Posttraumatic Stress Disorder Reaction Index Research Articles

Internalized stigma and traumatizing effects of psychiatric hospitalization in adolescents: Is there any difference between being hospitalized in adult or adolescent inpatient psychiatric services?

Psychiatric hospitalization serves as a critical treatment modality. However, hospitalization may pose risks of traumatization or stigma. This study primarily examined the internalized stigma and traumatizing effects of psychiatric hospitalization on adolescents. Additionally, the treatment of adolescents within adult inpatient psychiatric services may yield differing stigmatization and posttraumatic stress disorder (PTSD) symptomatology. Hence, the secondary objective was to discern the variance in stigmatization and PTSD symptoms between adolescents treated in adult inpatient psychiatric services (AIPS) and those in child and adolescent inpatient psychiatric services (CAIPS). The cohort consisted of patients from Akdeniz University's Adult Psychiatry Inpatient Service (n = 29) and Uludağ University's Child and Adolescent Psychiatry Inpatient Service (n = 28), matched for age and gender. Assessments using the Child Posttraumatic Stress Disorder-Reaction Index and the Internalized Stigma Scale for Children and Adolescents (ISSCA) were conducted 6 months after discharge. 36.8% and 10.5% of adolescents exhibited "mild" and "very severe" PTSD symptoms, respectively. Adolescents treated in CAIPS had higher Child Posttraumatic Stress Disorder-Reaction Index scores than those in AIPS. However, there was no significant difference between the AIPS and CAIPS groups regarding ISSCA-self and ISSCA-perceived scores. The current findings underscore that psychiatric hospitalization can lead to traumatic experiences in adolescents, especially those treated in CAIPS. Providing informed care and emotional support during hospitalization could bolster resilience and facilitate recovery among these individuals. While adolescents are sometimes placed in AIPS, it is crucial that professionals are adequately trained and supported in managing this vulnerable population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prevalence and associated factors of post-traumatic stress symptoms in hospitalised children with cancer and their parents in South China: A multicentred cross-sectional study

ObjectiveThis study aimed to examine the prevalence and risk factors of Post-Traumatic Stress Symptoms (PTSS) in hospitalised children with cancer and their parents and explore the PTSS correlation between parents and children. MethodsData were collected using the UCLA Posttraumatic Stress Disorder-Reaction Index for DSM-IV and the Chinese version of the Impact of Event Scale-Revised Questionnaire. ResultsOut of 203 families with hospitalised children with cancer, 77.3% of parents and 7.9% of children experienced PTSS. Time since diagnosis of less than 3 months (β ​= ​−0.063, P ​<​0.001), actively seeking financial help (β ​= ​−0.190, P ​= ​0.031), children living in rural areas (β ​= ​0.166, P ​=​0.023) and having a daughter with cancer (β ​= ​0.135, P ​=​0.040) were risk factors for parental PTSS. At the early stages of diagnosis (β ​= ​0.118, P ​= ​0.017), recurrence (β ​= ​0.140, P ​= ​0.042) and low monthly household income (β ​= ​−0.283, P ​= ​0.003) were risk factors for children's PTSS. No significant correlation between parental PTSS and children's PTSS (r ​= ​−0.06, P ​>0​.05). ConclusionsThe hospitalised children with cancer had a low prevalence of PTSS, but their parents' PTSS prevalence was high. No significant correlation was observed between parental and children's PTSS. Attention should be given to the mental health of families with hospitalised children with cancer. Early psychosocial support should be provided, especially to families with poor economic situations and a newly diagnosed or relapsed child.

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.

