Posttraumatic Stress Disorder In Children Research Articles

Does age matter in genetics? The role of ADCYAP1R1 in sex-specific risk for posttraumatic stress disorder in trauma-exposed preadolescent children

Following trauma exposure, children are a vulnerable population and at risk for developing posttraumatic stress disorder (PTSD). A large body of research has demonstrated the impactful role of genetics in vulnerability for PTSD in adult samples; yet very little research has examined genetic risk for PTSD in children. It is unknown whether genetic associations identified in adults are true for children; replication of findings from adult samples is needed in child samples. This study investigated an estrogen-responsive variant (ADCYAP1R1) that has been well-established to confer sex-specific risk for PTSD in adult samples, but is hypothesized to function differently in children, potentially due to pubertal changes in the estrogen system. Participants were children (n = 87; 57% female) ages 7 to 11 exposed to a natural disaster. Participants were assessed for trauma exposure and symptoms of PTSD. Participants provided a saliva sample, which was genotyped for the ADCYAP1R1 rs2267735 variant. In girls, the ADCYAP1R1 CC genotype was associated with PTSD (OR = 7.30). In boys, evidence for the opposite effect emerged, with the CC genotype attenuating risk for PTSD (OR = 8.25). When investigating specific PTSD symptom clusters, an association between ADCYAP1R1 and arousal emerged. This study is the first to investigate the relationship between ADCYAP1R1 and PTSD in trauma-exposed children. Findings for girls mirrored prior research on adult women, whereas findings for boys diverged from prior research on adult men. These potential differences between children and adults in genetic vulnerability for PTSD underscore the need for more genetic studies in child samples.

It’s all in the hair: Changes in hair cortisol concentrations in reaction to the COVID-19 pandemic predicts post-traumatic stress symptoms in children

About 25 to 35% of victims of a traumatic event will develop post-traumatic stress disorder (PTSD). Low cortisol levels appear to be a risk factor for the development of PTSD. In adults, decreased diurnal and cumulative cortisol levels before or shortly after a traumatic event are associated with increased post-traumatic symptoms in the months thereafter. In contrast, results from the only two studies conducted in children showed that elevated diurnal cortisol levels shortly after exposure to a traumatic event are associated with more severe post-traumatic symptomatology. Given that a pandemic can induce post-traumatic stress symptoms, we investigated whether cumulative cortisol levels prior to and in the beginning stages of the COVID-19 pandemic in Quebec (Canada) predicted post-traumatic stress symptoms in children. We collected hair samples from 69 children (8-12 y/o) without history of psychopathology and exposure to a traumatic event. Cortisol levels were measured before (December 2019 - February 2020) and at the beginning of the pandemic (March 2020 - May 2020). Post-traumatic stress symptoms were assessed every 3 months between June 2020 (T1) and March 2021 (T4). The results showed that the percentage change in cumulative cortisol levels between the beginning of and prior to the pandemic predicted post-traumatic stress symptoms at T1. Specifically, a decrease in cortisol levels early in the pandemic was associated with increased post-traumatic stress symptoms. This study suggests that a decrease in cortisol in response to a stressful event may be a predisposing factor for PTSD in children.

Посттравматичний стресовий розлад у дітей: раннє розпізнавання та координація надання медичної допомоги в умовах воєнного часу

