Child Posttraumatic Stress Reaction Research Articles

Investigation of Posttraumatic Stress and Depression Symptoms in Children Who Experienced the Kahramanmaraş Earthquake.

Trauma is important in the etiology of many problems including childhood anxiety, somatization, hostility and sleep disturbance. This research was conducted to examine the posttraumatic stress and depression symptoms of children who experienced the Kahramanmaraş earthquakes in Türkiye. The research, designed as a descriptive and relational type, was conducted with 636 children in the 10 to 18 age group who experienced the earthquake. Data were obtained through the Child Information Form, the Child Posttraumatic Stress Disorder Reaction Index (CPTSD-RI), and the Depression Inventory for Children. According to the scale scores, 100% of the children had depression symptoms, while 23% had severe trauma and 77% had very severe posttraumatic stress symptoms. It was revealed that children's posttraumatic stress reactions explained 71% of their depression (p < .001). It has been determined that the most important triggers affecting children's posttraumatic stress reactions are being trapped under debris and the problems they experience in reaching shelter and assistance (B: -3.706; B: -1.547; B: 3.969). It was determined that there was a strong relationship between posttraumatic stress reactions and depression symptoms of children who experienced the earthquake. It has been observed that the experiences of children during and after the earthquake can have an impact on their trauma situations.

Parent-reported posttraumatic stress reactions in children and adolescents: Findings from the mental health of parents and children in Ukraine study.

Despite the long-standing ongoing war in Ukraine, information regarding war-related negative mental health outcomes in children is limited. A nationwide sample of parents in Ukraine was surveyed to assess posttraumatic stress disorder (PTSD) symptoms in their children and to identify risk factors associated with child PTSD status. A nationwide opportunistic sample of 1,238 parents reported on a single randomly chosen child within their household as part of The Mental Health of Parents and Children in Ukraine Study. Data were collected approximately 6 months after the war escalation in February 2022. The prevalence of PTSD was estimated using the parent-reported Child and Adolescent Trauma Screen (CATS). Based on parental reports, 17.5% of preschoolers and 12.6% of school-age children met Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria for PTSD. Delay in milestone development (AOR = 2.38, 95% confidence interval [CI] [1.38-4.08]), having a parent affiliated with the emergency services or army (AOR = 2.13, [1.28-3.53]), parental PTSD/complex PTSD status (AOR = 1.88, [1.22-2.89]), and mean changes in parental anxiety (AOR = 1.98, [1.44-2.72]) were among the strongest predictors of increased risk of pediatric PTSD. Russia's war escalation in Ukraine resulted in an increased estimated prevalence of war-related PTSD in children of various ages. Urgent efforts to increase the capacity of national pediatric mental health services are critically needed to mitigate these challenges in an environment of limited financial and human resources. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Does posttraumatic stress predict frequency of general practitioner visits in parents of terrorism survivors? A longitudinal study

ABSTRACTBackground: Life threat to children may induce severe posttraumatic stress reactions (PTSR) in parents. Troubled mothers and fathers may turn to their general practitioner (GP) for help.Objective: This study investigated frequency of GP visits in mothers and fathers of adolescent and young adult terrorism survivors related to their own PTSR and PTSR in their surviving children.Method: Self-reported early PTSR (4–5 months post-disaster) in 196 mothers, 113 fathers and 240 survivors of the 2011 Utøya terrorist attack were linked to parents’ three years pre- and post-disaster primary healthcare data from a national reimbursement claims database. Frequency of parents’ GP visits was regressed on parent and child PTSR, first separately, then in combination, and finally by including an interaction. Negative binominal regressions, adjusted for parents’ pre-disaster GP visits and socio-demography, were performed separately for mothers and fathers and for the early (<6 months) and delayed (6–36 months) aftermath of the terrorist attack.Results: Parents’ early PTSR were significantly associated with higher early frequency of GP visits in mothers (rate ratio, RR = 1.31, 95%CI 1.09–1.56) and fathers (RR = 1.40, 95%CI 1.03–1.91). In the delayed aftermath, early PTSR were significantly associated with higher frequency of GP visits in mothers only (RR = 1.21, 95%CI 1.04–1.41). Early PTSR in children were not significantly associated with an overall increase in GP visits. On the contrary, in mothers, child PTSR predicted significant decrease in GP visits the delayed aftermath (RR = 0.83, 95%CI 0.71–0.97).Conclusions: Our study suggests that GPs may play an important role in identifying and providing for parents’ post-disaster healthcare needs. GPs need to be aware that distressed individuals are likely to approach them following disasters and must prepare for both short- and long-term healthcare needs.