Enhancing recovery in post-earthquake adolescents: examining the impact of a psychoeducational intervention on traumatic stress symptoms and coping strategies

AbstractAdolescents exposed to natural disasters are among the most vulnerable groups to the devastating effects of these events, including experiencing mental health issues such as Post-Traumatic Stress Disorder (PTSD), depression, and anxiety disorders. The study aims to evaluate the impact of an early-term psychoeducational intervention (2 months after the disaster) on adolescents who were exposed to the February 6th earthquakes in Turkey regarding symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, and coping styles. The study employed AB experimental design with a single-group, pre-test, post-test, and follow-up test evaluation. The sample consisted of 8 individuals aged between 12 and 18, relocated to another city (Istanbul) with their families to a container camp after exposure to the earthquake. Participants underwent an 8-session (one session per week) psychoeducational program developed by researchers composed of psychologists 2 months after the earthquake. To assess the effectiveness of the psychoeducational intervention, the Child and Adolescent Post-Traumatic Stress Disorder Reaction Index, Brief Symptom Inventory, and Coping Styles Scale-Brief Form was employed at three different time points (pre-intervention, post-intervention, and 4-month follow-up). Percentage distribution and the Friedman Test for comparisons were done for the data to be analyzed. Following the psychoeducational intervention, a statistically non-significant decrease in depression symptoms was observed, but the effect of the intervention was maintained over the 4-month follow-up period. While no change in anxiety symptoms was noted after the intervention, a significant decrease was observed in the follow-up. However, no improvement was observed in PTSD symptoms. Participants showed a statistically significant increase in religious coping, whereas a non-significant increase in planning, using emotional social support, and positive reinterpretation coping styles were observed. After large-scale disasters affecting numerous individuals, early psychological interventions should be planned and tailored for specific groups and specific needs instead of including every member of the group would be more time and cost-efficient.

Early predictors of prolonged grief among bereaved trauma survivors 8.5 years after a terrorist attack.

A better understanding of the development of prolonged grief disorder can help professionals identify bereaved in need of intervention efforts and improve the efficiency of services. We aimed to examine the prevalence of and risk factors for prolonged grief disorder in a sample of young, bereaved terrorist attack survivors almost a decade postloss. In total, 165 bereaved survivors (Mage = 27.75, SD = 4.27; 45.5% females) of the 2011 terror attack on Utøya island, Norway, participated in face-to-face, semistructured interviews. At 4-5 months after the attack, early posttraumatic reactions were measured using the Brief Grief Questionnaire, University of California at Los Angeles PTSD Reaction Index, the Hopkins Symptom Checklist-8, and the eight-item Children's Somatic Symptoms Inventory. At 8.5 years postloss, the Traumatic Grief Inventory-Self Report Plus was used to assess prolonged grief disorder. To explore the association between participants' sociodemographic characteristics, early postloss clinical characteristics, and later prolonged grief reactions, we used multiple linear regression analyses. We found that 4.8% of the participants fulfilled the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision diagnostic criteria for prolonged grief disorder 8.5 years after their traumatic loss. Lower age and high levels of early somatic complaints predicted higher prolonged grief reactions almost a decade postloss. Young, bereaved survivors may be at particularly high risk of experiencing persistent grief reactions following the traumatic loss of a peer. Pending replication of our findings, professionals should focus on identifying bereaved who experience intense somatic symptoms early after a traumatic loss. Targeting these symptoms may alleviate the exacerbation of persistent grief reactions several years after a traumatic loss. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Anxiety, Depression, and Posttraumatic Stress Disorder in Patients With Induced Laryngeal Obstruction