At the current stage, when military operations continue and there is possible development of various manifestations of psychotraumatic stress disorders in children, the acuteness and urgency of solving the problem determines the need for early recognition of the symptoms of post-traumatic stress disorder, due to its frequency and high risk and indicators of negative consequences. Purpose - to improve the quality of life of children in wartime conditions by early recognition of symptoms of the risk of developing post-traumatic stress disorder and increasing the awareness of primary care physicians about this condition and coordination of medical and psychological care. Materials and methods. Practical guidelines on the early recognition of symptoms of the risk of developing post-traumatic stress disorder in children are presented in the national Adapted clinical guideline based on evidence (2016), Unified clinical protocol (primary, secondary (specialized) and tertiary highly specialized medical care) (2019), as well as the guidelines of the National Institute for Health and Clinical Improvement of Great Britain (NICE, 2018) and information from PubMed databases, UpTo Date. For determining these recommendations the new version of the International Classification of Diseases (ICD-11) was taken into account. Results. An analysis of clinical guidelines and scientific literature related to the study of post-traumatic stress disorder in children, in particular, its early recognition by primary care physicians, was carried out. The question of the peculiarities of the clinical course of psychotraumatic disorders depending on the time of their appearance after a traumatic event and the age of children is highlighted. In the context of the time that has passed since the traumatic event and the age of the children, a screening program for the early recognition of symptoms of the risk of developing post-traumatic stress disorder, which require immediate response by primary care workers, is presented. Special attention was paid to children from war zones, geographically remote regions, displaced persons, refugees. Conclusions. Early conducting of a short screening assessment of the risk of developing post-traumatic stress disorder in children, a timely decision on the provision of medical and psychological assistance, will contribute to the improvement of their quality of life in wartime conditions. No conflict or interests was declared by the authors.

Bidirectional effects of parental and adolescent symptom change in trauma-focused cognitive behavioral therapy.

The current study examines dynamic, bidirectional associations between parent and adolescent symptom improvement in response to children's therapy for posttraumatic stress disorder (PTSD). Data were collected from a racially and ethnically heterogeneous sample of 1,807 adolescents (age 13-18 years old; 69% female) and a parent participating in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) at a community outpatient behavioral health clinic. Parents self-reported their depressive symptoms and youth self-reported their PTSD and depressive symptoms at the onset of treatment and every three months for up to nine months. Using a bivariate dual change score model (BDCSM) we examine: (a) individual dyad members' change in symptoms and (b) the bidirectional associations between changes in the parent's and youth's symptoms across treatment. Parents' and adolescents' symptoms at the start of treatment were correlated and both parents' and adolescents' symptoms decreased over the course of treatment. Parents' elevated depressive symptoms at each time point contributed to smaller decreases in their children's PTSD and depressive symptoms at the subsequent time point. Adolescents' elevated symptoms at each time point contributed to greater decreases in their parents' symptoms at the subsequent time point. These findings highlight the impact that parents and children have on each other's response to children's trauma-focused psychotherapy. Notably, parents' depressive symptoms appeared to slow their children's progress in treatment, suggesting that attending to parents' symptoms and providing them with supportive services may be an important adjunct to children's interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Childhood Trauma and PTSD Symptoms: Disentangling the Roles of Emotion Regulation and Distress Tolerance.

Research documents that a history of childhood trauma increases risk for post-traumatic stress disorder (PTSD), greater emotion regulation difficulties (ERD), and reduced distress tolerance (DT). Independent lines of research implicate ERD and DT as transdiagnostic risk factors and link them to PTSD. To elucidate how such mechanisms may influence the etiology, maintenance, and treatment of PTSD, the current study investigates the distinct mediating roles of emotion regulation and DT, exploring which explains a larger indirect effect from childhood trauma to PTSD symptom severity. Participants (N = 385, aged 18-48) who endorsed a history of childhood trauma provided retrospective report of cumulative childhood trauma exposure, and of current ERD, DT, and PTSD symptom severity. Single and dual mediation analyses were used to assess indirect effects through ERD and DT in the relation between cumulative childhood trauma exposure and current PTSD symptom severity. ERD and DT were significantly and inversely related. Higher current self-ratings of PTSD symptom severity were explained by cumulative childhood trauma through ERD (B = 0.93, p < 0.001) and DT (B = 0.50, p < 0.05). The full model explained 36% of the variance in PTSD symptom severity. Current findings provide preliminary evidence of DT and emotion regulation (with specific facets identified) as distinct mechanisms in the development of PTSD. Of clinical relevance, current findings support post-trauma processing theories that contend individuals' recovery requires accepting and learning to modulate trauma-related emotional states. Implications for methods of treatment and prevention are discussed.

