Posttraumatic Stress Disorder In Adolescents Research Articles

Le psychotraumatisme chez l’enfant et l’adolescent : donnés actuelles et perspectives

Exposure to a traumatic event is frequent in children and adolescents with the prevalence of Posttraumatic Stress Disorder (PTSD) probably being underestimated in this age group. PTSD is associated with distress and interference that can range from minor disruptions in the child's or adolescent's life, to severe and debilitating consequences impacting their development. Reactions to trauma exposure are defined according to their timeframe : peri-traumatic reactions (lastingminutes to hours), Acute Stress Disorder (ASD; between two days and one month) and PTSD (when symptoms persist more than one month). While a variety of symptoms are described in children and adolescents in response to trauma exposure and constitute the spectrum of reactions to trauma, PTSD is characterized by the association of three core symptoms: 1) re-experiencing the traumatic event in the form of vivid intrusive memories, flashbacks, or nightmares; 2) avoidance of thoughts and memories of the event; 3) persistent perceptions of heightened current threat, for example associated to hypervigilance or enhanced reactivity and exaggerated startle response. In the DSM-5, ASD and PTSD are distinct from anxiety disorders and obsessive-compulsive disorders, and included in a distinct category are Trauma and Stressor-Related Disorders. More recently, the ICD-11 adopted Complex PTSD as a new diagnostic category, which requires meeting the ICD-1 PTSD symptoms and three clusters that represent disturbances in self-organization (affect dysregulation, negative self-concept and disturbances in relationships), bridging the gap between trauma-related disorders and other complex developmental disorders including borderline personality disorder. Emerging evidence suggests that Individual Psychological Debriefing within the first three months of a traumatic event may increase the risk for PTSD in children and adolescents, and caution is warranted. Among the many existing interventions and programs for PTSD, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), a time-limited therapy that combines exposure, cognitive processive remodeling and enhancement of coping skills, is the most empirically validated for PTSD. Eye Movement Desensitization and Reprocessing (EMDR), an integrative psychotherapy based on bilateral brain stimulation through side-to-side eye movements or hand tapping, has also recently been found to be effective in children and adolescents. Although significant advances have recently been made, more research focusing on the understanding of the underlying mechanism and the risk factors of trauma and stressor-related disorders in children and adolescents as well as the implementation of evidence-based and accessible interventions is definitely warranted.

Impact of disaster exposure severity: Cascading effects across parental distress, adolescent PTSD symptoms, as well as parent-child conflict and communication.

Natural disasters are common and have potentially deleterious impacts on individuals, as well as on the relationships among family members (Adams et al., 2015; Paul, 2015). Additionally, caregiver-, offspring-, and family-level outcomes are often correlated following disaster. Thus, longitudinal work is needed to clarify the prospective associations among such constructs following severe disasters. The current study included 1,271 adolescents and investigated whether disaster exposure impacted adolescent posttraumatic stress disorder (PTSD) symptoms, parent distress, and family parent-child conflict and communication, as well as whether/how these factors influenced one another over time. This study used a dynamic cascade model and included adolescents (ages 12-17) and caregivers present for tornadoes in Missouri and Alabama in 2011. These participants were part of a larger study involving a web-based intervention. Over and above covariates (i.e., adolescent age, gender, race, treatment, prior trauma, adolescent alcohol use and depressive symptoms, and household income), families who experienced greater severity of disaster exposure had adolescents who reported more baseline PTSD symptoms and caregivers who reported more distress at baseline. Providing tangible resources (e.g., housing, food, transportation, essential possessions) to families post-disaster may reduce parent distress and adolescent PTSD symptoms. Additionally, reducing adolescent PTSD symptoms may prospectively improve relationships between parents and adolescents.

Association of Acyl-Ghrelin With Posttraumatic Stress Disorder in Adolescents Who Experienced Severe Trauma

Association of Acyl-Ghrelin With Posttraumatic Stress Disorder in Adolescents Who Experienced Severe Trauma

Health-Related Quality of Life and Costs of Posttraumatic Stress Disorder in Adolescents and Young Adults in Germany.