Patients with induced laryngeal obstruction (ILO) present with a variety of behavioral health profiles. Identifying these profiles is crucial in that behavioral health conditions may affect treatment duration and outcomes. To characterize the prevalence of anxiety, depression, posttraumatic stress disorder (PTSD), and physical somatic symptoms in adult and pediatric patients with ILO and determine the factors associated with anxiety, depression, PTSD, and physical somatic symptoms in patients with ILO? This cross-sectional study included a nonprobability sample of 83 adult and 81 pediatric patients diagnosed with ILO at outpatient adult and pediatric otolaryngology clinics between 2021 and 2023. Exclusion criteria included a comorbid respiratory diagnosis other than asthma, head or neck cancer, or neurological impairments. Recruitment took place between September 2021 and March 2023. The analyses were run in January 2024. Patients were prospectively screened for anxiety, depression, PTSD, and somatic physical symptoms. In addition, any past behavioral health diagnoses were extracted from the medical record. Comorbidities, ILO symptoms triggers, and onset details were gathered from ILO evaluations. Adult patients completed the Screen for Adult Anxiety Related Disorders (SCAARED), depression (Patient Health Questionnaire [PHQ]-9), and somatic physical symptoms portions of the Patient Health Questionnaires (PHQ-15), and the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (PCL-5). Pediatric patients completed the Screen for Child Anxiety Related Disorders (SCARED), depression (PHQ-9A) and somatic physical symptoms portions of the Patient Health Questionnaires for Adolescents (PHQ-15A), and the UCLA PTSD Reaction Index brief screeners. Eighty-three adult patients participated in this study (mean [SD] age, 45.8 [14.3] years; 64 female, 19 male). Eighty-one pediatric patients participated (mean [SD] age, 13.83 [2.55] years; 67 female, 14 male). Adult and pediatric patients with ILO screened positive for elevated rates of anxiety (53 adults [63%]; 49 children [60%]), depression (27 adults [32%]; 25 children [30%]), and PTSD (29 adults [34%]; 13 children [16%]). Most of the patients with anxiety and depression symptoms were formally diagnosed prior to ILO evaluation, with rates of previously diagnosed anxiety, depression, and PTSD also above published norms. Adults were twice as likely as children to present with PTSD (odds ratio, 2.1; 95% CI, 0.05-4.48). Elevated rates of physical somatic symptoms were also evident, with 38 adults (45%) and 32 children (39%) scoring in the moderate to severe range. This study found high rates of adult and pediatric patients with ILO screened positive for anxiety, depression, and PTSD symptoms. Future work should investigate how behavioral health and ILO treatments can best be coordinated to maximize treatment outcomes.

What will others think of me? The longitudinal association between trauma-related shame and guilt and psychopathology after a terror attack.

Trauma-related shame and guilt have been identified as important factors for mental health following interpersonal trauma. For survivors of terror and disasters, however, the role of shame and guilt remains largely unknown. To explore the long-term occurrence of trauma-related shame and guilt among survivors of a terror attack, and the potential importance of these emotions for mental health. A total of 347 survivors (48.7% female, mean age at the time of the attack: 19.25 years, s.d. = 4.40) of the 2011 massacre on Utøya island, Norway, participated in face-to-face, semi-structured interviews. Trauma-related shame and guilt were measured with items from the Shame and Guilt After Trauma Scale at 2.5 and 8.5 years post-terror attack. Post-traumatic reactions and anxiety/depression at 8.5 years post-terror attack were measured with the University of California at Los Angeles PTSD Reaction Index and the Hopkins Symptom Checklist-25, respectively. Associations between trauma-related shame/guilt and post-trauma psychopathology were analysed by multiple linear regressions. Trauma-related shame and guilt were prevalent among survivors at both 2.5 and 8.5 years post-terror attack. In unadjusted analyses, shame and guilt, at both time points, were significantly associated with post-traumatic stress reactions and anxiety/depression. Shame remained significantly associated with mental health when adjusted for guilt. Both earlier and current shame were uniquely related to mental health. Trauma-related shame and guilt may be prevalent in survivors of mass trauma several years after the event. Shame, in particular, may play an important role for long-term mental health. Clinicians may find it helpful to explicitly address shame in treatment of mass trauma survivors.