Effectiveness of abbreviated trauma-focused cognitive behavioural therapy for South African adolescents: a randomized controlled trial

ABSTRACT Background: In low- and middle- income countries (LMICs) trauma exposure among youth is high, but mental health services are critically under-resourced. In such contexts, abbreviated trauma treatments are needed. Objective: To evaluate the efficacy of an abbreviated eight-session version of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) for improving posttraumatic stress disorder (PTSD) and depression symptoms in a sample of South African adolescents. Method: 75 trauma-exposed adolescents (21 males, 54 females; mean age = 14.92, range = 11–19) with posttraumatic stress disorder (PTSD) symptoms were randomly assigned to eight sessions of TF-CBT or to usual services. At baseline, post-treatment and three-month follow-up, participants completed the Child PTSD Symptom Scale for DSM 5 (CPSS-5) and the Beck Depression Inventory II (BDI-II). The trial is registered on the Pan African Trial Registry (PACTR202011506380839).6. Results: 95% of TF-CBT participants completed treatment while only 47% of TAU participants accessed treatment. Intention-to-treat analyses found that the TF-CBT group had a significantly greater reduction in CPSS-5 PTSD symptom severity at post-treatment (Cohen’s d = 0. 60, p < .01) and three-month follow-up (Cohen’s d = 0.62, p < . 01), and a greater reduction in the proportion of participants meeting the CPSS-5 clinical cut-off for PTSD at both time points (p = .02 and p = .03, respectively). There was also a significantly greater reduction in depression symptom severity in the TF-CBT group at post-treatment (Cohen’s d = 0.51, p = .03) and three-month follow-up (Cohen’s d = 0.41, p = .05), and a greater reduction in the proportion of TF-CBT participants meeting the BDI clinical cut-off for depression at both time points (p = .02 and p = .03, respectively). Conclusion: The findings provide preliminary evidence of the efficacy of an abbreviated eight-session version of TF-CBT for reducing PTSD and depression symptoms in a LMIC sample of adolescents with multiple trauma exposure.

Dissociation mediates association between childhood trauma and distress from trauma research participation: analysis of pooled clinical data

ABSTRACT Background Childhood trauma and post-traumatic stress disorder (PTSD) are risk factors for emotional distress from trauma-related research participation. The role of dissociation, however, has not been investigated. This study examined the mediation effect of dissociation and PTSD on the relationship between childhood trauma and distress in trauma studies. Methods Pooled data of the Childhood Trauma Questionnaire, Impact of Events Scale-Revised, Dissociative Experiences Scale-Taxon, and Trauma Antecedents Questionnaire from 231 psychiatric patients (73% diagnosed with psychotic illnesses) at a psychiatric clinic in South Korea were analysed. We performed multiple mediation effect analysis to verify a structural model for distress in trauma-related questionnaires. Results Thirteen percent of participants reported distress after the survey. In the structural equation, the symptoms of PTSD did not show a significant relationship (p = .064). When the two parameters were included in the model, it was found that the direct effect of childhood trauma on distress was not significant (p = .43), but dissociation showed a direct effect on distress (p < .001). Discussion Childhood trauma affects distress through the sequential mediating effect of PTSD symptoms and dissociation. Dissociation should be considered as a significant contributor to distress from trauma research participation along with childhood trauma and PTSD.

Efficacy of psychological interventions for post-traumatic stress disorder in children and adolescents exposed to single versus multiple traumas: meta-analysis of randomised controlled trials.

Previous meta-analyses of psychotherapies for children and adolescents with post-traumatic stress disorder (PTSD) did not investigate whether treatment efficacy is diminished when patients report multiple (versus single) traumas. To examine whether efficacy of psychological interventions for paediatric PTSD is diminished when patients report multiple (versus single) traumas. We systematically searched PsycInfo, MEDLINE, Web of Science and PTSDpubs on 21 April 2022 and included randomised controlled trials (RCTs) meeting the following criteria: (a) random allocation; (b) all participants presented with partial or full PTSD; (c) PTSD is the primary treatment focus; (d) sample mean age <19 years; (e) sample size n ≥ 20. Trauma frequency was analysed as a dichotomous (single versus ≥2 traumas) and continuous (mean number of exposures) potential moderator of efficacy. Of the 57 eligible RCTs (n = 4295), 51 RCTs were included in quantitative analyses. Relative to passive control conditions, interventions were found effective for single-trauma-related PTSD (Hedges' g = 1.09; 95% CI 0.70-1.48; k = 8 trials) and multiple-trauma-related PTSD (g = 1.11; 95% CI 0.74-1.47; k = 12). Psychotherapies were also more effective than active control conditions in reducing multiple-trauma-related PTSD. Comparison with active control conditions regarding single-event PTSD was not possible owing to scarcity (k = 1) of available trials. Efficacy did not differ with trauma exposure frequency irrespective of its operationalisation and subgroup analyses (e.g. trauma-focused cognitive-behavioural therapy only). The current evidence base suggests that psychological interventions for paediatric PTSD can effectively treat PTSD in populations reporting single and multiple traumas. Future trials for PTSD following single-event trauma need to involve active control conditions.