Children's disaster reactions: the influence of exposure and personal characteristics.

This paper reviews children's reactions to disasters and the personal and situational factors that influence their reactions. Posttraumatic stress disorder (PTSD) and posttraumatic stress reactions are the most commonly studied outcomes, though other conditions also occur including anxiety, depression, behavior problems, and substance use. More recently, traumatic grief and posttraumatic growth have been explored. New research has delineated trajectories of children's posttraumatic stress reactions and offered insight into the long-term consequences of their disaster experiences. Risk factors for adverse outcomes include pre-disaster vulnerabilities, perception of threat, and loss and life disruptions post-disaster. Areas in need of additional research include studies on the timing and course of depression and anxiety post-event and their interactions with other disorders, disaster-related functional and cognitive impairment, positive outcomes, and coping.

Posttraumatic stress reactions in children and adolescents: Factor structure and gender invariance in the dysphoria and numbing model.

Posttraumatic stress reactions in children and adolescents: Factor structure and gender invariance in the dysphoria and numbing model.

Childhood traumatic events and adolescent overgeneral autobiographical memory: Findings in a UK cohort

BackgroundOvergeneral autobiographical memory has repeatedly been identified as a risk factor for adolescent and adult psychopathology but the factors that cause such over-generality remain unclear. This study examined the association between childhood exposure to traumatic events and early adolescent overgeneral autobiographical memory in a large population sample. MethodsThirteen-year-olds, n = 5,792, participating in an ongoing longitudinal cohort study (ALSPAC) completed a written version of the Autobiographical Memory Test. Performance on this task was examined in relation to experience of traumatic events, using data recorded by caregivers close to the time of exposure. ResultsResults indicated that experiencing a severe event in middle childhood increased the likelihood of an adolescent falling into the lowest quartile for autobiographical memory specificity (retrieving 0 or 1 specific memory) at age 13 by approximately 60%. The association persisted after controlling for a range of potential socio-demographic confounders. LimitationsData on the traumatic event exposures was limited by the relatively restricted range of traumas examined, and the lack of contextual details surrounding both the traumatic event exposures themselves and the severity of children's post-traumatic stress reactions. ConclusionsThis is the largest study to date of the association between childhood trauma exposure and overgeneral autobiographical memory in adolescence. Findings suggest a modest association between exposure to traumatic events and later overgeneral autobiographical memory, a psychological variable that has been linked to vulnerability to clinical depression.

Children Following the Ghislenghien Gas Explosion: PTSD Predictors and Risk Factors

This paper describes the risk factors for the development of posttraumatic stress reactions in children after a technological disaster in Ghislenghien, Belgium in 2004. Children were assessed at five months (T1, N = 128) and at fourteen months (T2; N = 69). At T1 and T2 respectively, 7 % and 4 % of the responding children showed severe posttraumatic stress reactions. Of those who showed posttraumatic stress reactions at T1, 60 % recovered from these symptoms at T2. One child developed severe posttraumatic stress reactions between T1 and T2. Risk factors related to posttraumatic stress reactions were: (a) type of exposure to the disaster; (b) peritraumatic dissociation during or immediately after the disaster; and (c) dissatisfaction with the received psychological help.