Supplemental Material for Validation of the Four-Item Very Brief University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index Screening Tool for Children and Adolescents

Supplemental Material for Validation of the Four-Item Very Brief University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index Screening Tool for Children and Adolescents

Traumatic Experiences and Posttraumatic Stress Disorder of Adolescents in Boarding Schools

In the context of abuse cases in boarding schools, stress among children and adolescents in boarding schools in Germany was discussed for the first time. So far, however, there is a lack of studies dealing with post-traumatic stress disorders of adolescents in boarding schools.The aim was to analyze the extent of trauma experiences and symptoms of post-traumatic stress disorders as well as psychopathological abnormalities in adolescents in boarding schools on the basis of self-reports using a secondary analysis of theMAYSI-2 and UCLA PTSD Reaction Index for DSM-IV screening questionnaires and to derive implications for research and care concepts. Data was available from155 adolescents, 70%of whomweremale.The adolescents had been in boarding schools for an average of 3.26 years (SD = 2.48). A traumatic experience was evident in 69.7%(n = 108) of the adolescents, and 51.6%(n = 80) of the adolescentswere "conspicuous" in at least one of the six scales of theMAYSI-2. Taken together, 33.5%(n = 52) of the adolescents met the criteria for a suspected post-traumatic stress disorder according to ICD-10. Screening procedures should be established in boarding schools to identify traumatic experiences and psychopathological abnormalities in a timely manner. Concepts from youth welfare institutions can be used to deal with trauma experiences.There is a need for further research on traumatic experiences directly related to the boarding school placement situation.

A Non-Inferiority Evaluation of Standard and Abbreviated Developmental Trauma and Adjustment Programming for Adopted and Foster Youth in Residential Care

ABSTRACT Youth who are involved with the adoption and foster care systems report notable rates of complex trauma responses associated with their developmental experiences, which can have deleterious implications for well-being across the lifespan. We implemented a retrospective quasi-experimental non-inferiority evaluation design using a frequency matching approach to estimate the degree of differential treatment effects reported by youth who completed a Developmental Trauma and Attachment Program protocol in its standard (DTAP) or abbreviated (DTAP-A) format at a long-term residential care facility located in the Midwestern United States. Program completers were 28 youth (M age = 12.39) who predominately identified as female (n = 23, 82%) with Caucasian/White (n = 12, 43%) or Multiracial (n = 10, 35%) racial identities. Analyses of scores on the UCLA Post-traumatic Stress Disorder Reaction Index and Behavior Assessment System for Children (3rd ed.) did not identify any statistical or practical significance between DTAP and DTAP-A program completers self-reported treatment gains. However, DTAP program completers tended to report clinically significant changes in posttraumatic stress disorder and personal adjustment to greater degrees when compared to those completing the DTAP-A protocol. Implications for increasing access, resource management, and supporting a continuum of care approach are provided.

A Scoping Review of Trauma-Informed Pediatric Interventions in Response to Natural and Biologic Disasters.

A scoping review was performed of trauma-informed psychological interventions to treat anxiety, depression, and posttraumatic stress symptoms in youth in response to natural/biologic disasters. The specific aims were to identify psychosocial interventions used in response to natural/biologic disasters, report the interventions' effectiveness, describe limitations, and provide treatment recommendations and future directions. Of the 45 studies extracted, 28 were on natural disasters and 17 on biologic disasters with the majority related to the COVID-19 pandemic. The most commonly implemented interventions were Cognitive Behavioral Therapy (CBT), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), and eye movement desensitization and reprocessing (EMDR). The UCLA Posttraumatic Stress Disorder Reaction Index (UCLA PTSD-RI) and the Strengths and Difficulties Questionnaire (SDQ) were the most frequently used measures. Methodological rigor was varied, with 60% randomized, controlled trials. Overall, there was a significant decrease in posttraumatic stress symptoms, distress, anxiety, and depression regardless of whether the participant received CBT, TF-CBT, or EMDR. Generally, there was not a significant decrease in anxiety and depression with yoga, cognitive fear-reduction, emotion-based drawing, and community health education. Recommendations for future directions include larger-scale studies with group and on-line interventions that include younger children with moderation analyses by gender and race/ethnicity.