Child posttraumatic stress symptoms in an acute injury sample: Patterns of associations among child report, parent report, and child heart rate parameters.

Parent-child agreement on measures of child posttraumatic stress disorder (PTSD) is moderate at best, and understanding of this discrepancy is limited. To address this, we conducted an item-level investigation of parent-child symptom agreement to examine the potential influence of parental posttraumatic stress symptoms (PTSS) on parents' reports of their child's PTSS. We also examined heart rate (HR) indices as possible independent indicators of child PTSD, examining patterns of association with parent versus child report. Parent-child dyads (N = 132, child age: 6-13 years, 91.7% White) were recruited after the child's hospital admission following an acute, single-incident traumatic event. At 1-month posttrauma, questionnaires assessing children's PTSS (self- and parental reports) and parental PTSS were administered. For a subset of participants (n = 70), children's HR recordings were obtained during a trauma narrative task and analyzed. Parent and child reports of child PTSS were weakly positively correlated, r = .25. Parental PTSS were found to be stronger positive predictors of parental reports of child PTSS than the children's own symptom reports, β = 0.60 vs. β = 0.14, and were associated with higher parent-reported child PTSS relative to child reports. Finally, children's self-reported PTSS were associated with HR indices, whereas parent reports were not, βs = -.33-.30 vs. βs = -.15-.01. Taken together, children's self-reported PTSS could be a more accurate reflection of their posttrauma physiological distress than parent reports. The potential influence of parental PTSS on their perceptions of their child's symptoms warrants further consideration.

Study protocol: development and randomized controlled trial of a preventive blended care parenting intervention for parents with PTSD

BackgroundChildren of parents with post-traumatic stress disorder (PTSD) are at increased risk of adverse psychological outcomes. An important risk mechanism is impaired parental functioning, including negative parenting behavior, perceived incompetence, and lack of social support. Several parenting interventions for trauma-exposed parents and parents with psychiatric disorders exist, but none have specifically targeted parents with PTSD. Our objective is to evaluate the effectiveness of a blended care preventive parenting intervention for parents with PTSD.MethodsThe intervention was adapted from an existing online intervention, KopOpOuders Self-Help. In co-creation with parents with PTSD and partners, the intervention was adapted into KopOpOuders-PTSD, by adding PTSD-specific content and three in-person-sessions with a mental health prevention professional. Effectiveness will be tested in a randomized controlled trial among N = 142 parents being treated for PTSD at Arkin Mental Health Care (control condition: treatment as usual, n = 71; intervention condition: treatment as usual + intervention, n = 71). Online questionnaires at pretest, posttest, and three-month follow-up and ecological momentary assessment at pretest and posttest will be used. Intervention effects on primary (parenting behavior) and secondary outcomes (perceived parenting competence, parental social support, parenting stress, child overall psychological problems and PTSD symptoms) will be analyzed using generalized linear mixed modeling. We will also analyze possible moderation effects of parental PTSD symptoms at pretest on primary and secondary outcomes.DiscussionThis study protocol describes the randomized controlled trial of KopOpOuders-PTSD, a blended care preventive parenting intervention for parents with PTSD. Findings can contribute to understanding of the effectiveness of parenting support in clinical practice for PTSD.Trial registrationThis protocol (Version 1) was registered on 11-02-2022 at ClinicalTrials.gov under identification number NCT05237999.