Use of the Breakthrough Series Collaborative to Support Broad and Sustained Use of Evidence-Based Trauma Treatment for Children in Community Practice Settings

Empirically supported treatments for posttraumatic stress reactions in children are not widely available. This observational study evaluates the feasibility and utility of adapting the Institute for Healthcare's Breakthrough Series Collaborative (BSC) to support the broad implementation and sustained use of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) in community practice settings. Study findings indicated that agency staff in diverse roles viewed the BSC methodology as a valuable and practicable approach for facilitating skillful delivery of TF-CBT with fidelity. Use of TF-CBT increased over the course of the collaborative and findings from a survey conducted one year later indicated that participating agencies were able to sustain and spread the practice.

Measuring Posttraumatic Stress Reactions in Children: A Preliminary Validation of the Children’s Responses to Trauma Inventory

The Children’s Responses to Trauma Inventory (CRTI) is a self-report measure for posttraumatic stress reactions in children. We validated the original CRTI through secondary data analysis of four clinical and nonclinical samples (N = 96) and expert consultation. After revision, the CRTI was further validated in 8- to 12-year-old traumatized children in the general population (N = 243). The original CRTI showed moderate to excellent reliability and both convergent and discriminant validity, but it also had limitations in formulation and scope of the items. The revised measure showed good to excellent reliability. Convergent validity was established against measures for posttraumatic stress and quality of life. These preliminary results must be confirmed in larger samples with more extensive analyses.

Posttraumatic stress reactions in siblings after mutual disaster: Relevance of family factors

In this study, the importance of family factors in the development of posttraumatic stress reactions in children after trauma is studied by comparing siblings and nonsiblings who experienced the tsunami in Southeast Asia in 2004 as tourists. Thirty-eight sibling pairs aged 6-17 years were interviewed using the UCLA Posttraumatic Stress Disorder Reaction Index. The sibling differences were similar to differences found in randomly selected children in the same sample, indicating that family influences may not be as important as anticipated. The results are an important contribution to our understanding of what contributes to and influences the development of posttrauma reactions in children. They also suggest the importance of conducting individual assessments even after mutually experienced trauma.

Treatment and Prevention of Posttraumatic Stress Reactions in Children and Adolescents Exposed to Disasters and Terrorism: What Is the Evidence?

ABSTRACT— Youth who are exposed to devastating natural disasters or terrorist attacks report high levels of posttraumatic stress (PTS) and may develop posttraumatic stress disorder (PTSD). This article summarizes evidence on the treatment of PTS reactions in these youth and describes interventions developed for the immediate aftermath of the event, the short‐term recovery and rebuilding phase, or the long‐term recovery phase. Psychological first aid and evidence‐based psychoeducational materials show promise for the early phases of postdisaster recovery. For youth with persistent PTSD, cognitive‐behavioral interventions appear promising but require further study. Children and adolescents exposed to disasters and acts of terrorism may need multicomponent interventions because their reactions are often multifaceted and often include other psychological problems.

Social Support, Discrimination, and Coping as Predictors of Posttraumatic Stress Reactions in Youth Survivors of Hurricane Katrina

This study examined the influence of aspects of the post–Hurricane Katrina recovery environment (i.e., discrimination, social support) and coping behaviors on children's posttraumatic stress reactions (symptoms of posttraumatic stress disorder [PTSD], anxiety, and depression). Data corresponding to 46 youth (M = 11.43 years; 39% girls; 33% African American, 67% European American) revealed that greater helpfulness from extrafamilial sources of social support predicted lower levels of child-rated symptoms of PTSD, anxiety, and depression. A positive predictive relation was found between helpfulness from professional support sources and PTSD, perhaps suggesting that parents whose children were experiencing higher PTSD symptom levels sought professional support and reported it to be helpful. Youths' avoidant coping behaviors predicted both PTSD and anxiety symptoms. Discrimination, active coping, and familial support did not predict any of the posttraumatic stress reactions assessed in this study.