The fear that remains: Associations between trauma, related psychopathology, and fear-potentiated startle in youth resettled as refugees.

Fear-potentiated startle (FPS) can be used to measure fear and safety learning-behaviors affected by trauma that may map onto posttraumatic stress disorder (PTSD). Therefore, FPS could be a candidate biomarker of trauma-related psychopathology and a potential identifier of trauma-exposed youth in need of focused treatment. We enrolled n=71 (35 females, Mage =12.7 years) Syrian youth exposed to civilian war trauma. Eyeblink electromyogram (EMG) data from a differential conditioning FPS paradigm were obtained 2.5 years after resettlement. Youth provided self-report of trauma exposure (Harvard Trauma Questionnaire) and PTSD symptoms (UCLA PTSD Reaction Index). While FPS during conditioning was not associated with symptoms, associations with psychopathology emerged in fear extinction. Probable PTSD was associated with FPS in the last block of extinction, such that FPS to threat cue was significantly greater in the PTSD+ group compared to the PTSD- group at the end of extinction (F=6.25, p=.015). As with adults, we observed a deficit in extinction learning but not fear conditioning in youth with PTSD. These results support the use of trauma-informed cognitive behavioral therapy based on the learning principles of extinction in youth with PTSD.

Effectiveness of a school-based, lay counselor-delivered cognitive behavioral therapy for Chinese children with posttraumatic stress symptoms: a randomized controlled trial

Improving children's access to mental health services need more innovative solutions, especially in low- and middle-income countries. School-based psychosocial interventions delivered by lay counselors may be an efficient way to improve children's access to mental health services. But few studies were conducted to examine the effectiveness of these interventions. Therefore, this study is to evaluate the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) in a group format delivered by lay counselors to children with trauma-related symptoms in China. A total of 234 children (aged 9-12 years) with full or subthreshold posttraumatic stress disorder (PTSD) were randomly assigned to group-based TF-CBT or treatment as usual (TAU). In the intervention group, 118 children received 10-12 sessions of group-based TF-CBT delivered by lay counselors for 9 consecutive weeks. In the TAU group, 116 children received the usual school services provided by psychology teachers. The primary outcome was the reduction in PTSD severity, which was assessed with the UCLA PTSD reaction index for DSM-5 (PTSD-RI-5). The secondary outcomes included the reduction in PTSD severity and the remission of PTSD, both of which were measured with the PTSD checklist-5 (PCL-5). Secondary outcomes also included the reduction in depression severity and the reduction in generalized anxiety severity. Blinded assessments were collected at baseline, posttreatment (primary endpoint), and 3-month follow-up. This trial is registered with Chinese Clinical Trial Registry, ChiCTR1900027131. At posttreatment, the intervention group scored significantly lower than the TAU group on PTSD-RI-5 PTSD (30.98 vs. 39.22; adjusted mean difference [AMD],-7.35; 95% CI,-11.66 to-3.04), PCL-5 PTSD (28.78 vs. 38.04; AMD,-8.49; 95% CI,-13.23 to-3.75), depression (5.52 vs. 7.96; AMD,-1.63; 95% CI,-2.50 to-0.76), and generalized anxiety (7.23 vs. 8.64; AMD,-1.21; 95% CI,-2.20 to-0.23). The remission of PCL-5 PTSD was also significantly higher in the intervention group (42.86% vs. 13.54%, χ 2 =13.10, P<0.001). These two groups showed a similar level of symptoms at the 3-month follow-up. The group-based TF-CBT can significantly alleviate PTSD, depression, and generalized anxiety right after treatment in Chinese children who suffer from different types of trauma. But the long-term effects of this intervention need to be further tested. This intervention can be delivered by trained lay counselors in low- and middle-income countries. None.