Neurostructural associations with traumatic experiences during child- and adulthood

Adverse experiences can lead to severe mental health problems, such as posttraumatic stress disorder (PTSD), throughout the lifespan. In individuals with PTSD, both global and local brain volume reductions have been reported—especially in the amygdala and hippocampus—while the literature on childhood maltreatment suggests a strong dependency on the timing of adverse events. In the present study, we pooled data from two studies to contrast the effects of reported trauma exposure during neurodevelopmentally sensitive periods in early life with trauma exposure during adulthood. A total of 155 women were allocated into one of six age-matched groups according to the timing of traumatization (childhood vs adulthood) and psychopathology (PTSD vs trauma-exposed healthy vs trauma-naïve healthy). Volumes of the amygdala and hippocampus were compared between these groups. Six additional exploratory regions of interest (ROI) were included based on a recent meta-analysis. Amygdala volume was strongly dependent on the timing of traumatization: Smaller amygdala volumes were observed in participants with childhood trauma and PTSD compared to the healthy control groups. In contrast, larger amygdala volumes were observed in both groups with trauma exposure during adulthood compared to the trauma-naïve control group. Hippocampal volume comparisons revealed no statistically significant differences, although the descriptive pattern was similar to that found for the amygdala. The remaining exploratory ROIs showed significant group effects, but no timing effects. The timing might be an important moderator for adversity effects on amygdala volume, potentially reflecting neurodevelopmental factors. Albeit confounded by characteristics like trauma type and multiplicity, these findings pertain to typical childhood and adulthood trauma as often observed in clinical practice and speak against a simple association between traumatic stress and amygdala volume.

Diagnostic test accuracy of screening tools for post-traumatic stress disorder among refugees and asylum seekers: A systematic review and meta-analysis

BackgroundRefugees and asylum seekers often experience traumatic events resulting in a high prevalence of post-traumatic stress disorder (PTSD). Undiagnosed PTSD can have detrimental effects on resettlement outcomes. Immigration medical exams provide an opportunity to screen for mental health conditions in refugee and asylum seeker populations and provide links to timely mental health care. ObjectiveTo assess the diagnostic accuracy of screening tools for PTSD in refugee and asylum seeker populations. MethodsWe systematically searched Medline, Embase, PsycINFO, CENTRAL and CINAHL up to 29 September 2022. We included cohort-selection or cross-sectional study designs that assessed PTSD screening tools in refugee or asylum seeker populations of all ages. All reference standards were eligible for inclusion, with a clinical interview considered the gold standard. We selected studies and extracted diagnostic test accuracy data in duplicate. Risk of bias and applicability concerns were addressed using QUADAS-2. We meta-analyzed findings using a bivariate random-effects model. We partnered with a patient representative and a clinical psychiatrist to inform review development and conduct. ResultsOur review includes 28 studies (4,373 participants) capturing 16 different screening tools. Nine of the 16 tools were developed specifically for refugee populations. Most studies assessed PTSD in adult populations, but three included studies focused on detecting PTSD in children. Nine studies looked at the Harvard Trauma Questionnaire (HTQ) with diagnostic cut-off points ranging from 1.17 to 2.5. Meta-analyses revealed a summary point sensitivity of 86.6% (95%CI 0.791; 0.917) and specificity of 78.9% (95%CI 0.639; 0.888) for these studies. After evaluation, we found it appropriate to pool other screening tools (Posttraumatic Stress Disorder Checklist, the Impact of Event Scale, and the Posttraumatic Diagnostic Scale) with the HTQ. The area under the curve for this model was 79.4%, with a pooled sensitivity of 86.2% (95%CI 0.759; 0.925) and a specificity of 72.2% (95%CI 0.616; 0.808). ConclusionsOur review identified several screening tools that perform well among refugees and asylum seekers, but no single tool was identified as being superior. The Refugee Health Screener holds promise as a practical instrument for use in immigration medical examinations because it supports the identification of PTSD, depression, and anxiety across diverse populations. Future research should consider tool characteristics beyond sensitivity and specificity to facilitate implementation in immigration medical exams. RegistrationOpen Science Framework: 10.17605/OSF.IO/PHNJV