Post-traumatic Stress Reactions in Children after two large Earthquakes in Iceland

Bödvarsdóttir, Í., Elklit, A. & Gudmundsdottir, D.B. Post-traumatic Stress Reactions in Children after two large Earthquakes in Iceland. Nordic Psychology, 58, 91–107. The aim of the study was to explore the psychological consequences of two earthquakes in Iceland in two probability samples of children aged 10–15 years (67 exposed and 73 non- exposed). Three months after the earthquakes, children answered demographic questions, stressor questions, and completed the Child Posttraumatic Stress Reaction Index (CPTS-RI), the Trauma Symptom Checklist (TSC) and the Crisis Support Scale (CSS). Thirty-three percent of the exposed group and 6% of the control group fulfilled the diagnostic criteria for PTSD. Experiences of great horror during the earthquake and thoughts about future earthquakes explained 49% of the variance in PTSD. Wish for relocation, arousal, and avoidance symptoms predicted psychological distress, as measured by the TSC total score, explaining 65% of the variance. The exposed children reported more emotional support than controls immediately after the earthquake, but not at three months post earthquake. Exposed children who did not receive crisis intervention but reported that they would have wanted it had significantly more PTSD symptoms than all other groups, suggesting that all exposed children should be offered crisis intervention and receive continuous attention from adults even after a moderate disaster. Key words: Earthquake, posttraumatic stress disorder, psychological symptoms, social support.

Multisample cross-validation of a model of childhood posttraumatic stress disorder symptomatology

This study is the latest advancement of our research aimed at best characterizing children's posttraumatic stress reactions. In a previous study, we compared existing nosologic and empirical models of PTSD dimensionality and determined the superior model was a hierarchical one with three symptom clusters (Intrusion/Active Avoidance, Numbing/Passive Avoidance, and Arousal; Anthony, Lonigan, & Hecht, 1999). In this study, we cross-validate this model in two populations. Participants were 396 fifth graders who were exposed to either Hurricane Andrew or Hurricane Hugo. Multisample confirmatory factor analysis demonstrated the model's factorial invariance across populations who experienced traumatic events that differed in severity. These results show the model's robustness to characterize children's posttraumatic stress reactions. Implications for diagnosis, classification criteria, and an empirically supported theory of PTSD are discussed.

Posttraumatic Stress Reactions in New York City Children After the September 11, 2001, Terrorist Attacks

To assess the prevalence of posttraumatic stress reactions (PTSR) in New York City (NYC) children following the September 11, 2001, attacks and determine the key predictors of PTSR. Cross-sectional random digit-dial survey in NYC of parents of children 4-17 years old 4 months after the attacks. PTSR in children was measured using the 20-item Posttraumatic Stress Disorder Reaction Index-Child Revision, with parents as respondents. Overall, 18% of NYC children had "severe" or "very severe" PTSR, and 66% had "moderate" PTSR. In a multivariate model, parental posttraumatic stress disorder (PTSD; odds ratio [OR] = 4.50; P <.01), the parent crying in front of the child (OR = 3.19; P <.001), seeing 3 or more graphic images of the disaster on television (OR = 3.18; P <.01), and living in Manhattan were associated with severe or very severe PTSR in children. A substantial proportion of NYC children had severe or very severe PTSR after September 11, and most children exhibited at least moderate PTSR. These findings suggest an enhanced role for primary care physicians, particularly pediatricians, for screening, treatment, and referral (coupled with appropriate training and reimbursement), especially in light of continued terrorist threats. These findings also have implications for advice that pediatricians can give to parents about limiting disaster-related television exposure and children's need for emotional support.

Children's mental health after disasters: the impact of the World Trade Center attack.