BackgroundPosttraumatic stress disorder (PTSD) is one of the psychopathological consequences of sexual and/or physical abuse. The economic burden is assumed to be high, whereas health-related quality of life and education is negatively affected. This study aims to determine health care costs, health-related quality of life, and educational interruption in adolescents and young adults with PTSD after sexual and/or physical abuse in Germany.MethodsThis analysis used data of 87 participants aged 14–21 years of a randomized controlled trial. Health care utilization, health-related quality of life (EQ-5D-5L), sick leave days, productivity, and delay or failure to achieve educational aims were assessed. Health care costs from a payer perspective were calculated using unit costs for the year 2014.ResultsMean health care costs for a six-month period were 5,243€ (SE 868€). In particular, costs of inpatient stays in psychiatric hospitals, general hospitals and rehabilitation as well as child welfare institutions were high. In addition, health-related quality of life was lower due to anxiety/depression, resulting in a mean EQ-5D index and EQ-VAS score of 0.70 and 61.0, respectively. Furthermore, participants reported on average 27 sick leave days, a productivity loss of 61%, and a delay in education attainment as well as having been unable to achieve educational aims.ConclusionPTSD in adolescents and young adults is associated with a high economic burden. Health-related quality of life was substantially reduced. Furthermore, delay and productivity losses in education were observed.Clinical Trial RegistrationGerman Clinical Trials Register identifier: DRKS00004787; date of registration: 18th March 2013; https://www.drks.de.

A Systematic Review of the Effect of Social Support on Post-Traumatic Stress Disorder in Post-Earthquake Adolescents

Introduction: Earthquakes can cause mental health disorders in adolescents, one of which is post-traumatic stress disorder (PTSD). The present study aimed to assess the effect of social support on post-traumatic stress disorder in adolescents after an earthquake.Methods: The study was a systematic review with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach. Articles were searched for using the Scopus, ScienceDirect, ProQuest, EBSCO and SAGE databases before classifying them into 3 categories: prevalence, risk factors, social support, and post-traumatic stress disorder. The inclusion criteria regarding the literature were documents that were original; where the source was from a journal; where the article was written in English and where the full text was available. The age of the subjects in the articles was determined to be in the range of 10-20 years old. The publication time limit was 2015 to 2020.Results: Adolescents who experienced an earthquake were found to demonstrate a high prevalence of post-traumatic stress disorder with the proportion in girls being higher than boys. Showing social support has a significant effect on PTSD after an earthquake. The earthquake-related factors that were the most strongly associated with probable PTSD were feeling scared of dying and exposure to an earthquake.Conclusion: Social support and the prevalence rates of PTSD should be observed in more detail. These results indicate that it is important to provide and strengthen the social support available to reduce the risk and severity of post-traumatic stress disorder after an earthquake among adolescents.

Training Pediatricians to Identify and Manage Adolescent Depression and Post-Traumatic Stress Disorder Following the Parkland Gun Violence Tragedy

Purpose: Youth who are exposed to gun violence, including school shootings, are at increased risk for developing major depression and post-traumatic stress disorder (PTSD) leading to an increase in suicide. Primary care providers (PCPs) are uniquely positioned to be able to identify early signs of mental health problems and intervene, yet they lack appropriate training in identifying signs of depression and of PTSD. Experiential training for PCPs using standardized patients has shown promise in improving screening for and diagnosis of adolescent depression. However, this training had not previously …

The effectiveness of psychological interventions for post-traumatic stress disorder in children, adolescents and young adults: a systematic review and meta-analysis.