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Cognitive Behavioral Intervention on Trauma in Schools (CBITS), and Other Promising Practices in the Treatment of Post-Traumatic Stress Disorder in Children and Adolescents: Evidence Evaluation

PTSD is a serious mental health condition with a lifetime prevalence of 1% to 14% in the general population. Several studies have evaluated evidence-based treatment approaches for children and adolescents. Interventions focusing on trauma are considered first-line treatments. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and a similar type of group intervention, the Cognitive Behavioral Intervention on Trauma in Schools (CBITS), have received the most empirical support from randomized controlled trials. Moreover, several other promising therapeutic CBT protocols are in the process of being applied and evaluated. This literature review highlights the common elements of CBT approaches for treating PTSD in children and adolescents, provides a detailed review of the therapeutic ingredients of TF-CBT and CBITS, and presents various other promising CBT protocols that are currently being used or evaluated. Future directions for the field are also discussed.

Postoperative opioid administration and post-traumatic stress symptoms in preschool children after cardiac surgery

PurposeThe purpose of this study was to explore relationships between postoperative opioid administration and posttraumatic stress symptoms (PTSS) in preschool-aged children surviving cardiac surgery. Design and methodsThis was a cross-sectional, descriptive study using survey administration and medical chart review. Primary caregivers of children aged three to six years who underwent cardiac surgery at our institution between 2018 and 2020 were invited to participate. Opioid administration was calculated according to morphine milligram equivalents and indexed to the child’s body weight. Caregivers completed the Young Child Posttraumatic Stress Disorder Checklist to explore child PTSS. We used correlational methods to assess the strength and direction of relationships between postoperative opioid administration and child PTSS. ResultsWe did not find a statistically significant relationship between total postoperative opioid administration and child PTSS. When analyzing individual opioid agents, morphine did show a significant inverse relationship to YCPC scores (rs = −.57, p = .017) in children with single ventricle physiology. ConclusionsTotal postoperative opioid administration was not statistically significantly related to child PTSS in our sample. Differing patterns of association were noted among children with single- versus bi-ventricular physiology. Postoperative morphine administration was favorably associated with PTSS in children with single-ventricle physiology. Practice implicationsNurses caring for preschool children who undergo cardiac surgery should anticipate the potential development of PTSS in their patients. Studies using larger sample sizes and longitudinal design are needed to replicate the significant relationship between morphine administration and PTSS in preschoolers with single-ventricle physiology.

The Use of Trauma Healing in Treating PTSD in Post-Disaster Victims: A Narrative Review

Aims: Natural disasters can have an impact on the material (physical), psychological and social aspects. The traumatic experience is a psychological impact on victims that are often found. traumatic experience or traumatic stress if it lasts for 6 months will result in PTSD (Post Traumatic Stress Disorder). There are various interventions to treat PTSD, this intervention is known as trauma healing. Trauma healing can be one of the appropriate rehabilitation tools for disaster victims, especially to heal post-disaster trauma. The purpose of the study is to find out what trauma healing interventions are in handling PTSD in post-disaster victims. Method: The method used is a narrative review with PRISMA 2009 guidelines. The search is based on Garuda, EBSCO, Proquest, and PubMed. The studies reviewed were RCT research, quasi-experiment, and qualitative research in English and Indonesian with full text, as well as intervention studies within the last 7 years of publication from 2015 to 2021. Result: Trauma healing that can be given and proven effective to treat or reduce PTSD symptoms is CBT (Cognitive Behavioral Therapy), remembrance therapy, dhikr and play therapy. The results of the search used turned out to be for CBT therapy and play therapy were more effective in reducing PTSD in children, while dhikr was effective in adults, and remembrance therapy was very suitable for adults who experienced PTSD with other physical problems such as hypertension. Conclusions: Therapy as post-disaster trauma healing to overcome PTSD is divided into two, namely therapy for children and adults. Therapy for children is playing therapy and CBT, while for adults there is dhikr, and remembrance therapy is used for adults who experience physical disorders such as hypertension.