The effects of the posttraumatic stress and general health status on paediatric burns and their sleep habits

BackgroundBurns are serious injuries that can require hospitalization and have physical and emotional sequelae. Sleep disturbance can occur after trauma as evidenced by posttraumatic stress symptoms such as re-experiencing of a trauma with repetitive dreams, memories and flashbacks. This area has been minimally examined with pediatric burn survivors; therefore, the aim of this study was to investigate the effects of posttraumatic stress and general health on sleep habits of pediatric burn survivors from. MethodThis is a correlational descriptive study. Its sample included 7–18-year-old inpatients at the burn clinic of a university hospital from January to November 2019. This study used the Posttraumatic Stress Disorder Reaction Index, the General Health Questionnaire (12) and the Children’s Sleep Habits Questionnaire for data collection. ResultsOf the participants, 58.6% were male, 46.5% were primary school students, and 62.6% had no diseases other than their burns. 20.2% of the children had epilepsy, 14.2% had diabetes and 3% had pneumonia. Of the child burn victims, 45.5% were brought to the hospital because of contact with fire. All of them had first-degree burns, 59.6% had second-degree burns, and 80.8% had third-degree burns. After their burns, infections developed in 20.2% during trauma and in 43.4% during burn treatment. A structural equation model indicated that the child burn victims’ general health perceptions did not significantly affect their sleep habits (p > 0.05). A significant correlation was found between the children’s posttraumatic stress disorder and their sleep habits (p < 0.05). Posttraumatic stress disorder explained 7.2% of their sleep habits. A positive and significant correlation was found between the children’s general health perceptions and posttraumatic stress disorder (r = 0.74, p < 0.05). ConclusionBurns of any kind can cause posttraumatic stress, sleep disorders and impairment of health status in children.

The main effect and gene-environment interaction effect of the ADCYAP1R1 polymorphism rs2267735 on the course of posttraumatic stress disorder symptoms-A longitudinal analysis.

Many studies have been performed to investigate the association between the ADCYAP1R1 polymorphism rs2267735 and posttraumatic stress disorder (PTSD), but the results have been inconsistent, and the way in which this gene affects the course of PTSD has not been widely investigated. Thus, a longitudinal study of the course (development trajectory) of PTSD is needed. In this study, we performed a longitudinal analysis of rs2267735 in 1017 young, trauma-exposed Chinese people (549 females and 468 males, ranging from 7 to 11 years old). At four time points after trauma exposure (2.5, 3.5, 4.5, and 5.5 years), we measured PTSD symptoms with the University of California, Los Angeles PTSD Reaction Index (PTSD-RI) for DSM-IV (Child Version). We employed a latent growth model (LGM) for the longitudinal data to test the association between rs2267735 (main and gene-environment interaction effects) and the course of PTSD symptoms. The results of LGM showed that the gene-environment interaction (rs2267735 × trauma exposure) effects were associated with PTSD symptoms in girls at 2.5 years (β = -0.291 and P = 0.013 for LGM intercept). The gene-environment interaction (rs2267735 × trauma exposure) effect was also correlated with PTSD symptoms in girls at 3.5 and 4.5 years (β = -0.264 and P = 0.005; β = -0.217 and P = 0.013). Our study revealed that the gene-environment interaction of the ADCYAP1R1 polymorphism rs2267735 is associated with PTSD symptoms in girls at 2.5 years and that the effects may be stable over time and not related to the PTSD symptom recovery rate. This is the first study to detect the how the ADCYAP1R1 gene affects the course of PTSD after trauma exposure in a longitudinal view.

Posttraumatic stress and growth in adolescent childhood cancer survivors: Links to quality of life.