This paper summarizes the results of systematic studies published in peer-reviewed journals from 1999 to 2002 addressing post-traumatic stress reactions in children after mass disasters. Children's post-traumatic reactions are considered in five different contexts--natural disasters, large-scale human-induced accidents, spree shootings, war, and terrorism. Association of these reactions with gender and age, as well as longitudinal course, is addressed. Other post-traumatic reactions in children after a mass disaster, as well as the comorbidity of these with stress reactions, are reported. With this as background, the most relevant epidemiologic investigations conducted after the World Trade Center attacks are then described. It is expected that new knowledge in the area of children's post-traumatic reactions to disasters will result from the research initiatives launched after September 11, 2001.

Parent-child discrepancy in reporting children's post-traumatic stress reactions after a traffic accident

This study examines possible parent-child discrepancies in the reporting of post-traumatic stress reactions in children after a traffic accident. Sixteen children exposed to the same traffic accident were interviewed about post-traumatic stress reactions at 5 weeks and at 6 months after the event, utilizing the Child Posttraumatic Stress Reaction Index (CPTS-RI). Independently, the parents' reported their child's degree of post-traumatic stress reactions on the CPTS-RI: Parent questionnaire, at the same two times. Clinicians also assessed the children's level of general functioning on the Children's Global Assessment Scale. The children reported significantly more post-traumatic stress reactions than observed by their parents 4 weeks after the accident. The parent-child discrepancy was more pronounced among younger children. The level of children's self-reported post-traumatic stress reactions decreased significantly from the first to the second assessment. At the second assessment, 6 months after the accident, there was no significant parent-child discrepancy observed. The children showed a normal level of functioning despite their post-traumatic stress reactions. The reported parent-child discrepancy indicates that information about children's post-traumatic stress reactions after an accident is best obtained directly from the children.

Posttraumatic stress reactions in children and adolescents one year after the 1999 Taiwan chi‐chi earthquake

This study was to investigate the range and severity of post‐traumatic stress reactions displayed by children and adolescents residing near the epicenter, one year after the Taiwan Chi‐Chi Earthquake and to examine the relations of these symptoms to developmental stages and objective features of trauma exposure. Earthquake Exposure Index for Youths and Child Posttraumatic Stress Disorder Reaction Index were administered to 1,169 children and 1,201 adolescents from two heavily impacted townships. Severity of posttraumatic stress reactions was found to vary by a “dose effect” of earthquake exposure. Variation in the prevalence of PTSD symptoms was found across age and gender groups. Younger children and females reported more PTSD symptoms. More adolescents disclosed restricted negative affects and guilty feelings, whereas younger boys presented such symptoms in a more extreme way. Given that age and gender show variable effects on post‐traumatic symptoms developed, there may be a need to implement a broad disaster recovery project with periodic screenings as well as age‐specific and gender‐appropriate mental health program.

Traumatic experiences and post‐traumatic stress reactions in children from Kurdistan and Sweden

This paper examines the types and scores of traumatic experiences, post-traumatic stress symptom and behavioural disorders among Kurdistanian refugee children in Sweden and a comparative Swedish group. The Harvard-Uppsala Trauma Questionnaire for Children (HUTQ-C), the Post-Traumatic Stress Disorder for Children (PTSS-C) and the Child Behaviour Checklist (CBCL) were administered in interview form to 32 children from each sample, controlled for age, gender and trauma levels. No significant differences were found between the 2 samples regarding types of traumatic events, frequencies of post-traumatic stress disorder, post-traumatic stress symptom scores or behavioural problem scores, except in 3 aspects: Kurdistanian children reported more war experience and being lost, while Swedish children presented higher frequencies of leisure-time accidents. This study supports the assumption that children differ from adults by showing more similarities than differences regarding traumatic experiences and post-traumatic stress reactions, after being exposed to an equivalent number of reported traumatic events. The refugee children's stay in Sweden can be considered as a healing factor.

Traumatic experiences and post-traumatic stress reactions in children from Kurdistan and Sweden

Traumatic experiences and post-traumatic stress reactions in children from Kurdistan and Sweden