Children and adolescents display different symptoms of post-traumatic stress disorder (PTSD) than adults. Whilst evidence for the effectiveness of psychological interventions has been synthesised for adults, this is not directly applicable to younger people. Therefore, this systematic review and meta-analysis synthesised studies investigating the effectiveness of psychological interventions for PTSD in children, adolescents and young adults. It provides an update to previous reviews investigating interventions in children and adolescents, whilst investigating young adults for the first time. We searched published and grey literature to obtain randomised control trials assessing psychological interventions for PTSD in young people published between 2011 and 2019. Quality of studies was assessed using the Cochrane Risk of Bias tool. Data were analysed using univariate random-effects meta-analysis. From 15 373 records, 27 met criteria for inclusion, and 16 were eligible for meta-analysis. There was a medium pooled effect size for all psychological interventions (d = -0.44, 95% CI -0.68 to -0.20), as well as for Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and Eye Movement Desensitisation and Reprocessing (EMDR) (d = -0.30, 95% CI -0.58 to -0.02); d = -0.46, 95% CI -0.81 to -0.12). Some, but not all, psychological interventions commonly used to treat PTSD in adults were effective in children, adolescents and young adults. Interventions specifically adapted for younger people were also effective. Our results support the National Institute for Health and Care Excellence guidelines which suggest children and adolescents be offered TF-CBT as a first-line treatment because of a larger evidence base, despite EMDR being more effective.

Prevalence of Post Traumatic Stress Disorder among School-age Adolescent

Aim: After a traumatic event, the person can develop post-traumatic stress disorder (PTSD), the purpose of the study is to assess the prevalence of PTSD in adolescents in public middle schools of the prefecture of Salé in Morocco and study anxiety and depression which are the comorbid disorders of the PTSD. The survey was carried out from March to June 2017.
 Methods: 523 students were selected by the cross-sectional method from fifteen schools that were randomly selected, the age of the students vary between 12 and 17 years. For the survey, standardized questionnaires (the socio-demographic data, the Life Events Checklist, the CPTS-RI (Children's Post Traumatic Stress Reaction Index), the STAIY (State Trait Inventory Anxiety Form Y) and the CDI (Children Depression Inventory) were used which were filled in by the students.
 Results: The prevalence of PTSD was 70.4% in the students who have PTSD. We found that the prevalence in boys was 46.74%, while in girls it was 53.26%. In addition to that, 81% of students found to be anxious and 51.8% of students have depression.
 Conclusion: There is a high prevalence of post traumatic stress disorder among adolescents, there are practical implications for the support and care of these adolescents.

Prevalence of Post-Traumatic Stress Disorder among School-Age Adolescent

Aim After a traumatic event, the person can develop post-traumatic stress disorder (PTSD), the purpose of the study is to assess the prevalence of PTSD in adolescents in public middle schools of the prefecture of Salé in Morocco and study anxiety and depression which are the comorbid disorders of the PTSD. Methods 523 students were selected by the cross-sectional method from twenty five schools that were randomly selected, the age of the students vary between 12 and 17 years. For the survey, standardized questionnaires (the socio-demographic data, the Life Events Checklist, the CPTS-RI, the STAIY and the CDI) were used which were filled in by the students. Results The prevalence of PTSD was 70.4% in the students who have PTSD. We found that the prevalence in boys was 46.74%, while in girls it was 53.26%. In addition to that, 81% of students found to be anxious and 51.8% of students have depression. Conclusion There is a high prevalence of post-traumatic stress disorder among adolescents. There are practical implications for the support and care of these adolescents.

Posttraumatic stress disorder in children and adolescents with chronic pain.

Despite high comorbidity between posttraumatic stress disorder (PTSD) and chronic pain evident in adult populations, little research has been conducted in the pediatric population to assess this association. Therefore, this study aimed to estimate the prevalence of trauma and PTSD in pediatric patients with chronic pain. Additionally, investigation into whether the Child Report of Posttraumatic Symptoms (CROPS) is a valid PTSD screening tool for this patient population and identification of an appropriate clinical cutoff for screening PTSD was undertaken. Data of N = 297 children and adolescents aged 8 to 17 years were collected during an intensive interdisciplinary pain treatment. At admission, patients self-reported pain characteristics and posttraumatic stress symptoms (assessed with the CROPS). During the inpatient stay, therapists completed a checklist that enabled a PTSD diagnosis according to criteria of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Overall, 18.2% of the patients reported a trauma that met criterion A of DSM-5. Of those patients, approximately 59.3% had a PTSD diagnosis, equivalent to 10.8% of the whole sample. Overall, the CROPS demonstrated good reliability and validity in terms of internal consistency, item characteristics, and factor structure. Patients with PTSD had higher CROPS scores than patients without trauma. To identify patients with PTSD, a CROPS cutoff point of 21 is most appropriate in this population. This study demonstrated high prevalence of PTSD in children and adolescents with severe chronic pain. Regarding PTSD screening in this population, results revealed that valid PTSD assessment and identification of patients with PTSD seems possible despite overlapping symptoms. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Binge Drinking in Adolescence and Early Adulthood: The Salience of PTSD and PTSD-Linked Strain Sensitivity from a Developmental Perspective