Pediatric cancer can be considered an event potentially leading to posttraumatic stress symptoms (PTSS) as well as posttraumatic growth (PTG). While clinically significant levels of PTSS are rare in childhood cancer survivors, PTG is common in this population. However, the relationship of PTG to overall adaptation and quality of life (QOL) in pediatric cancer patients is not clear. Therefore, our study aims to analyse the relationships of PTSS and PTG with QOL in childhood cancer survivors. In this study, 172 childhood cancer survivors completed measures of quality of life (Minneapolis-Manchester Quality of Life Scale; child and adolescent version), posttraumatic stress (UCLA PTSD Reaction Index for DMS-IV) and posttraumatic growth (Benefit Finding Scale for Children). Correlation analyses were carried out separately for the child (up to 13 years, N = 47) and adolescent (more than 13 years, N = 125) groups and each QOL dimension. In the adolescent group, the relationship of PTSS and PTG with QOL was further verified by regression analyses while controlling for age, gender, and time off treatment. In children, negative relationships between PTSS and QOL were found, but the relationships between QOL and PTG were not significant. In adolescents, significant relationships were found for all dimensions of QOL and PTSS and also for several dimensions of QOL and PTG. The relationships between PTSS and QOL dimensions were negative in both groups, and the relationships between PTG and QOL in the adolescent group were weakly positive. In adolescents, regression analyses controlling for age, gender and time off treatment were performed and confirmed a negative relationship of PTSS with all QOL dimensions except for social functioning. For PTG, regression analyses revealed a significant positive relationship with QOL dimensions of social functioning, outlook on life and intimate relations. While the relationship between PTSS and QOL is negative for almost all QOL dimensions in children and adolescents, the nature of the relationship between PTG and QOL appears to be more complex and changing over time. PTG in children may reflect different processes with different outcomes than PTG in adolescents.

Development and pilot testing of a five item traumatic stress screener for use with adolescents in pediatric primary care

BackgroundAlmost 80% of adolescents in the US have experienced a traumatic event, and approximately 7% have post-traumatic stress disorder. However, there is a lack of validated and feasible assessments for assessing traumatic stress symptoms in pediatric primary care, and traumatic stress symptoms are routinely unidentified. This study aimed to develop, pilot test, and assess the psychometric properties of the Adolescent Primary Care Traumatic Stress Screen (APCTSS), a five-item yes/no screener for post-traumatic stress symptoms in adolescents designed for use in pediatric primary care.MethodsThe APCTSS was developed by pediatricians, psychiatrists, psychologists, and social workers who all provide care to trauma-affected adolescent patients. The providers sought to create a developmentally appropriate tool that accurately reflected DSM-5 posttraumatic stress symptoms and that was feasible and acceptable for use in pediatric primary care. To develop the APCTSS, they combined and adapted the UCLA Post-traumatic Stress Disorder (PTSD) Reaction Index for DSM-5 with the adult Primary Care PTSD Screen for DSM-5. Next, 213 adolescent medicine patients were universally approached during routine clinic visits and 178 agreed to participate and were enrolled. The 178 patients were aged 13-22 (M=18.4, SD=2.3), 64.4% female; 62.1% Black or African-American, and 20.7% Hispanic/Latinx. Patients completed APCTSS, Patient Health Questionnaire for Adolescents (PHQ-A), and the Child PTSD Symptom Scale for DSM-5 Interview (CPSS-5-I), and 61 completed the Traumatic Events Screening Inventory for Children (TESI-C).Results56.7% reported a criterion A trauma, 30.1% met criteria for DSM-5 PTSD, 7.4% met criteria for subsyndromal PTSD symptoms, and 19.0% for post-event impairing symptoms. Validity and reliability testing indicated that the APCTSS was internally consistent, had good concurrent and discriminant validity, and demonstrated good sensitivity and specificity in identifying adolescents at high risk for post-trauma symptoms. Over half of patients (56.0%) who screened positive on the APCTSS (score ≥2) would not have been identified as having a mental health concern using the PHQ-A, including 60.8% of patients who had probable PTSD, subsyndromal PTSD, or post-event impairing symptoms.ConclusionsMany youth with trauma-related mental health symptoms are unidentified in pediatric primary care, which is a missed opportunity for early identification and may contribute to a host of poor outcomes. The development of an effective and feasible traumatic stress screening tool for youth primary care may improve early intervention, and the health and well-being of trauma affected youth.