Challenges in simultaneous validation of mental health screening tools in multiple languages: Adolescent assessments in Hausa and Pidgin in Nigeria

BackgroundWith growing global recognition of the need to address mental health, a key challenge is determining who needs mental health services. Most self-report screening tools were developed in English-speaking high-income settings, and this cultural milieu influences the types and content of items, the manner in which items are asked, and the options for responding to items. Approaches have been developed for transcultural translation and validation. However, these approaches are typically applied in one language at a time, which is of limited utility in linguistically diverse settings. MethodsTo address challenges in cross-cultural validation, we undertook a unique process of simultaneously validating tools in two languages in Nigeria. Through this dual-language validation, we explored how cultural and contextual differences may influence what is considered valid for a mental health tool. We validated the Depression Self Rating Scale, Child PTSD Symptom Scale (CPSS), and Disruptive Behavior Disorders Rating Scale with a community sample of 330 adolescents aged 12–17. Validity was assessed in Hausa and Pidgin, two languages commonly spoken in Nigeria. Clinical psychologists used the Kiddie-Schedule for Affective Disorders and Schizophrenia to establish caseness. ResultsMost items had good discriminant validity, except on the CPSS, on which only 8 of 17 items discriminated by caseness. Findings indicate the influence of culture (e.g., linguistic differences in translatability of items) and context (e.g., items that reflect experiences of hunger or foodborne illness; different PTSD caseness by language might reflect differential trauma exposure between populations). We also identified items that operated differently between languages. ConclusionWe identified shortcomings in cross-cultural validation procedures with regard to determining whether language, context, or or other differences influence performance of items. For future validation efforts, we recommend systematically collecting information on context and stressful/traumatic exposures as a way to contextualize interpretation of the validity findings. AcronymsDepression Self Rating Scale (DSRS), Child PTSD Symptom Scale (CPSS), Disruptive Behavior Disorders Rating Scale (DBDRS), Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), Area Under the Curve (AUC), Diagnostic Odds Ratio (DOR), Low- and Middle-Income Countries (LMICs), Posttraumatic Stress Disorder (PTSD).

Intergenerational transmission of risk for PTSD symptoms in African American children: The roles of maternal and child emotion dysregulation.

Emotion dysregulation is a transdiagnostic risk factor for many mental health disorders and develops in the context of early trauma exposure. Research suggests intergenerational risk associated with trauma exposure and posttraumatic stress disorder (PTSD), such that maternal trauma experiences and related symptoms can negatively impact child outcomes across development. The goals of the present study were to examine child and mother correlates of child PTSD symptoms and the unique roles of child and maternal emotion dysregulation in understanding child PTSD symptoms. Subjects included 105 African American mother-child dyads from an urban hospital serving primarily low-income minority individuals. Correlational results showed that child trauma exposure, child emotion dysregulation, maternal depressive symptoms, maternal emotion dysregulation, and potential for maternal child abuse all were significantly associated with child PTSD symptoms (ps < 0.05). Hierarchical linear regression models revealed that child trauma exposure, maternal depression, and maternal abuse potential accounted for 29% of the variance in child PTSD symptoms (p < 0.001). Both child emotion dysregulation (Rchange² = 0.14, p < .001) and maternal emotion dysregulation (Rchange² = 0.04, p < .05) were significantly associated with child PTSD symptoms independent of other risk factors and potential for maternal abuse was no longer a significant predictor. These results suggest that maternal emotion dysregulation may be an important factor in influencing their child's PTSD symptoms above and beyond child-specific variables. Both maternal and child emotion dysregulation could be valuable treatment targets for improving maternal mental health and parenting behaviors and bolstering child health outcomes, thus reducing intergenerational transmission of risk associated with trauma. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Exploring Agreement Between Adolescent Self-Reported PTSD Symptoms and Clinical Diagnoses on a Psychiatric Inpatient Unit