Background: Post-traumatic stress disorder (PTSD) has been identified by past research as a risk factor for substance use. Further, past research has indicated that individuals with PTSD may demonstrate an increased sensitivity to strain. Despite this, no study has examined the relevance of these processes for understanding binge drinking behaviors from a developmental perspective. Purpose/Objectives: Understand the relevance of PTSD-linked strain sensitivity for predicting binge drinking in adolescence and adulthood. Methods: This study utilizes data from the Pathways to Desistance study, comprising the responses of 1354 juvenile offenders across seven years following an adjudication. A series of ordinal logistic regression models estimated these effects in adolescence and early adulthood. Results: Results indicate that adolescent PTSD interacted with witnessed violence to produce lower frequency binge drinking. This effect was non-significant in early adulthood. Conclusions/Importance: These findings indicate that adolescent PTSD-sufferers demonstrate diminished sensitivity to witnessed violence. This may have to do with adolescence social processes.

TEPT y Ansiedad en niños y adolescentes 2 años posterior al terremoto de 2016 en Unidades Educativas de la ciudad de Portoviejo, Ecuador

El trastorno de estrés postraumático (TEPT) es una de las consecuencias de la exposición a desastres naturales más frecuente e incapacitante en niños, quienes representan la población más vulnerable para desarrollarlo, por lo que el médico pediatra debe estar preparado para identificar los rasgos y características de estos trastornos y poder realizar un diagnóstico oportuno. Objetivo: determinar la presencia de TEPT y ansiedad en los niños y adolescentes que presenciaron el terremoto de abril del 2016 en la Provincia de Manabí, en las unidades educativas Antonio Meléndez, María de la Merced y Francisco Pacheco. Metodología: estudio observacional, transversal, retrospectivo, descriptivo, analítico, con 271 niños de 9 -14 años. Encuestas: factores sociodemográficos y económicos, Escala Infantil de Síntomas de Trastorno de Estrés Postraumático (CPSS), la Escala de Ansiedad de Spence; datos fueron procesados con SPSS V22. Los estadísticos OR y Chi cuadrado, IC 95% y p menor a 0.05. Resultados: TEPT se presentó en 18,1% y el Trastorno de Ansiedad en 23,1%, mayor en el sexo femenino para ambos trastornos, el trastorno de ansiedad presentó una diferencia significativa en los escolares respecto a los adolescentes, la probabilidad de presentar comorbilidad entre ambos trastornos fue elevada. Conclusiones: el TEPT está presente en niños de la zona a dos años del terremoto del 2016, el sexo femenino y los niños de menor edad presentan mayor riesgo.

The Leptin Gene rs7799039 Modulates the Prevalence of Posttraumatic Stress Disorder After an Earthquake in Han Chinese Adolescents.