Investigation of suicide probability in sexually abused adolescents and the associated factors

ObjectiveThe objectives of this study are to compare the suicide probability of adolescent sexual abuse victims with a control group. MethodThe study group consisted of 120 adolescents (105 female, 15 male) who had experienced sexual abuse, and the control group comprised 120 adolescents with sociodemographic features similar to those of the study group. Participants completed the following questionnaires: the Suicide Probability Scale, Brief Symptom Inventory, and child Post-Traumatic Stress Disorder Reaction Index. ResultsThe study group reported greater hopelessness, higher rates of suicidal ideation, increased hostility/impulsivity, and had higher general suicide probability subscale scores (determined via the Suicide Probability Scale) compared to the control group. Of the sexual abuse victims, general suicide probability scores were found to be higher among females and among subjects who indicated abuse involving contact and penetration, blaming oneself or their families for the abuse and the development of post-traumatic stress disorder and/or major depressive disorder following the abuse. ConclusionsOur findings showed that individuals who had suffered sexual abuse were more likely to be at risk of suicide and that certain features of the victim, the abuse, and the abuser also related to the probability of suicide.

The longitudinal association between symptoms of posttraumatic stress and complicated grief: A random intercepts cross-lag analysis.

Knowledge about the temporal relationship between disturbed grief and symptoms of posttraumatic stress disorder (PTSD) may have important implications for clinicians working with bereaved trauma survivors. We aimed to investigate the longitudinal association between symptoms of complicated grief and PTSD in a bereaved trauma-exposed sample. In total, 275 bereaved survivors (M age = 19.3, SD = 4.6 years; 47.3% females) of the 2011 massacre on Utøya Island, Norway, participated in semistructured interviews 4-5 months (Time 1 [T1]), 14-15 months (Time 2 [T2]), and 30-32 months (Time 3 [T3]) posttrauma. Complicated grief was measured using the Brief Grief Questionnaire, and posttraumatic stress reactions using the University of California at Los Angeles PTSD Reaction Index. To explore associations between symptoms of complicated grief and PTSD over time, we used a random intercepts cross-lagged panel model. The participants had lost a close friend (n = 256) and/or a family member/partner (n = 19) in the attack. We found a strong correlation between stable individual differences in symptoms of complicated grief and PTSD across the three time-points. PTSD symptoms at T2 predicted complicated grief reactions at T3, but not vice versa. Findings suggest that targeting PTSD symptoms among trauma-exposed bereaved may hinder later development of complicated grief. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Trauma exposure and mental health outcomes among Central American and Mexican children held in immigration detention at the United States-Mexico border.

We explored the associations between early-life adversity and migration-related stress on the mental health of Central American and Mexican migrating children held in United States immigration detention facilities. Migrating children have high rates of trauma exposure prior to and during migration. Early-life adversity increases risk for developing mental health disorders. Forced separation of migrating children from their parents at the United States-Mexico border potentially exacerbates this risk. We sought to determine whether exposure to trauma prior to immigration and specific features of immigration detention were associated with posttraumatic stress symptomatology. We interviewed parents of 84 migrating children (ages 1-17) after families were released from immigration detention facilities to assess children's migration- and detention-related experiences. A modified version of the University of California Los Angeles Posttraumatic Stress Disorder (PTSD) Reaction Index was administered to assess children's PTSD symptoms and document trauma exposure. A total of 97.4% of children experienced at least one premigration traumatic event. PTSD symptom severity was most strongly predicted by premigration trauma and duration of parent-child separation. This study contributes to a growing empirical literature documenting that early-life adversity increases risk of developing mental health disorders, particularly following additional stress exposure, and that remaining with parents during immigration detention may help mitigate children's stress response.