ABSTRACT A significant number of adolescents in the U.S. experience traumatic events, putting them at risk for developing Posttraumatic Stress Disorder (PTSD). Despite this risk, PTSD is not a commonly assigned diagnosis in psychiatric settings. The current study examined rates of psychiatrist-reported PTSD (PR-PTSD) diagnoses compared to probable PTSD diagnoses based on adolescent self-reported PTSD (SR-PTSD) symptoms on a psychiatric inpatient unit (n = 151, age 13–17). Self-report measures included questions on exposure to trauma and The Child PTSD Symptom Scale for DSM-5 (CPSS-5). Approximately 60% of participants met criteria for a “probable PTSD diagnosis” on the CPSS-5; however, only 10 out of 151 (6.6%) and 58 out of 151 (38.4%) were given PR-PTSD at admission and at discharge, respectively. Chi-square analyses indicated adolescents with SR-PTSD were more likely to have previous psychiatric admissions, χ2(1, N = 149) = 3.87, p = .049. There was also a significant association between SR-PTSD and suicide risk, χ2(3, N = 148) = 9.93, p = .019. Both the null and low suicide risk groups contributed the most to predicting SR-PTSD based on the standardized residuals being ±1.96. Additionally, SR-PTSD and insurance status were significantly associated, χ2(1, N = 147) = 4.48, p = .034. All of the cells equally contributed to the significance. When comparing diagnosis given at admission to SR-PTSD, agreement was poor (κ=.070, p = .043), and there was no agreement between diagnosis given at discharge and SR-PTSD (κ=.116, p = .074). Findings from the study highlight a discrepancy in SR-PTSD and PR-PTSD in adolescent psychiatric settings.

The Lasting Effects of Early Adversity and Updating Ability on the Tendency to Develop PTSD Symptoms Following Exposure to Trauma in Adulthood

BackgroundAdverse childhood experiences (ACEs) serve as a risk factor for developing posttraumatic stress disorder (PTSD) in those who experience additional adult trauma. However, while some individuals with ACEs develop severe PTSD symptoms following exposure to additional adult trauma, others do not. We propose that updating prior knowledge in the face of new inconsistent information may account for these individual differences. This notion is based on prior work showing that for individuals with a reduced ability to update negative-to-positive outcome associations, greater trauma is correlated with elevated PTSD symptoms. On the other hand, individuals with flexible updating do not develop such symptoms. Objective.Here, we tested whether reduced updating moderates the relationship between ACEs and PTSD symptoms following additional adult trauma.MethodsFirefighters (N = 123, Mage = 28.02, SDage = 4.69) were assessed for childhood adversity and PTSD symptoms and completed a performance-based learning paradigm to evaluate reduced updating.ResultsWe predicted and found strong associations between ACEs and PTSD symptoms for individuals with reduced updating of negative–but not positive–outcomes.ConclusionsThe results may serve as a first step toward improving mental health outcomes in individuals with ACEs and protecting them from the aversive effect of exposure to additional adult trauma.

Translation and Validation of the Clinician Administered PTSD Scale (CAPS-CA-5) for Portuguese Children and Adolescents

The aim of this study was to translate and validate into European Portuguese the CAPS-CA-5 (Clinician Administered PTSD Scale for Children and Adolescents), a semi-structured scale for the diagnosis of post-traumatic stress disorder in children and adolescents, according to the DSM-5 criteria. This study was developed in three stages. In the first stage, the translation and back-translation of CAPS-CA-5 into European Portuguese was carried out. In the second stage, the version obtained in the previous step was subjected to a pre-test. In the third stage, the final version of CAPS-CA-5, the KIDCOPE questionnaires and the Depression, Anxiety and Stress Scale-Children were applied to 101 children who had experienced at least one potentially traumatic event. The children included in this study were between seven and 18 years old and had a follow-up period in a Child Psychiatry or Pediatrics Clinic in one of the three hospitals involved in this project of at least one month. Regarding the confirmatory factor analysis, our results show that the CAPS-CA-5 is a suitable psychometric instrument to assess the diagnosis and symptoms severity of post-traumatic stress disorder according to DSM-5. Convergent validity was comparable to its original version. Although there were negative relationships with almost all of its clusters, these were not statistically significant when applied with the positive coping strategies of the KIDCOPE. The European Portuguese version of the CAPS-CA-5 showed a good internal consistency (Cronbach's α for the total scale was 0.89). The European Portuguese version of CAPS-CA-5 has similar psychometric properties to its original version.