The study's aim was to examine the prevalence and severity of posttraumatic stress disorder (PTSD) longitudinally among high school students with different genotypes of the leptin gene (LEP) rs7799039 after the 2008 Wenchuan earthquake in China. The symptoms of PTSD were measured by the PTSD Checklist-Civilian Version (PCL-C) based on DSM-IV-TR criteria in 462 students at 6, 12, and 18 months after the earthquake. The genotypes of LEP rs7799039 were identified by polymerase chain reaction-restriction fragment length polymorphism analyses in 2018 using genomic DNA prepared in 2008 and stored at -80°C and verified by DNA sequencing. The association of LEP genotypes with PTSD was then analyzed by various statistical methods. The AA homozygotes had higher prevalence of PTSD than the G allele carriers at 12 months (22.30% vs 10.53%, P = .013) and higher median (interquartile range [IQR]) PCL-C scores at 12 (27.00 [24.00-35.75] vs 26.00 [22.00-31.25], P = .010) and 18 months (27.00 [21.00-32.00] vs 24.00 [19.00-29.00], P = .003) post-earthquake among female subjects. Female students had higher PCL-C scores than male subjects at 6 and 12 months regardless of the genotypes but only among the AA homozygotes at 18 months (27.00 [21.00-32.00] vs 22.00 [18.00-26.00], P = .000). The potential risk factors for and predictors of PTSD severity differed at different time points during follow-up. LEP rs7799039 was a potential factor for PTSD at 12 months and a predictor of PTSD severity at 18 months post-earthquake. An association of LEP rs7799039 with the prevalence and severity of PTSD in Chinese adolescents was observed. These results indicate that females with the LEP rs7799039 AA genotype had more severe PTSD characteristics compared to female G allele carriers, suggesting that psychosocial or pharmacologic managements may particularly be needed by these female subjects.

Dysfunctional posttraumatic cognitions, posttraumatic stress and depression in children and adolescents exposed to trauma: a network analysis.

The latest version of the International Classification of Diseases (ICD-11) proposes a posttraumatic stress disorder (PTSD) diagnosis reduced to its core symptoms within the symptom clusters re-experiencing, avoidance and hyperarousal. Since children and adolescents often show a variety of internalizing and externalizing symptoms in the aftermath of traumatic events, the question arises whether such a conceptualization of the PTSD diagnosis is supported in children and adolescents. Furthermore, although dysfunctional posttraumatic cognitions (PTCs) appear to play an important role in the development and persistence of PTSD in children and adolescents, their function within diagnostic frameworks requires clarification. We compiled a large international data set of 2,313 children and adolescents aged 6 to 18years exposed to trauma and calculated a network model including dysfunctional PTCs, PTSD core symptoms and depression symptoms. Central items and relations between constructs were investigated. The PTSD re-experiencing symptoms strong or overwhelming emotions and strong physical sensations and the depression symptom difficulty concentrating emerged as most central. Items from the same construct were more strongly connected with each other than with items from the other constructs. Dysfunctional PTCs were not more strongly connected to core PTSD symptoms than to depression symptoms. Our findings provide support that a PTSD diagnosis reduced to its core symptoms could help to disentangle PTSD, depression and dysfunctional PTCs. Using longitudinal data and complementing between-subject with within-subject analyses might provide further insight into the relationship between dysfunctional PTCs, PTSD and depression.

Posttraumatic Stress Disorder Among Low-Income Adolescents Experiencing Family-Neighborhood Income Disparities.

Certain neighborhood factors may increase the risk of exposure to trauma, therefore increasing the risk of posttraumatic stress disorder (PTSD). Other aspects of neighborhoods can be protective, such as neighborhood-based social relationships, which provide social support that buffers the risk of developing PTSD. The strength of these social relationships may not be as dependent on neighborhood conditions as much as they are contingent on socioeconomic similarities between neighborhood residents. Using a nationally representative sample of hospital emergency department admissions in the United States (N = 13,669,251), this study hypothesized that an interaction between family-level income and neighborhood-level income would be associated with adolescent PTSD. The results show that female adolescents who resided in the highest income areas were 1.39 times more likely, 95% CI [1.09, 1.77], to be diagnosed with PTSD than those who lived in the lowest income areas. This association was not statistically significant for male adolescents. Additionally, low-income female youth were nearly one-third more likely than their non-low-income counterparts to be diagnosed, odds ratio (OR) = 1.29, 95% CI [1.12, 1.48], whereas low-income male youth were nearly twice as likely than their non-low-income counterparts to be diagnosed, OR = 1.95, 95% CI [1.62, 2.34]. Furthermore, there was an interaction among both male and female adolescents such that lower-income adolescents living in higher-income areas had higher odds of a PTSD diagnosis compared to their higher-income peers in areas that were in the same median household income quartile.

