the prevalence of post-traumatic stress disorder (PTSD) on Tunisian adolescents enrolled in secondary schools during the COVID-19 pandemic and to identify associated factors.MethodsWe conducted a cross-sectional, descriptive, and analytic study on a sample of Tunisian adolescents. Participants were randomly selected from two schools in the region of Hamma (southern of Tunisia). This survey took place during the period extending from 5 March to 26 May 2021. Students were asked to complete a pre-established information sheet which contains questions about socio-demographic features, medical history, knowledge about the pandemic of COVID-19, and personal or family history of being infected with this virus. The Child PTSD Symptom Scale (CPSS) was used to screen for PTSD among students.ResultsThe sample was composed of 326 students (92 boys and 234 girls; mean age 16.65 years). The prevalence of PTSD was 37.4% according to the CPSS. Adolescents had more PTSD symptoms when they lived in a conflictual family atmosphere (AOR = 3.1 [1.4–6.9]). Moreover, adolescents who were infected by the virus, or whose relatives were contaminated or dead because of the COVID-19 infection, were more likely to develop PTSD symptoms. We stated that students who estimated that their knowledge about the COVID-19 pandemic were insufficient had a significant higher risk for PTSD (AOR = 2.5 [1.4–4.6]).ConclusionStudents seemed to have high frequency of PTSD symptoms during the COVID-19 pandemic. The identification of risk and protective factors are interesting to guide screening and prevention actions.Key points• Adolescents were vulnerable to psychological distress during COVID-19 pandemic, they were more exposed to develop post-traumatic stress disorder.• A total of 37.4% was the prevalence of PTSD among Tunisian adolescents. Sufficient information about the pandemic was protective. Conflictual family atmosphere constitutes a risk factor.• Family and social efforts should be directed toward supporting teenagers to cope with the pandemics’ mental health burden.

Comorbidity Patterns of Posttraumatic Stress Disorder and Depression Symptoms: Cross-Validation in Two Postearthquake Child and Adolescent Samples

Background. Children and adolescents who have been exposed to a major natural disaster are more likely to suffer from posttraumatic stress disorder (PTSD) and depression. However, only a few studies have examined comorbidity patterns at the symptom level. Furthermore, researchers should validate their findings using multiple samples to address the psychological reproducibility challenge. Methods. The Child PTSD Symptom Scale (CPSS) and Center for Epidemiological Studies Depression Scale for Children (CES-DC) were administered to two postearthquake child and adolescent samples (Wenchuan earthquake, N = 1506 ; Ya’an earthquake, N = 720 ). Each sample was followed up twice. Comorbidity patterns were characterized by cross-lagged panel network analysis (CLPN), and communities were determined by bootstrap exploratory graphical analysis (bootEGA). Results. Except for having difficulty remembering important aspects of the trauma, the remaining dysphoria symptoms could be considered bridge symptoms between PTSD and depression. Most often, intrusive and avoidant symptoms clustered together, whereas dysphoria symptoms tended to cluster with depressive symptoms. The relationship between PTSD and depression was reciprocal; within PTSD, intrusive symptoms often triggered avoidance symptoms. The correlation coefficient between the two networks was 0.70, and the correlation coefficient of node centrality was 0.55. Findings. The association between dysphoria symptoms and depression was strong, and intrusive symptoms constituted the core symptoms of PTSD. Depression and PTSD were causally related, explaining the high comorbidity rates. Two sample networks had similar global characteristics but different local characteristics. The conclusions can be generalized to some extent.