Methodology of "14-7" Program: A Longitudinal Follow-Up Study of the Pediatric Population and Their Families Exposed to the Terrorist Attack of Nice on July 14th, 2016.

Introduction: After a traumatic event, children and adolescents may present several clinical consequences, the most common being Post-Traumatic Stress Disorder (PTSD). Most children and adolescents with PTSD have comorbid disorders, such Attention Deficit Hyperactivity Disorder, depression, attachment and anxiety disorders, sleep disturbances and behavior problems. However, epidemiological studies on the development of PTSD and other psychiatric disorders in children and adolescents as a consequence of a terrorist attack and mass murder are lacking. Long-term follow-up of exposed children and adolescents will help identify risk and protective factors of developing psychiatric and psychological conditions after exposure to traumatic events or situations. The main objective of this article is to present the methodology of “14–7” program. The aim of “14–7” program is to characterize the risk and protective psychosocial factors affecting the clinical evolution of a pediatric population sample, exposed to the terrorist attack of July 14th, 2016 in Nice. Method and Analysis: “14–7” program is a multicentre longitudinal cohort study. Major inclusion criteria are children and adolescents exposed to the terrorist attack and aged under 18 years on July 14th, 2016. These children and adolescents will be compared to a non-exposed to the “14–7” terrorist attack group, matched on age and gender. Participants will be assessed at baseline (T1), 2 years (T2) and 5 years (T3) after the initial assessment (T1), and every 5 years until they are 25 years old. Multiple domains are assessed: 1) mental health disorders, 2) intensity of PTSD symptoms, 3) intensity of comorbid symptoms, 4) quality of the parent–child relationship, 5) intelligence quotient, 6) parental symptoms. We will also establish a biological collection of saliva samples, magnetic resonance imaging (MRI) and actigraphy data collection. Main analyses comprise analyses of variance and regression analyses of predictors of clinical evolution over time. Ethics and Dissemination: The National Ethics Committee “NORD OUEST III” approved the “14–7” Program protocol (number 2017-A02212-51). All patients and their caregivers signed informed consent on enrolment in the “14–7” Program. Inclusions started on November 21st, 2017. Three hundred thirty-five individuals have been included (191 children and adolescents, 144 parents).Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03356028

Cardiac reactions to emotional words in adolescents and young adults with PTSD after child abuse.

Post-traumatic stress disorder (PTSD) is associated with alterations in cardiac reactivity to threat cues. Meta-analyses have summarized that adults with PTSD have increased heart rates in response to trauma-related stimuli. However, the opposite effect (i.e., cardiac hyporeactivity) has recently been reported in subgroups of PTSD patients. In children and adolescents with PTSD, reports of cardiac alterations are rare and ambiguous. So far, most studies in adolescents and young adults are restricted to victims of accidents, even though PTSD is highly prevalent in victims of child maltreatment. The present study aimed at investigating cardiac reactions in adolescents and young adults with PTSD after child abuse. Cardiac responses to standardized emotional words were studied in 39 adolescent and young adult PTSD patients after childhood sexual and/or physical abuse as compared to 39 healthy control subjects (age range: 15-20years). The experimental paradigm consisted of a passive reading task with neutral, positive, physically threatening, and socially threatening (swear) words. Results showed that cardiac reactions to negative stimuli, particularly physically threatening stimuli, were less pronounced in PTSD patients than in controls. Moreover, cardiac reactions in response to socially threatening words were less variable in the PTSD group. No differences between and within groups were present in reaction to neutral or positive stimuli. Findings suggest that a physiologically blunted subtype of PTSD may already manifest during adolescence and young adulthood. Moreover, the results of the present study emphasize the relevance of individual trauma history for physiological reactions.

Post‐traumatic stress symptoms of children and adolescents exposed to the 2008 Wenchuan Earthquake: A longitudinal study of 5‐HTTLPR genotype main effects and gene–environment interactions

Experiencing disasters causes severe mental disorders, among which post-traumatic stress disorder (PTSD) is the most common. We conducted a longitudinal study to examine the effect of 5-hydroxyl tryptamine transporter gene-linked polymorphic region (5-HTTLPR) genotype on child and adolescent PTSD symptom course after the 2008 Wenchuan Earthquake. We genotyped 963 participants who personally experienced the earthquake. PTSD symptoms were measured by University of California, Los Angeles PTSD reaction index at 2.5, 3.5, 4.5 and 5.5 years after the earthquake, respectively. Latent growth model was utilised to examine the main effect and gene-environment interaction effect of 5-HTTLPR on PTSD's symptom course. 5-HTTLPR genotype predicted initial PTSD symptom severity (β=0.108, p=.019) and rates of symptom recovery (β=-0.120, p=.031) between 2.5 and 5.5 years. Compared with L' allele carriers, those with S'S' genotype showed higher initial symptom severity but also faster recovery rate. 5-HTTLPR genotype only predicted symptom severity at 2.5 years after the earthquake, after controlling for sex, age, ethnicity and trauma severity (β=0.108, p=.019). This is the first evidence of the effect of 5-HTTLPR genotype on child and adolescent PTSD symptoms longitudinally, offering a novel perspective on the effect of 5-HTTLPR on PTSD symptom development following trauma exposure.

Posttraumatic Stress Disorder and executive dysfunction among children and adolescents: A Latent Profile Analysis

Background/ObjectiveThe current study aimed to examine the relationship between Posttraumatic Stress Disorder (PTSD) symptoms and executive dysfunction in children and adolescents after psychological trauma. MethodParticipants were 13,438 of children and adolescents aged 6 to 18 years exposed to the 2008 Wenchuan earthquake. PTSD and dysexecutive symptoms were assessed using the UCLA PTSD Reaction Index for Children and the Self-Report Dysexecutive Questionnaire. Latent Profile Analysis (LPA) was conducted using Mplus version 7.4. Subgroup differences in trauma exposure and quality of life were calculated using ANCOVA. ResultsA 4-class parallel model was found to best describe latent PTSD symptom profiles and executive dysfunction. Individuals in higher symptom groups showed more trauma exposure and lower quality of life. ConclusionsThis LPA study shed light on the relationship between PTSD and executive dysfunction symptoms in children and adolescents. The correlation between PTSD and executive dysfunction was maintained after individual differences were taken into consideration. Our findings provide a new view on how PTSD relates to executive dysfunction and several suggestions for treating child and adolescent PTSD patients.

The UCLA PTSD Reaction Index for DSM-5 Brief Form: A Screening Tool for Trauma-Exposed Youths

Children and adolescents who experience potentially traumatic events are at risk for developing posttraumatic stress disorder (PTSD). Although psychometrically sound measures are now available to assess these youths, brief tools are currently needed for screening purposes. Two studies were conducted to develop and validate the UCLA PTSD Reaction Index for DSM-5-Brief Form (RI-5-BF). Study 1 used item response theory models to derive the RI-5-BF from the UCLA PTSD Reaction Index for DSM-5 and assess its internal consistency using a sample of 486 trauma-exposed youths (mean age= 13.32 years, SD= 2.90) recruited through a practice research network. Study 2 used receiver operating characteristic analyses and diagnostic efficiency statistics to assess the discriminant-groups validity and clinical utility of the RI-5-BF in identifying children at different levels of PTSD risk using a sample of 41 treatment-seeking youths (mean age= 12.44 years, SD= 2.99). In study 1, item response theory models identified the 11 most informative items across their respective subscales. The RI-5-BF exhibited excellent internal consistency in both studies (α > .93). In study 2, receiver operating characteristic analyses indicated that an RI-5-BF score of 21 maximized sensitivity and specificity. Moreover, diagnostic likelihood ratios across multiple levels of scores provided support for the measure's clinical utility in identifying different levels of PTSD risk. These findings provide support for both the psychometric properties of the RI-5-BF as a brief screening measure for PTSD in children and adolescents and its utility for identifying youths meriting further assessment and consideration for treatment.